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VALUeHEALTH Report Summary

Project ID: 643847
Funded under: H2020-EU.3.1.

Periodic Reporting for period 1 - VALUeHEALTH (Establishing the value and business model for sustainable eHealth services in Europe - VALUeHEALTH)

Reporting period: 2015-04-01 to 2016-03-31

Summary of the context and overall objectives of the project

VALUeHEALTH is an EU funded R&D project within the Horizon 2020 Framework Programme.

VALUeHEALTH is establishing how eHealth interoperability can create, deliver, and capture value for all stakeholders, to justify a sustainable market in scaling up cross-border interoperability. The consortium is developing an evidence-based business plan for sustainable interoperability, with sustainable revenue streams for developing and operating self-funding priority pan-European eHealth Services beyond 2020.

VALUeHEALTH comprises a rich multi-stakeholder consortium of experienced partners and funded experts, to bring together many essential viewpoints to undertake the work plan and - importantly - to endorse and champion its results.

Starting with the cross-border interoperability use cases already approved by the eHealth Network for the CEF [1], eight VALUeHEALTH partners cooperate with multiple stakeholders though a robust methodology to prioritise use cases relevant to Member States for cross-border and also within border health service business needs.

The consortium is

- designing an over-arching business model and multiple stakeholder Value Propositions for European scale interoperability;
- defining the multisided market needed to sustain investments in interoperability services;
- performing state of the art Cost Benefit Assessment and risk assessments;
- and from this will develop a strategic plan for sustainability.

VALUeHEALTH will define the interfaces, standards and platform services and tools needed to deliver the prioritised use cases, and from this derive a design and deployment roadmap for the essential generic and healthcare specific services. The project will provide a gap analysis of standards, specifications and translations plus their urgency of need and estimated costs.
The project is collating European experience of success strategies for promoting high-quality structured and coded EHRs, and of organisational changes needed to capitalise on richly interoperable health records, to produce a roadmap of scale-up adoption strategies, recommended incentives and who should fund them.

Finally, VALUeHEALTH will integrate and validate these results to produce a definitive Business Plan and Strategy for taking forward public-private investment in digital eHealth services, to give clear guidance to the CEF on how it may construct its digital service infrastructure Building Blocks for health, to ensure maximum value and optimal sustainability beyond 2020. This will not only include the costs and revenues, and their timelines, but the strategies needed to derive value from them - which is vital to justify sustainability.

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

"VALUeHEALTH has made good progress on all of its five objectives. Each of the objectives outlined corresponds to the work of a specific work package. The relationship between the objectives and the work package is identified in each case. All work packages have, nevertheless, worked collaboratively and been supportive of the collective work of the consortium.

1. Develop a prioritised set of use cases reflecting Member State health business needs for cross-border and within-border digital services on a European scale.

Pursuing this objective, reported under work package 1 in this report, has been the dominant activity of the first half of the project. It has been important for VALUeHEALTH to define a good quality and reproducible process for identifying and then prioritising business use cases (health and care provision services) that are the most likely to yield a compelling business justification for future investments in interoperability, both within border and cross-border. When engaging with the invited experts and stakeholders during the first year, we received useful feedback. The opinion of many of them was that we should eventually also produce guidance on how Member States could undertake a similar exercise themselves in the future. Work package 1 has produced two deliverables in year 1. The first deliverable is concerned with the methodology used, and the second is more focused on the results we have obtained. The work package has delivered, for use during the rest of the project, two highest ranked use cases:
• Safe prescribing
• Integrated care and self-management for long-term conditions.
These two highest-ranked cases were named "prioritised use cases".

2. Design an over-arching business model framework that encompasses and delivers customised value propositions across a wide range of relevant stakeholders, a Cost Benefit Assessment, risk assessments and sustainability strategies.

Work package 2 provides the focus of the project on methods and frameworks. As the spine of the project as a whole, work package 2 began its work at the kick-off meeting, gathering information from the multiple experts on the drivers, and the barriers, for investments in interoperability and the wide-scale adoption of standards. During the first year of the project, this work package has identified the business critical stakeholders who influence investment decisions and influence value realisation from more interoperable health data. Once the prioritised use cases were identified, in November 2015, a Business Modelling Task Force was established. Its task was to develop value chains and value propositions, and start to populate a Business Model Canvas. Through this Task Force the reference business use case of diabetes was nominated to be the best typical example of a long-term condition that could showcase both of the prioritised business use cases. As a result, patient stories - based around the selected reference business use case (diabetes) - have now been developed for three specific scenarios. This work is now being used throughout the consortium, and by all the other work packages. The first deliverable of this work package is now at an advanced stage.

3. Develop a roadmap of scale-up adoption strategies, conditions for success including clinical documentation and care collaboration, and recommended incentives,

Work package 3 is focused on the organisational, workflow and behavioural changes that would be needed to scale up adoption and maximise the benefit from investments in interoperability. It is particularly focused on incentive schemes that encourage better quality clinical documentation and encourage appropriate information sharing and care collaboration. During the first year of project work, its work has included a substantial amount of desk research, reviewing both the academic and applied literature and examining the findings from pilot projects of integrated care. This has been complemented by useful interactions with the experts and stakeholders during our main project meetings. This work has included identifying barriers, in particular stakeholder resistance, and experience gained in overcoming these difficulties. The first deliverable from this work package is a collation of adoption challenges and success strategies, intended to scope the eventual roadmap and its proposed structure. This deliverable is complete, and is currently being reviewed internally. It will rapidly be finalised and submitted following the first periodic review, since is not officially part of the first reporting period.

4. Develop an ICT and interoperability deployment roadmap, defining the digital infrastructure services that are needed to deliver the priority use cases, and the interoperability assets and platform services that will be needed to design, implement, deploy and maintain these services.

During the first year of the project, work package 4 has paid particular attention to the evolution of the Connecting Europe Facility (CEF) and the first wave of eHealth Digital Services. The combination of CEF core services and generic services will need to be maintained, and possibly extended to meet the needs of the prioritised use cases pre and post-2020 (if these are ultimately to be selected by European decision-makers). It is recognised that the balance between CEF-related centralised and distributed assets and services may evolve. In the first year, this work package has sought to be agnostic about precisely what balance between centralised and distributed ones is eventually in place by 2020. It has worked with the prioritised use cases, the reference clinical case of diabetes and the three patient stories to develop use case description templates. It has developed a functional needs assessment for the cross-border digital services that would be needed to support unplanned care, planned care and transfers of care or specialist referral between Member States, in order to provide continuity of care and safe prescribing to patients with diabetes. These items are all documented in Deliverable 4.1. This is the necessary preparatory work to develop the interoperability deployment roadmap and its costs.

5. Deliver a Business Plan and Sustainability Plan which will identify sustainable streams of revenue to establish, operate and grow pan-European eHealth Services beyond 2020, when such services will need to be self-funding.

In the first year of the project, work package 5 has prepared for later consultation and endorsement on the project’s final business plan, by forming an Alliance of experts and stakeholders, with clearly defined roles (explained in its first deliverable, D5.1). It convened an experts meeting in month 1, and a multi-stakeholder meeting in month 6. A webinar was held at the start of year 2 to update the Alliance members and to receive their feedback on the results of the project's first year. Following publication of its first deliverable, work package effort has focused on collaboration with work package 2 on the construction of value chains. All of the stakeholders within the value chains are represented in the Alliance. WP5 has in particular established links to the RDAction, Joint Action on Rare Diseases which supports amongst others the ongoing formation of European Reference Networks (ERNs). Rare diseases and ERNs being both high priorities of the Cross Border Directive are amongst the most important stakeholders and expected “consumers” of the current CEF eHSI services, extended for the ERN specific use cases."

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)


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