Periodic Reporting for period 3 - GERONTE (Streamlined Geriatric and Oncological evaluation based on IC Technology for holistic patient-oriented healthcare management for older multimorbid patients)
Okres sprawozdawczy: 2024-04-01 do 2025-03-31
The population is ageing, and the number of patients with complex multimorbidity is expected to increase sharply in the coming years. The traditional disease-centred approach is not suitable for managing such patients, as it fails to consider the interactions between coexisting conditions. This situation calls for a paradigm shift towards a patient-centred model, designed to facilitate and secure care pathways, support clinical decision-making, and reduce healthcare costs.
Adopting this new approach would represent a major breakthrough in daily medical practice, with multiple clinical, organisational and economic impacts that must be carefully assessed.
The GerOnTe system addresses this challenge through the following key components:
1- Coordinated management via a patient-tailored, interdisciplinary Health Professional Consortium (HPC), bringing together hospital- and home-based professionals under the supervision of a dedicated case manager;
2- Timely monitoring of symptoms and patient-reported outcomes at home through a web-based application, enabling the anticipation and prevention of avoidable adverse events;
3- Personalised self-management support, including tailored guidelines based on an intrinsic capacity assessment performed by a geriatrician, to foster patient empowerment and facilitate independent living;
4- Integrated data collection from electronic health records into a secure, interoperable dashboard accessible to all HPC members, ensuring shared decision-making and continuity of care.
Adopting this new approach would represent a major breakthrough in daily medical practice, with multiple clinical, organisational and economic impacts that must be carefully assessed.
The GerOnTe system addresses this challenge through the following key components:
1- Coordinated management via a patient-tailored, interdisciplinary Health Professional Consortium (HPC), bringing together hospital- and home-based professionals under the supervision of a dedicated case manager;
2- Timely monitoring of symptoms and patient-reported outcomes at home through a web-based application, enabling the anticipation and prevention of avoidable adverse events;
3- Personalised self-management support, including tailored guidelines based on an intrinsic capacity assessment performed by a geriatrician, to foster patient empowerment and facilitate independent living;
4- Integrated data collection from electronic health records into a secure, interoperable dashboard accessible to all HPC members, ensuring shared decision-making and continuity of care.
As a first step, four rounds of questionnaires were conducted among more than 40 European health professionals from various disciplines. This process identified the essential data to be included in the minimal dataset of the GerOnTe dashboard, covering cancer, comorbidities, intrinsic capacity assessment, patient preferences, and real-time symptom monitoring. Major symptoms and patient-reported outcomes are collected in real time during treatment, with defined alert thresholds and collection frequencies. A library of patient advice was also developed to support symptom management and promote healthy ageing. The minimum composition of the Health Professional Consortium (HPC) was established, forming the operational basis of the project.
An initial attempt to develop the web application failed following MyPL’s liquidation. myPatientSpace (an Irish company) successfully replaced MyPL and delivered a web platform comprising a patient-facing app for PROMs collection and symptom management, with a professional dashboard. This allowed the FRONE study to start in eight French centres in October 2024, with coordination by the EUCLID clinical trial unit (CTU) and support from the rest of the consortium.
In parallel, Bocconi University delivered the literature review on cost-effectiveness, the economic evaluation and business case protocols, and a dashboard of clinical trial indicators. Following these analyses and stakeholder discussions, the TWOBE study (originally planned in Belgium and the Netherlands) was replaced by the IMPLEMENT study, an observational study conducted across 20 centres in five European countries to analyse current care pathways from clinical, organisational, and economic perspectives.
Dublin City University developed the GerOnTe evaluation process protocol, contributed to the app co-creation and partner consultations, and attended the Site Initiation Visits for FRONE. The initial program theory, based on a scoping review, is in its final draft and aims to identify barriers and facilitators affecting the implementation of the GerOnTe care pathway.
The e-Senior partner supported digital development through focus groups, app testing, and stakeholder engagement activities to ensure the tool’s usability and acceptability. They delivered a coordination strategy, practical guidebooks, focus group tools for Work Packages, and the report on small-scale pilots, as well as training materials (manuals and videos) for FRONE participants.
The communication and dissemination strategy was reinforced through a unified visual identity, website, social media presence, newsletters, and brochures, ensuring engagement with professionals and patients alike. Public outreach is planned at later stages.
All developments were conducted in accordance with the ethics management plan, under the supervision of an independent ethics advisor and an ethics committee representing all Work Packages.
An initial attempt to develop the web application failed following MyPL’s liquidation. myPatientSpace (an Irish company) successfully replaced MyPL and delivered a web platform comprising a patient-facing app for PROMs collection and symptom management, with a professional dashboard. This allowed the FRONE study to start in eight French centres in October 2024, with coordination by the EUCLID clinical trial unit (CTU) and support from the rest of the consortium.
In parallel, Bocconi University delivered the literature review on cost-effectiveness, the economic evaluation and business case protocols, and a dashboard of clinical trial indicators. Following these analyses and stakeholder discussions, the TWOBE study (originally planned in Belgium and the Netherlands) was replaced by the IMPLEMENT study, an observational study conducted across 20 centres in five European countries to analyse current care pathways from clinical, organisational, and economic perspectives.
Dublin City University developed the GerOnTe evaluation process protocol, contributed to the app co-creation and partner consultations, and attended the Site Initiation Visits for FRONE. The initial program theory, based on a scoping review, is in its final draft and aims to identify barriers and facilitators affecting the implementation of the GerOnTe care pathway.
The e-Senior partner supported digital development through focus groups, app testing, and stakeholder engagement activities to ensure the tool’s usability and acceptability. They delivered a coordination strategy, practical guidebooks, focus group tools for Work Packages, and the report on small-scale pilots, as well as training materials (manuals and videos) for FRONE participants.
The communication and dissemination strategy was reinforced through a unified visual identity, website, social media presence, newsletters, and brochures, ensuring engagement with professionals and patients alike. Public outreach is planned at later stages.
All developments were conducted in accordance with the ethics management plan, under the supervision of an independent ethics advisor and an ethics committee representing all Work Packages.
GerOnTe aims to progress beyond the state of the art in five key areas:
1. Standardised data collection
GerOnTe will validate a core dataset for decision-making and treatment to be integrated into a summary dashboard supporting secure and efficient clinical decision-making. This dataset complements existing self-reporting and self-management tools, while enhancing them with a dedicated library; a feature rarely available in current applications. Patient preferences will also be systematically incorporated into the dataset, reinforcing the patient-centred approach that underpins the GerOnTe model.
2. ICT tool for data collection and presentation to the Health Professional Consortium
GerOnTe research will deliver several technological innovations, including:
- integration of structured, semi-structured, and unstructured clinical data into a shared data lake;
- real-time, automated management of multimorbid older cancer patients’ care processes through clinical business intelligence;
- streaming analytics using reports and KPIs defined in Work Package 3;
- a foundation for advanced data science and future machine learning capabilities;
- an intuitive, user-friendly platform for all stakeholders, designed to maximise adoption and usability.
3. Economic methods and KPIs
The project will develop an innovative, multidisciplinary methodological framework to estimate the full costs of complex healthcare services and programmes such as the GerOnTe model. This will include the design and validation of key performance indicators (KPIs) for economic and clinical assessment.
4. Clinical trial in France
A proof of concept will be conducted through the FRONE clinical trial, using a stepped-wedge design to assess feasibility and quantify the impact on all stakeholders (patients, healthcare professionals, hospitals, and health authorities). Endpoints will include patient-reported outcomes (notably quality of life), as well as professional and organisational indicators, enabled by a comprehensive multidisciplinary network for large-scale evaluation.
5. Realist evaluation of an e-health implementation
GerOnTe will conduct one of the largest realist evaluations of an e-health implementation to date. Data collected through the FRONE trial will inform high-quality outputs, including a formal implementation guide for the GerOnTe intervention and a detailed business plan for scaling up the model of care and associated technology. These outcomes will facilitate replication and adaptation across Europe, offering a significant advantage to innovators aiming to adopt and expand the GerOnTe approach in other healthcare contexts.
1. Standardised data collection
GerOnTe will validate a core dataset for decision-making and treatment to be integrated into a summary dashboard supporting secure and efficient clinical decision-making. This dataset complements existing self-reporting and self-management tools, while enhancing them with a dedicated library; a feature rarely available in current applications. Patient preferences will also be systematically incorporated into the dataset, reinforcing the patient-centred approach that underpins the GerOnTe model.
2. ICT tool for data collection and presentation to the Health Professional Consortium
GerOnTe research will deliver several technological innovations, including:
- integration of structured, semi-structured, and unstructured clinical data into a shared data lake;
- real-time, automated management of multimorbid older cancer patients’ care processes through clinical business intelligence;
- streaming analytics using reports and KPIs defined in Work Package 3;
- a foundation for advanced data science and future machine learning capabilities;
- an intuitive, user-friendly platform for all stakeholders, designed to maximise adoption and usability.
3. Economic methods and KPIs
The project will develop an innovative, multidisciplinary methodological framework to estimate the full costs of complex healthcare services and programmes such as the GerOnTe model. This will include the design and validation of key performance indicators (KPIs) for economic and clinical assessment.
4. Clinical trial in France
A proof of concept will be conducted through the FRONE clinical trial, using a stepped-wedge design to assess feasibility and quantify the impact on all stakeholders (patients, healthcare professionals, hospitals, and health authorities). Endpoints will include patient-reported outcomes (notably quality of life), as well as professional and organisational indicators, enabled by a comprehensive multidisciplinary network for large-scale evaluation.
5. Realist evaluation of an e-health implementation
GerOnTe will conduct one of the largest realist evaluations of an e-health implementation to date. Data collected through the FRONE trial will inform high-quality outputs, including a formal implementation guide for the GerOnTe intervention and a detailed business plan for scaling up the model of care and associated technology. These outcomes will facilitate replication and adaptation across Europe, offering a significant advantage to innovators aiming to adopt and expand the GerOnTe approach in other healthcare contexts.