Periodic Reporting for period 1 - DYNAMO (Modelling and dynamic assessment of integrated health and care pathways enhancing response capacity of health systems)
Reporting period: 2023-01-01 to 2023-10-31
Threats to health systems such as pandemics, natural disasters or economic crises have profound implications for population health, economic progress, and social cohesion. Health system resilience – the ability to adjust to both expected and unexpected conditions while maintaining functionality – is key to coping with such threats. While unexpected systemic disruptions challenge the absorptive capacity of a health and care system to maintain the same level (quantity, quality, and equity) of services and protection of the population despite adverse impacts on available resources, trends like ageing populations and the increase of chronic diseases challenge the transformative capacity of the health care system to adjust. In response to these challenges, strategies have so far focused on better coordination of the different health and care services. These strategies are usually built around prospective disaster plans anticipating different scenarios and setting out measures of coordinated response. Multi-disciplinary care pathways are one instrument to develop and communicate coordinated response processes. They bundle interdependent tasks and activities organising care and support journeys on the individual and population (group) level, both within and across settings such as primary health care, ambulatory care, hospitals, specialised centres, and long-term health care facilities. A key point of criticism of this approach is that it tends to be quite static, both in terms of responding to unforeseen scenarios and in transferring approaches from one (regional) setting to another. This is not so much a challenge based on a general lack of methods or approaches, but a challenge of lean and cost-effective (re-)design of pathways, i.e. a lack of tools allowing stakeholders to develop and assess new pathways quickly and with minimum effort, preferably by the use of digital tools. What is urgently needed is a lean and powerful solution that enables quick, data-supported, and IT platform-independent planning of care pathways for situations where health system functions are threatened by pandemics, natural disasters, and other crises. As a strategic planning tool, the solution must be able to effectively guide the evidence-based modelling of “crises pathways” across different health sectors and adjacent public service domains. DYNAMO brings together procurer organisations from Italy, Spain, Portugal, Poland and the UK that not only see the need for such a solution but are willing to act on it now. Together, they will develop and pilot a novel tool providing at least three core functions to effectively support service planning in times of crisis, namely:
• dynamic crisis pathway planning and design across various organisations and settings, suitable to deal with a range of system threats,
• data-supported impact assessment concerning alternative pathway option at the stage of pathway design,
• and staff planning and skills matching that is appropriate for health systems in crisis situations.
• dynamic crisis pathway planning and design across various organisations and settings, suitable to deal with a range of system threats,
• data-supported impact assessment concerning alternative pathway option at the stage of pathway design,
• and staff planning and skills matching that is appropriate for health systems in crisis situations.
The DYNAMO consortium is using a special funding instrument, pre-commercial procurement (PPC), to co-develop such a novel planning tool developed with relevant market participants. In pre-commercial procurement (PCP), public procures buy Research & Development (R&D) from several competing suppliers in parallel to compare alternative approaches and identify the most cost-effective solutions that the market can deliver for their requirements. R&D is divided into phases (solution design, prototyping, initial development and testing of a limited number of initial products), with the number of competing R&D providers reduced after each R&D phase. The schema graphically summarises how the procurement stages will be organised within the DYNAMO PCP.
During the first phase of DYNAMO, work has so far concentrated on eliciting key requirements for the novel crisis pathway planning tool, involving a diverse range of stakeholders. Also, an Open Market Consultation (OMC) was conducted with a view to preparing a public call for tender addressing relevant R&D suppliers. The remaining phases of the overall project will focus on the co-development of the envisaged solutions with selected suppliers according to a multi-staged process.
During the first phase of DYNAMO, work has so far concentrated on eliciting key requirements for the novel crisis pathway planning tool, involving a diverse range of stakeholders. Also, an Open Market Consultation (OMC) was conducted with a view to preparing a public call for tender addressing relevant R&D suppliers. The remaining phases of the overall project will focus on the co-development of the envisaged solutions with selected suppliers according to a multi-staged process.
Moving well beyond current practice and market offerings, DYNAMO strives for a digital pathway planning solution unifying three core elements that cannot be found in one single application on the current market. The DYNAMO procurer organisations have set ambitious requirements to be fulfilled by the R&D delivery, structured around three needs, namely (a) multi-disciplinary care pathway design fit for crisis situations, (b) ex-ante impact assessment at pathway planning stage and (c) task planning and skills matching. Throughout its various project phases, DYNAMO will ultimately yield accessible, affordable, and efficient technology solutions that contribute to health systems resilience.