The VeH project partners worked with a wide range of European experts to undertake a careful analysis of scenarios that could add value to the existing unplanned care scenarios, by defining a list of additional business use cases which would be feasible to deliver and useful both within and across borders. A set of prioritisation criteria were developed to assess these use cases, and through a robust methodology two were prioritised, one of which was safe prescribing.
The project convened a Business Modelling Task Force to examine in detail the actors who need to be involved and motivated to contribute to collective success, and what the value propositions would be for each. It further built on the work and ideas of this set of actors to develop value chains that showed how this value can be realised only when the actors are correctly aligned.
The Business Model Canvas was used to model more formally the ways in which the value propositions could be realised: who are the customers that will pay, who are strategic partners to help co-create the solution and ensure its acceptance, and what are the main activities that need to be undertaken to deliver collective value. VeH elected to focus it on the physical or virtual entity or structure designated with the responsibility for managing and coordinating (or contracting out) the new pan-European shared cross-border eHealth services that will be established via the CEF.
A cost effectiveness analysis from a health systems perspective was also carried out, in order to assess the value of eHealth interoperable solutions compared to current practices for the optimal management of patients with Type 1 diabetes, as the reference use case. The results of this cost-effectiveness analysis suggested that significant added-value could be generated from investing in such enhanced eHealth services, enabling more Type 1 diabetes patients to be optimally managed, and at lower costs, within and across borders in Europe.
The information flows for the diabetes business use case and the interoperability assets and services needed to deliver them were also examined. The project found that much of what is needed in terms of the eHDSI is already in place. Additional investments would be needed only in so far as necessary to build on the existing unplanned care infrastructure. Indeed, the major implications of VeH’s proposals are to convey more information through the existing infrastructure and add incrementally additional needed services such as the HealthCare Encounter Report. VeH has proposed an EC project-like roadmap for how these additional components might be developed and deployed across MS and at a European level.
Several kinds of organisational change are also needed to take advantage of these enhanced cross border services which should improve trust and accountability in sharing data and sharing care. For example, data quality challenges to ensure that accurate and complete enough patient summaries can be generated to adequately inform the recipient about the patient. VeH has in particular examined the strategies for improving data quality, working with a selected group of European hospitals.
The final VeH business plan itself, brings the main findings of the project together as proposals to be considered by the eHealth Network and the E.C. This two-year Business Plan proposes the establishment of an EU eHealth Business Unit (EU eHBU) which is envisioned to play a central role in the sustainability of the eHDSI, post 2020, i.e. after the end of the CEF programme. It sets out the top five business plan objectives, as activities to be fulfilled by the EU eHBU during its first two years of operation, after being successfully set up and rendered operational. It outlines the financial scheme that is proposed through this plan, and a financial forecast, emphasising a mixed model of public funds, non-monetary (in-kind) contributions, and commercial revenues.
The results of VeH have been distilled into a series of recommendations, to be considered for adoption and submission for decision by the eHealth Network, after it has also investigated the funding implications. These recommendations for the sustainability of eHDSI services were presented to the eHealth Network in May 2017, to multi-stakeholder audiences at the eHealth Week conference in Malta, also in May 2017, and to CEN TC/251 in June 2017 (with other SDOs in attendance.
