Periodic Reporting for period 1 - GERONTE (Streamlined Geriatric and Oncological evaluation based on IC Technology for holistic patient-oriented healthcare management for older multimorbid patients)
Reporting period: 2021-04-01 to 2022-09-30
Population is aging and the number of complex multimorbid patients to manage will increase sharply. Disease-
centred approach is not appropriate to manage these patients. Change to a patient-centred approach will simplify
care pathways, secure management and treatment decision making and decrease healthcare costs. It will be a real
breakthrough for daily practice with multiple impacts that must be quantified. GERONTE multimorbid patient-centred
system proposes:
1) Coordination of management by a patient-tailored, interdisciplinary health professional consortium (HPC),
including hospital- and home-based professionals, with a case manager;
2) Timely registration of symptoms and patient-reported outcomes at home through a web-based app for anticipation
of avoidable adverse events;
3) Proposal of self-management guidelines according to intrinsic capacity evaluation by geriatrician for patient-driven
improvement of independent living;
4) Structured collection of data from electronic health record into a dashboard made available to HPC members as
well as patient and caregiver, thanks to its capacity to securely interoperate with all electronic health records including
software managing medical data.
centred approach is not appropriate to manage these patients. Change to a patient-centred approach will simplify
care pathways, secure management and treatment decision making and decrease healthcare costs. It will be a real
breakthrough for daily practice with multiple impacts that must be quantified. GERONTE multimorbid patient-centred
system proposes:
1) Coordination of management by a patient-tailored, interdisciplinary health professional consortium (HPC),
including hospital- and home-based professionals, with a case manager;
2) Timely registration of symptoms and patient-reported outcomes at home through a web-based app for anticipation
of avoidable adverse events;
3) Proposal of self-management guidelines according to intrinsic capacity evaluation by geriatrician for patient-driven
improvement of independent living;
4) Structured collection of data from electronic health record into a dashboard made available to HPC members as
well as patient and caregiver, thanks to its capacity to securely interoperate with all electronic health records including
software managing medical data.
WP1 established which health care professionals should be involved in the HPC and how they should communicate with one another within the GerOnTe model, which existing multimorbidity data needed to be made available to the HPC and which symptoms and PROMs are relevant for real-time patient reporting during the patient trajectory and finally how intrinsic capacity/frailty and patient preferences should be assessed and reported to the HPC
WP2 which worked on developing the tools for GerOnTe, achieved two deliverables. MyPL the technical partner of the consortium, with the participation of other partners and stakeholders, developed the Holis(TM) GV application with four modules. One for patients, one for caregivers, one for nurses and finally one for doctors. The tool is available in english, dutch and french on mobile devices and desktop.
The patient interface allows for symptoms reporting and self-management, it also offers information on ways to alleviate symptoms. The nurse interface allows for access to patient information and for nurses to register patients and link with doctors, while the interface for doctors allows for access to patient information and for decision making. WP2 also performed a mapping of the clinical sites and produced a report with results and recommendations for implementation.
WP3 is working on developing the methods for GerOnTe. It has already delivered a literature review on the cost-effectiveness of healthcare services for older multimorbid patients, the protocol for economic evaluation of GerOnTe, the definition of the protocol for business case in Geronte as well as the definition of a dashboard of indicators for the clinical trials.
The objective of WP4 is to perform two clinical trials, i.e. FRONE in France and TWOBE in Belgium and the Netherlands, in accordance with ethical and regulatory requirements. WP4 has delivered a clinical trial methodology and trial committees' charters, it has also submitted protocols for regulatory and ethical approvals for the FRONE and TWOBE studies and is currently awaiting approbation. It is working on the statistical analysis plan for the studies and necessary processes and contracts to begin the study once approbations are obtained.
So far WP5 has delivered the evaluation process protocol for Geronte which is a concise practical guide for all partners as to how the evaluation will be done.
WP6 is working on stakeholder engagement to ensure that GerOnTe’s technology is both useful and usable for the target users, to that end WP6 developed a coordination strategy for stakeholders' engagement and a practical guidebook and tools for Focus Groups in WP1-5. WP6 also produced a report on the small-scale pilots.
So far WP7 has delivered the projects personalized visual identity, a dedicated Website, Twitter and LinkedIn accounts as well as a brochure. WP7 has also worked on WP specific strategies and created internal and external newsletters.
The objective for WP8 is to ensure efficient and effective management of GerOnTe and to optimise the communication environment in which it is performed by the consortium.
WP9 sets out the 'ethics requirements' that the project must comply with, it has delivered an ethics management plan, as well as nominated an independant ethics advisor.
WP2 which worked on developing the tools for GerOnTe, achieved two deliverables. MyPL the technical partner of the consortium, with the participation of other partners and stakeholders, developed the Holis(TM) GV application with four modules. One for patients, one for caregivers, one for nurses and finally one for doctors. The tool is available in english, dutch and french on mobile devices and desktop.
The patient interface allows for symptoms reporting and self-management, it also offers information on ways to alleviate symptoms. The nurse interface allows for access to patient information and for nurses to register patients and link with doctors, while the interface for doctors allows for access to patient information and for decision making. WP2 also performed a mapping of the clinical sites and produced a report with results and recommendations for implementation.
WP3 is working on developing the methods for GerOnTe. It has already delivered a literature review on the cost-effectiveness of healthcare services for older multimorbid patients, the protocol for economic evaluation of GerOnTe, the definition of the protocol for business case in Geronte as well as the definition of a dashboard of indicators for the clinical trials.
The objective of WP4 is to perform two clinical trials, i.e. FRONE in France and TWOBE in Belgium and the Netherlands, in accordance with ethical and regulatory requirements. WP4 has delivered a clinical trial methodology and trial committees' charters, it has also submitted protocols for regulatory and ethical approvals for the FRONE and TWOBE studies and is currently awaiting approbation. It is working on the statistical analysis plan for the studies and necessary processes and contracts to begin the study once approbations are obtained.
So far WP5 has delivered the evaluation process protocol for Geronte which is a concise practical guide for all partners as to how the evaluation will be done.
WP6 is working on stakeholder engagement to ensure that GerOnTe’s technology is both useful and usable for the target users, to that end WP6 developed a coordination strategy for stakeholders' engagement and a practical guidebook and tools for Focus Groups in WP1-5. WP6 also produced a report on the small-scale pilots.
So far WP7 has delivered the projects personalized visual identity, a dedicated Website, Twitter and LinkedIn accounts as well as a brochure. WP7 has also worked on WP specific strategies and created internal and external newsletters.
The objective for WP8 is to ensure efficient and effective management of GerOnTe and to optimise the communication environment in which it is performed by the consortium.
WP9 sets out the 'ethics requirements' that the project must comply with, it has delivered an ethics management plan, as well as nominated an independant ethics advisor.
Geronte intends to progress beyond the state of the art in five areas:
Standardised data collection :
Geronte will define a core dataset for decision making and treatment as well as a baseline dataset on that need to be gathered from health records. GerOnTe self-reporting and self-management applications will focus on older patients with multimorbidity and cancer, who so far have been rarely included in trials testing such tools. Patient preferences will be accounted in a parallel process that will also feed the dataset, to ensure Holis is patient-centered.
ICT tool for data collection and presentation to the HPC:
GerOnTe research will provide the following innovations:
• feeding a data lake with structured, semi-structured and unstructured clinical data;
• clinical business intelligence by managing, in real time and automatically, multimorbid older cancer patients’ healthcare process;
• streaming analytics, using reports and QKPIs defined in WP3;
• a tool for data science and future machine learning capabilities;
• an easy to use platform for each stakeholder with positive user experience for better adoption.
Economic methods and QKPIs :
The GerOnTe project will develop an innovative, multi-disciplinary, comprehensive methodological framework for estimating the full costs of complex healthcare services/programs such as the GerOnTe model.
Two clinical trials in three countries :
Proof of concept will be done in two clinical trials (namely, FRONE & TWOBE) using a stepped wedge approach to demonstrate feasibility and quantify impact on stakeholders (patients, health professionals, hospitals, health authorities). Performance of two trials in two different health systems will increase the external validity of our demonstration. Endpoints will include patients’ perspectives as well as health professionals’ and health decision-makers’ perspectives, allowed by a comprehensive network of competences for performance of large-scale studies.
Realist evaluation of an e-health implementation :
GerOnTe will be one of the largest realist evaluations of an e-health implementation ever done. This unique data collection from FRONE and TWOBE will inform a number of high-quality outputs, and in particular a formal guide for the implementation of the GerOnTe intervention, and a worked business plan for scaling up the use of the technology and the model of care, and using both on a much wider scale. This will give a head start to innovators in other countries who are interested in following in the lead of GerOnTe.
Standardised data collection :
Geronte will define a core dataset for decision making and treatment as well as a baseline dataset on that need to be gathered from health records. GerOnTe self-reporting and self-management applications will focus on older patients with multimorbidity and cancer, who so far have been rarely included in trials testing such tools. Patient preferences will be accounted in a parallel process that will also feed the dataset, to ensure Holis is patient-centered.
ICT tool for data collection and presentation to the HPC:
GerOnTe research will provide the following innovations:
• feeding a data lake with structured, semi-structured and unstructured clinical data;
• clinical business intelligence by managing, in real time and automatically, multimorbid older cancer patients’ healthcare process;
• streaming analytics, using reports and QKPIs defined in WP3;
• a tool for data science and future machine learning capabilities;
• an easy to use platform for each stakeholder with positive user experience for better adoption.
Economic methods and QKPIs :
The GerOnTe project will develop an innovative, multi-disciplinary, comprehensive methodological framework for estimating the full costs of complex healthcare services/programs such as the GerOnTe model.
Two clinical trials in three countries :
Proof of concept will be done in two clinical trials (namely, FRONE & TWOBE) using a stepped wedge approach to demonstrate feasibility and quantify impact on stakeholders (patients, health professionals, hospitals, health authorities). Performance of two trials in two different health systems will increase the external validity of our demonstration. Endpoints will include patients’ perspectives as well as health professionals’ and health decision-makers’ perspectives, allowed by a comprehensive network of competences for performance of large-scale studies.
Realist evaluation of an e-health implementation :
GerOnTe will be one of the largest realist evaluations of an e-health implementation ever done. This unique data collection from FRONE and TWOBE will inform a number of high-quality outputs, and in particular a formal guide for the implementation of the GerOnTe intervention, and a worked business plan for scaling up the use of the technology and the model of care, and using both on a much wider scale. This will give a head start to innovators in other countries who are interested in following in the lead of GerOnTe.