Transforming chronic care in rural Europe through pre-commercial procurement
Europe’s population is ageing, and the number of people living with disabilities and chronic diseases is rising. Those in rural areas are less likely to have access to high-quality health services and programmes compared to people living in cities and suburbs. Coordinated by authorities of Region Västerbotten in Sweden, the CRANE(opens in new window) project is working to develop an integrated self-management model to improve the well-being of chronic patients, drawing on the potential of health data and piloting the concept of the European Health Data Space(opens in new window) (EHDS). The project focuses on three rural regions where more than 30 % of the population is aged 65 or over: Region Västerbotten in Sweden, Extremadura in Spain, and Region Agder in Norway. These areas are described as front runners in the demographic challenge and serve as testing grounds for solutions that are designed from the outset to be transferable and scalable to larger urban contexts elsewhere in Europe and beyond. CRANE’s model aims to shift the role of the citizen from passive patient to active participant, targeting a situation in which more than 80 % of chronic patients move to self-care. This ambition rests on two pillars: healthcare from home and the ecosystem.
The garden of care
The first brings monitoring and intervention technology into the home, using intelligent data processing to enable actionable interaction with patients and reduce the need for professional healthcare visits. The second is referred to as the ‘garden of care’: an extended, flexible concept of integrated care that surrounds each person with a tailored network of health and social care services, family support and service providers, adapted dynamically to individual needs. Central to the technical architecture is a secure public-private data platform. CRANE’s unique approach is to make each citizen the owner of their own health data, allowing them to turn this into actionable support. The platform is designed to apply the latest encryption technology and to build trust through transparent and open data policies, as well as feedback mechanisms that demonstrate tangible health gains for users. A value-based assessment framework runs throughout the procurement process, drawing on early health technology assessment (HTA), systematic literature reviews and stakeholder engagement. This framework evaluates potential value across four domains (patient, economic, clinical and organisational) at defined stages of the process, with the aim of generating evidence, identifying unmet needs and ensuring that solutions developed under CRANE are ready for value-based service procurement when the project concludes. The expected benefits extend beyond clinical outcomes, encompassing improved mental health and social connectedness for older people, optimised use of public health and care resources, reduced rates of hospitalisation and emergency assistance, and strengthened local supply chains alongside new opportunities for European health innovation businesses.
