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WHO - ITU mHealth Hub in EU

Periodic Reporting for period 2 - WHO-ITU-mHealth (WHO - ITU mHealth Hub in EU)

Reporting period: 2018-09-01 to 2020-08-31

The push to use Information and Communication Technologies, specifically mobile technology (mHealth), to support health care has been driven by the need to find cost-effective ways to improve quality and access to health and care services for a population that lives longer with increasingly complex chronic conditions.

WHO, ITU and Ministry of Health Andalusia, Spain, are working together to create a joint mHealth Hub for Europe. The Hub is intended to serve as a mechanism to share success in mHealth across the European region and boost uptake of mHealth solutions amongst national governments. The Hub will provide services in areas of operational research, training and education, identifying standards, regulatory and policy goals, and implementation support. It will have a dual focus on knowledge management & innovation, and on practical implementation. Over long term, the mHealth Hub will serve as a resource for Europe to support countries in deploying and regulating mHealth in their national health services.

The objectives of this project are:
1. To establish an EU mHealth Hub for collecting and disseminating research and experience relating to the large-scale implementation of mHealth programs;
2. To build capacity for the Hub to be able to support Member States and implementing partners in setting up large-scale mHealth programs.
3. To define a business model for the Hub activities which ensures its service continuity and financial sustainability beyond the project duration
"The work is organized into 6 work packages:
•WP1 - Project Management
•WP2 - Knowledge Tools
•WP3 - Hub Selection
•WP4 - Capacity Building and Operationalization of the Hub
•WP5 - Innovation and Policy
•WP6 - Ethics Requirements
The institution selected as the Host and Implementer of the Hub (WP3) was the Andalusian Public Health System (SSPA). The Hub was formally established on February 2020. The official launch of the Hub was at ITU HQ in Geneva on February 18th with participation of WHO HQ & Digital Health Department, the Delegation of Andalusian Regional Minister of Health and Families, representative of the Delegation of the European Union to the UN, the Hub Consortium partners and members of Missions of Spain, Italy and Austria to UN.

The Hub Consortium partners had a first face-to-face Workshop on 17-19 February to kick off its activities and to start the actual implementation and operationalization of the Hub. The Project then worked on developing the Knowledge Tools (WP2): KT1 Assessment frameworks of mHealth solutions, KT2 An intervention-specific mHealth programme and KT3 Integrating mHealth innovations into health systems. They will be the starting point for development of national programs for implementing specific mHealth services.

WP4 has carried out work in the areas:
•Stakeholders Identification
•Synergies & Partnerships
•Sustainability Strategies for the Hub (eg Large scale implementation of Service Portfolio)
•Defining mechanisms for attracting additional funds
•Business Models definitions for advanced services
The Hub website was launched in February 2020. It contains a COVID-19 apps Hub repository with more than 80 apps from public and private initiatives.

In Country engagement area the Hub received responses from Iceland, Montenegro, Poland, North Macedonia, Czech Republic, Turkey, Croatia, Spain, Moldova, Norway following an EOI launched in March by ITU Regional Office for Europe. The Hub organized a Webinar ""European mHealth Hub Support for Country-Level Implementation"" on June 30th and participated at the “eHealth Network - COVID-19 - Coordinated Actions” meeting on July 15th to promote 3 options of engagement with countries:
1. Implementing and scaling up mHealth programmes (mDiabetes)
2. Piloting European mHealth Hub Knowledge Tools (KT)
3: Strategic support, i.e. hosting workshops, monitoring and evaluation, in kind contributions.

Hub received political commitment from:
•Hungary (co-creation of a Roadmap for implementation and setup of large scale mHealth intervention in the area of Diabetes prevention and management)
•Czech Republic (co-creation of a Roadmap for integration of mHealth in the national health system)
•Finland, Germany (strategic support)
•Austria, Turkey, Croatia, Poland (knowledge exchange)

On September 28, a Regional Webinar was organized in cooperation with Regional Cooperation Council of Western Balkans (RCC) and the South-Eastern Europe Health Network (SEEHN).

D5.1 (WP5) towards a Common Policy Framework for mHealth in Europe, targets primarily policy makers, and indirectly app developers and end users (citizens and healthcare professionals). 8 policy areas related to mHealth where the Hub will provide recommendations and guidance are:
•Governance models and change management
•Integration mechanism with EHR and interoperability
•Ethical and regulatory issues – secondary use of data and data security
•Business models, innovation funds and reimbursement.
•Human centred design and patient safety - Patient empowerment, health literacy and digital skills.
•Assessing the impact of the innovations
•ICT infrastructure
•Policy for addressing countries health priorities in times of emergency.
An analysis of those will lead to a concrete set of procedures, measures and actions proposed to policy makers and relevant stakeholders on how to develop and advance mHealth policies and strategies. A key outcome of D5.1 is the definition of a policy development process model for mHealth.

We produced 3 publications on mHealth Policies with case studies from Portugal, Austria and Italy.

Interviews with Estonia, France, Ireland, Kazakhstan and North Macedonia were conducted in July and August 2020 that aimed at identifying and highlighting trends and gaps in country mHealth policies and implementations. Monitoring trends in innovation landscape in Europe is another activity in incipient phase in WP5.
Hub delivered D4.7 (WP6) “Ethical and legal compliance issues of the mHealth Hub Project”."
The Project works towards five expected impacts:

1. Creating evidence on health outcomes, quality of life and care efficiency gains in the NCD management by using mHealth solutions.
2. Enabling mHealth to be deployed in national and regional level health services and to deliver large scale benefits, first of the selected entities, and later in the rest of Europe.
3. Becoming the focal point for expertise on mHealth in the EU and identifying and highlighting trends and gaps in policies, standards, regulations, etc. and best practices and barriers to the creation of consistent mHealth infrastructure and strategy.
4. Unique platform to support innovation in and up-scaling of mHealth by convening cross sector stakeholders (young entrepreneurs, start-ups, governments, technical officers etc.).
5. Creating synergies with the existing EU platforms of stakeholders such as eHealth network of Member States and also the EU EIP on Active and Healthy Ageing. (requirement, scope, impact).

The knowledge tools in WP2 address items 1 and 2. Items 4 and 5 are the focus of WP4 and WP5, while item 3 will be the result of a successful project and a strong, operational Hub. In WP4 the Hub partners are working on defining a business model for the Hub that will ensure its service continuity and financial sustainability beyond the project funding.
Workshop on Knowledge Tools mBreatheFreely, Tromso, Norway, 2017
Workshop on Knowledge Tools mAgeing, Geneva, Switzerland, 2017