Arrhythmias monitoring and comprehensive care

Project Information

RITMOCORE

Grant agreement ID: 727796

DOI

10.3030/727796

Project closed

EC signature date 12 October 2016

Start date 1 November 2016

End date 31 July 2022

Funded under

• SOCIETAL CHALLENGES - Health, demographic change and well-being

Total cost

€ 11 750 553,81

EU contribution

€ 4 112 693,83

Coordinated by

AGENCIA DE QUALITAT I AVALUACIO SANITARIES DE CATALUNYA
Spain

Periodic Reporting for period 2 - RITMOCORE (Arrhythmias monitoring and comprehensive care)

Reporting period: 2018-12-01 to 2022-07-31

Summary of the context and overall objectives of the project

RITMOCORE transforms the care pathway of patients with bradycardias, implanted with a pacemaker, most aged over 70. The steady growth of the demand, mostly due to the ageing population, and budgets’ resistance to follow such demand has two main consequences, on one hand there is a requirement to purchase more devices, and on the other hand, the increase in the workload of clinicians becomes unsustainable.

RITMOCORE’s model addresses both problems: how to purchase more devices, and how to make the best use of clinicians’ time, while increasing quality of care and contributing to preserve long term sustainability of the healthcare system. With that aim, RITMOCORE shifts from purchasing devices to purchasing services, where payments are outcome based, and where services are supported by advanced ICT systems. The model increases efficiency in healthcare systems by fostering alignment between all participants in the care pathway - healthcare services, suppliers, and patients.

Thus, RITMOCORE was articulated around through risk-sharing contracts around these pillars:

I. The personalisation of the treatment to the patients to offer them the most adequate attention to their condition and environment, including the provision of devices, the storage logistics, the technical assistance services during the implantation and explanation procedures, as well as the most appropriate technologies to the characteristics of each patient.

II. Remote monitoring of patients, reducing travels and visits to the hospital to only those clinically relevant.

III. The coordination of the monitoring, control and treatment of patients with pacemakers between the different levels of care involved, by means of the integration, connection and interoperability of the solution.

IV. Activation of the patient through human and technological resources, to participate in the control and monitoring of their own condition, improving their sense of security and self-control through information, training, support, monitoring, participation in patient networks.

V. The Change Management, key to implement in an effective way the advances proposed by the RITMOCORE model in each hospital.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

Preparation stage (1/11/2016 – 26/11/2020)

During the first period of the project, RITMOCORE Consortium and buyers group successfully worked on the preparation of the procurement though the refinement by co-creation of the innovative care model enhanced by digital technologies, preliminarily developed by the partners during the preparation of the proposal. This model was the basis for the tender preparation. The Buyers Group developed the value-based procurement tenders and published them on January 16th, 2020, according to the European and national legal framework about public procurement.

Execution stage (26/11/2020 – 31/07/2022)

The main activities during this period started with the contracts signature:
The execution of the procurement procedures (WP3), under complex circumstances which include the impact of the Brexit, the COVID pandemic and a judicial appeal. The process lasted much more than expected due to the lack of acceptable bidders for 2 of the 4 lots, that motivates the need of moving into a negotiated procedure.
The deployment and evaluation of the services (WP4) by the awarded bidders in the three Hospitals (STPAU, HUB and LHCH).
The dissemination of the activities and the preparation of the exploitation, based on the elaboration of conclusions and guidelines (WP5).
The management of the project (WP1) dealing with the closing of partner FSA, and the change of responsibilities of partner SMH due to a reduction of personnel in the entity.


Main results

Overall RITMOCORE model has satisfied the expectations of all participant stakeholders, except for procurer FAMT, that didn’t success despite the repeated efforts.

• Clinical results have overcome expectations,
• the alignment in the clinical pathway of all participant stakeholders have increased efficiency, effective and active coordination with primary care has been stablished,
• the improvement in patient experience has been largely satisfactory,
• the participation in the tender process confirms the acceptance by the industry of the need to evolve to new service provision models,
• the satisfactory operational deployment validates the governance model,
• and the results of the judicial appeal confirm the legal validity of the proposed purchasing model.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

RITMOCORE is a pioneer project of Digital Transformation in real life. Three main ideas from the experience that were essential for the digital transformation deployed.

• RITMOCORE is not for short-term saving but for long term sustainability.
• Increasing efficiency along full care path for the best care possible with available resources.
• Efficiency is to be built on alignment of interests for all stakeholders and the use of digital tools.

Digital transformation has been on the minds of managers in all sectors, including healthcare, for years. The COVID pandemic has accelerated technology adoption in businesses, including hospitals.
Virtually every aspect of modern life has been, and will continue to be, radically reshaped by innovation and technology – and healthcare is no exception. Sustained advances in computing and the democratization of information are driving choice and control throughout our daily lives, giving us heightened expectations around digital services. Technology is continually opening up new possibilities for prevention, care and treatment. Digital Transformation is the rethinking of how an organization uses technology, people and processes to fundamentally change its delivery of care. It is about setting up a corporate strategy to deliver more sustainable value to patients, healthcare professionals and the organizations themselves. It stands for leveraging digital capabilities (eg. mobile, cloud, analytics), but mainly focusing on transformation (patient experience, process optimization, data-based decision making).

RITMOCORE digital transformation levers:

i) Hospital centred to patient centred care

Procedures and attention to pacemakers’ patients have been designed according to the hospital needs and convenience. The attention through the different care levels (primary care, specialised care, tertiary hospitals) is not aligned nor coordinated. RITMOCORE aligns the pacemakers’ patient journey with the patient care path, increasing coordination between different care levels and opening channels between professionals to preserve the essential holistic view of the patient.

ii) Prevention: From reactive model to preventive model

RITMOCORE allows early identification of complications and adoption of preventive measures through remote monitoring and coordinated care

iii) Servitisation and value based: From purchasing price-based devices to long term value-based service contracts

RITMOCORE moves from purchasing pacemakers based on a price competition to purchase long term services, which includes pacemakers’ provision, based on a value competition and sharing risks between providers and healthcare services.

iv) It means to move from Product-Evidence-Price to Need-Solution-Value

The traditional approach in the purchase of services follows the sequence from the product, supported by evidence and looking for the best price. The RITMOCORE model promotes a radical change starting from the need, looking for the solution that provides more value.

RITMOCORE Consortium multidisciplinary meeting