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Pre-commercial Procurement of innovative ICT-enabled integrated care solutions to advance multidisciplinary health and care for patients with chronic heart failure

Periodic Reporting for period 1 - INCAREHEART (Pre-commercial Procurement of innovative ICT-enabled integrated care solutions to advance multidisciplinary health and care for patients with chronic heart failure)

Reporting period: 2021-02-01 to 2022-01-31

The five procurers represented in the INCAREHEART consortium (Jämtland, Lisbon, Naples, Central Macedonia, and Turkey) share the sense of urgency to radically improve integrated care for patients with CHF. They are willing and ready to adopt an innovative integrated care solution that overcome fragmented health and care service provision. INCAREHEART will jointly procure R&D services to shape an ICT-enabled integrated care solution supporting the implementation of a comprehensive multidisciplinary and cross-organisational care and support model for people living with CHF across a fully integrated patient pathway. Building on the (siloed) solutions for integrated healthcare delivery available on the market so far, suppliers will, for the first time, integrate a comprehensive set of key features such as digital shared care plans and others into one modular ICT platform. This will enable a breakthrough in effectively bringing different care providers, family caregivers, and patients into a shared, ICT-supported CHF care pathway that cuts across detection, acute treatment, and care, as well as jointly managed long-term care.
The first year of the INCAREHEART project focussed on:
1) The elicitation of requirements for service provision based on the building blocks identified: The INCAREHEART procurers have elaborated 127 requirements for the envisaged ICT-enabled integrated heart failure care solution. These requirements had to be followed by tenderers submitting offers to the INCAREHEART Call for Tenders. They are grouped into functional, non-functional, legal, regulatory, operational, staff and business-related requirements, considering the profiles of the targeted stakeholders. The requirements have been elicited through interviews, focus groups and questionnaires, aiming to involve patients, their informal carers as well as health and care professionals in the co-design of the requirements elicitation process. Change management considerations and approaches are addressed to support better requirements elicitation considering necessary changes that future users of the solutions as well as clinicians and other health and care professionals might have to embrace, advancing a suitable approach and mechanisms that the INCAREHEART procurers and suppliers can apply to facilitate the adaptation to the processes.

2) The development of use cases and service process models. Use cases were developed involving all relevant types of INCAREHEART users based on appropriate formative evaluation measures. User feedback was elicited by means of interviews or focus groups. For the purposes of INCAREHEART, a use case is understood as a structured textual description of a specific example of care service use following a dedicated pathway, thereby focusing in particular on activities by all stakeholder involved and outputs to each user, not only of the ICT solution, but of any part of the socio-technical system. Based on a set of common use cases and requirements, INCAREHEART organisational & service processes were modelled and documented.

3) In preparation of the PCP call for tender, an Open Market Consultation (OMC) has been held to capture the views of the market about the INCAREHEART challenge. A market engagement phase enables procurers to verify if suppliers can deliver the required outcomes, if the requirements are formulated appropriately, and if there is appetite from the market in the upcoming procurement. The feedback from the market enables the procurers to assess the capacity, capability, and willingness of the supply side to develop a solution based on the information provided. To achieve this aim, which is critical to ensure the Pre-Commercial Procurement (PCP) success, the INCAREHEART partners have conducted the following open market consultation activities:
a) The publication of a Prior Information Notice (PIN) and a specific dissemination and communication campaign to engage with the market.
b) 5 online local webinars in the procurers’ local languages to present the PCP and interact with potential participants.
c) 1 online webinar in English to present the PCP to an international audience and 1 online webinar to present results of the OMC phase.
d) 1 OMC online questionnaire to collect market feedback on the planned procurement.
e) A matchmaking tool for potential suppliers in need of support in the building of a consortia capable of addressing the needs of the procurers in full.
f) A mechanism to reply in an agile format the questions received from the market during the Open Market Consultation (FAQs).

The OMC phase took place from June to August 2021.

The Call for Tender was published on 15th December 2022. The tender documents set out all the requirements and deadlines for procurement and include supporting materials such as application forms and model agreements.
INCAREHEART suppliers are required to provide an innovative digital platform effectively supporting integrated CHF care pathway management. This requires integrating a range of innovative key features across four conceptual components of integrated CHF care into a single system, a challenge that has not yet been successfully met albeit market innovation can well be observed in relation to some (siloed) digital tools supporting selected components of integrate care delivery. By pursuing a modular architectural approach, the suppliers are requested to support flexible prioritisation of individual features throughout the entire INCAREHEART co-design process, e.g. in case levels of innovation achievable within the boundaries of the current project cannot be regarded satisfactory when it comes to particular features. A modular system architecture approach is also expected to support the sustainability of the solution requested from the suppliers, e.g. when it comes to adding additional applications to the INCAREHEART system potentially emerging on the market after the project’s end.

When doing so, suppliers will always be aware that the requested integrated CHF management system operates using health (and other) data, which is recognised as very sensitive and consequently carefully protected in law. Suppliers must describe how privacy requirements of both patients and professionals are to be met. The solution may rely on aggregation or employ a trusted third party to deliver data anonymisation, however, they must recognise that the GDPR definition of personal data includes anonymous data that can in principle be reattributed to the patient, even
by such a third party. Results are to be structured in cohorts and to stratify the population into meaningful risk / treatment strata. The solution must also clearly address the problem of coding quality of data manually entered by health and care professionals.

The INCAREHEART solution is expected to deliver great value to patients and the family caregivers in the first place, but also to our health systems and care systems that are faced with a need to become more efficient. One of the core properties of the INCAREHEART integrated care solution will be its seamless integration a) technically into existing systems but also b) into processes and working practices. The INCAREHEART solution is to be adaptable to a variety of "legacy" technology infrastructure and to different existing organisational structures and processes.
INCAREHEART Building Blocks
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