Advanced ICT systems and services for integrated care Specific challenge: Research on new models of care organisation demonstrates that advanced ICT systems and services may have the potential to respond to, amongst others, the increasing burden of chronic disease and the complexity of co-morbidities and in doing so contribute to the sustainability of health and care systems. One challenge in re-designing health and care systems is to develop integrated care models that are more closely oriented to the needs of patients and older persons: multidisciplinary, well-coordinated, anchored in community and home care settings, and shifting from a reactive approach to proactive and patient-centred care. Scope: Proposals should go beyond the current state of art in tele-health and tele-care systems by developing new approaches for integrated care supported by ICT systems and services. Proposals should address barriers from technological, social and organisational points of view in the following domains: Development of robust, privacy compliant, accurate and cost-effective systems that facilitate monitoring of patient status, patient activity and compliance with therapy; Fusion, analysis and interpretation of patient and care provider data, to improve decision making among formal and informal care givers and patients; Multi-channel and multi-actor interaction and exchange of knowledge in integrated care settings, across digital collaborative platforms; Development of patient-oriented services to support patient empowerment, self-care, adherence to care plans and treatment at the point of need; Development of new patient pathways, new training programmes for the care workforce and new organisational models to improve the coordination of care services as well as the skills and collaboration of health professionals, social carers and informal care givers; Personalisation of care management programmes to specific characteristics of patients' profiles, through analysis of multimodal data, risk stratification algorithms for chronic diseases and multi-morbidity conditions, predictive algorithms of patient's status, and personalisation tools for patients and; The creation of new knowledge for the management of co-morbidities and for addressing poly-pharmacy.The design process of such ICT systems and services should entail participation of a wide range of users, developers and stakeholders, including medical doctors, nurses, social workers, patients as well as programmers and interaction designers. Gender and ethical issues should be paid due attention. Validation should provide proof-of-concept with both qualitative parameters and quantitative success measures.The Commission considers that proposals requesting a contribution from the EU of between EUR 3 and 5 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts Expected impact: Reduced admissions and days spent in care institutions, and improvements in the daily activities and quality of life of older persons through effective use of ICT and better coordination of care processes. Strengthened evidence base on health outcomes, quality of life and care efficiency gains from the use of ICT in integrated care. Improved cooperation and secure information exchange among the actors involved in health, social and informal care services. Improved interaction between patients and their carers, and more active participation of patients and their relatives or other informal care givers in care processes. Improved usability and adaptability of ICT systems for integrated care, taking account of the complex relationship between digital technologies and their social and human context of application. Reinforced medical knowledge with respect to management of co-morbidities. Strengthened European industrial position in ICT products and services by measurable indicators such as new business areas, start-ups and protected intellectual property Type of action: Research and innovation actions
