European Innovation Partnership on Active and Healthy Ageing

Action Group C2 Interoperable Independent

Living Solutions

Peter Wintlev-Jensen and Marianne van den Berg

European Commission

21-22 June 2012

• Registration and lunch 12.00 – 13.00

• 13.00 – 13.30 Welcome and introduction from the EC• 13.30 – 14.15 Introduction of participants• 14.15 – 14.45 Presentation of mapping of commitments • 14.45 – 18.00 Discussion on major areas of activity• 18.00 – 18.15 First conclusions and summary

• Closing

Cocktail and networking

Agenda: Day 1: 21st of June

Opening

• 9.00 – 9.30 Presentations of outline action plan and monitoring framework

• 9.30 – 12.30 Identification of Working Groups, major tasks and first allocation of participants

• Lunch

• 13.30 – 14.30 Governance principles• 14.30 – 15.00 Logistics and infrastructure for working

groups and action group• 15.00 – 15.30 Tasks to be performed before next meeting • 15.30 – 16.00 Conclusions and next steps

• Closing

Agenda: Day 2: 22nd of June

Welcome and introduction

EIP on AHA: Objectives and headline target

Headline target by 2020

• Increasing the number of healthy life years (HLYs) by 2 in the EU on average

A triple win for Europe

• Enabling EU citizens to lead healthy, active and independent lives until old age

• Improving the sustainability and efficiency of social and health care systems

• Developing and deploying innovative solutions, thus fostering competitiveness and market growth

EIP on AHA: Background• Not a new EC instrument, neither financial nor legal

• Aligning and optimising the use of existing tools, under a single and coherent framework

• Bringing together actors at all levels and sectors to build synergies whilst mobilising available resources and expertise

• Defining a common vision in achieving common objectives and goals, built upon commitments

• Speeding up the innovation process from research to market – by removing bottlenecks and barriers and leveraging the demand-supply

• Scaling up and multiply successful innovation at EU level

Public consultation• 524 submissions

Steering Group Workshops• Mapping of research• Care&Cure• Prevention, early diagnosis• Active ageing & independent living

Fiches with actions• 127 submissions

StrategicImplementation Plan• Steering Group 7th of

November 2011

Three-step process stakeholder involvement

EC Communication

• Adopted 29th February 2012

• Commission’s response to the Strategic Implementation Plan (SIP) and commitment to its implementation

• Key elements:Setting up the necessary support framework- Favourable regulatory framework- Effective funding mechanisms- Marketplace: evidence base, data and innovative ideas

Support at national, regional and local level

Launching actions on the ground

Monitoring and assessment of progress

Governance for effective implementation

Prevention, screening & early diagnosis

Care & Cure Active ageing & independent living

•Health literacy, patient empowerment, ethics and adherence

•Personal health management

•Prevention, early diagnosis of functional and cognitive decline

•Guidelines for care, workforce (multimorbidity, polypharmacy, frailty and collaborative care)

•Multimorbidity and R&D

•Capacity building and replicability of successful integrated care systems

•Assisted daily living for older people with cognitive impairment

•Flexible and interoperable ICT solutions for active and independent living

•Innovation improving social inclusion of older people

Vision / Foundation•Focus on holistic and multidisciplinary approach

•Development of dynamic and sustainable care systems of tomorrow

•New paradigm of ageing

•Innovation in service of the elderly people

•Regulatory and standardisation conditions

•Effective funding

•Evidence base, reference examples, repository for age-friendly innovation

•Marketplace to facilitate cooperation among various stakeholders

Horizontal issues

Strategic Framework of the EIP on AHA

• Prescription and adherence action at regional level

• Personalised health management, starting with a Fall Prevention Initiative

• Action for prevention of functional decline and frailty with first action focused on physiological frailty and malnutrition

• Replicating and tutoring integrated care for chronic diseases, including remote monitoring at regional level

• Development of interoperable independent living solutions, including guidelines for business models

• Thematic marketplace: innovation for age friendly buildings, cities and environments

Invitations for Commitment

Partners breakdown

GR

IT

MT

SL

AT

PL

SE

DK

FI

DE

NLUK

IE

BE

FR

ES

PT

LU

ALL 261

Spain 63

Netherlands 34

Belgium 29

UK 27

Italy 26

Portugal 18

Germany 11

Denmark 8

France 8

Ireland 7

Greece 6

Finland 6

Sweden 4

Poland 2

Austria 1

Luxembourg 1

Malta 1

Slovenia 1

All Non EU 8

European Innovation Partnership

Commitments

A1: Prescription and adherence

A2: Falls Prevention Initiative

A3: Functional decline and frailty

B3: Integrated care for chronic diseases

C2: Interoperable independent living solutions

D4:Age friendly environments

Commitments / Reference Sites statistics

35 3251

6741 35

261

54

0

50

100

150

200

250

300

A1: Adhe

rence

A2: Fall

s prev

entio

n

A3: Func

tional

declin

eB3:

Integ

rated

care

C2: ILS

D4: Age-f

riend

lyCom

mit Total

Referen

ce Site

A1: Adherence

A2: Falls preventionA3: Functional decline

B3: Integrated care

C2: ILSD4: Age-friendly

Commit TotalReference Site

Invitations for Commitment

Partners breakdown

2

1

1

1

1

1

2

25 6

NL 67

9

14

European Innovation Partnership

Reference Sites 2

FI

DE

SE

CZ

GR

SI

IT

FR

NLUK

DK

IE

ESPT

Total: 54 candidate Reference Site applications

22

Introduction Interoperable Independent

Living Solutions

C2: Rationale (Operational Plan 07/11)

• ICT solutions can prolong independent living of older people and extend the time they remain active and safe in their preferred environment. They also have a huge potential to enhance social inclusion and participation of older people, reduce depression rates, enhance quality of work for cares and make overall care provision economically sustainable (e.g. by avoiding and reducing hospital stays).

• Current solutions for telemonitoring, telecare or social interaction are largely proprietary, based on single provider design and cannot be easily adapted to multiple and changing users' and organisational needs

• Enhancing deployment and take up of interoperable independent living solutions based on open standards.

C2: Objective

Development of interoperable independent living solutions, including guidelines for business models.

C2: Action ready to be launched

• By 2015: Availability of key global standards and validated implementations of interoperable platforms, solutions and applications for independent living.

• By 2015: Availability of evidence on the return on investment of these solutions and applications, based on experience involving at least 10 major suppliers, 100 SMEs and 10.000 users.

C2: Deliverables

By 2013 launch a cooperation platform of key stakeholders: industry, users, care service organisations, service providers, insurance companies, housing companies and regions / major cities.

Between 2012-2014 pursue joint development of open standards and reference architectural leading to global standard setting and developing and disseminating guidelines on sustainable financing and business models based on these open standards.

Promote wide availability of open and flexible solutions and tools for building independent living applications and services.

Mobilise and pool demands including at least 10 pan-European implementations based on innovative procurement to accelerate development.

Launch large scale pilot projects (10.000 users) to develop comprehensive socio-economic evidence on impact from innovation.

C2: Envisaged Activities

Funding, legislative and organisational changes. More specific:

• Availability of adeuate support from EU and other funding instruments, eg: AAL, CIP ICT PSP, FP7, Horizon 2020, Public Private Partnership schemes.

• Putting in place standardisation mandates or other formal/informal standardisations mechanisms.

C2: Specific Conditions

Aims of the meeting Interoperable Independent

Living Solutions

• Meet the other members of your Action Group

• Start developing the steps to arrive at the Action Plan- Identify major areas of activities- Monitoring framework

• Discuss the relevant governance structure and logistics

• Timetable and next steps

Aims of the meeting

Introduction of participants Interoperable Independent

Living Solutions

Mapping of commitments Interoperable Independent

Living Solutions

Working Groups Interoperable Independent

Living Solutions

• Interoperability and standardisation

• Implementation

• Socio-economic evidence

C2: Possible Working Groups

Interoperability and standardisation• Devices• Platforms• Technology• Application• Business models• Architecture: reference and impact• Ad hoc Integration

• Best practices

• Functional stable Ecosystem and value chains within this system• Standardise Semantic discussion and interoperate• Make concrete: Medical health data, Social care records• Database: personal data, services delivered when by whom• Repository of interoperable specification/standardisation• Data protection and data privacy , social network• Database: conflict of interest user-provider

• Investment together SME

Implementation• Empowerment: Information and promotion development stage • Barriers: social, acceptance,…./Behavioural transformation• Health literacy• Smart technology• User choice• Paying customer and providers: marketplace• Where can you find info• Stakeholder cooperation: Involvement of stakeholders: Partnership building• Trusted environment: certification• Matrix of needs• Adaptability and flexibility: every person gets what he/she needs• Put user in centre: design on ergonomy• Conflict of interests

• Engagement of experts• Policies• Political awareness• Scaling up strategies

• Workflows: changing, supporting• Installation and integration skills: Maintainability and follow-up: reliability• Providers behavioural transformation

• Innovative procurement: change law/legislation and New public private investments models• Training on procurement

• Liability and legal obligations• Support legacy systems

• Business models

Socio-economic evidence• Evidence about what works and procurement• Where find evidence• Link different type of evidence• Sharing knowledge• Assessment of the whole process• Speed getting evidence back

• Cost benefit analysis/business model• Business model innovation workshops• Innovative framework evidence: looking at impact: economy and social,

innovation on new jobs and growth• Methodology: new HTA methods and policy HTA• Return of investment (social and economic): types of people looking• New capital venture model / crowd-funding• Quality of data• Baselines

• RoI: Closed versus open interoperable solutions (competitiveness)• Tools for measurement

• Template monitoring and indicators• Common key Performance indicators

Other topics• Stimulating innovation in itself

• Permission free innovation• Experimental areas/topics free of/flexibility legislation• Basis new legislation

• Keeping attached other action groups/exhange across actions

• Involvement stakeholders not represented• Put patient in centre

• Terminology: patient, end-user

• Dissemination / best practices /mutual learning

First conclusion and summary

Day 2

Opening

• 9.00 – 9.30 Presentations of outline action plan and monitoring framework

• 9.30 – 12.30 Identification of Working Groups, major tasks and first allocation of participants

• Lunch

• 13.30 – 14.30 Governance principles• 14.30 – 15.00 Logistics and infrastructure for working

groups and action group• 15.00 – 15.30 Tasks to be performed before next meeting • 15.30 – 16.00 Conclusions and next steps

• Closing

Agenda: Day 2: 22nd of June

1. What is our headline outcome objective?

2. What types of activities will we work on to make it happen?• group the activities in relation to the outcome objective and include role of partners, areas

for synergies and co-operation, co-development…

3. What specific deliverables do we expect from our work? What are the key milestones and operational targets? How will we make it happen?• Description of concrete tasks to be performed in 2013, 2014 and beyond• Major common deliverables and milestones identified, eg annual progress reports• Operational targets• Timing

4. How are we going to measure our progress? • Define 5-7 outcome indicators and process indicators (input / output), consider the short

and long term (eg. progress reports)

5. Governance• the structure and main principles for the governance of the Action, including the overall

action and activity areas

6. What are the key gaps identified for potential future actions?

Action Plan

• Enhancing deployment and take up of interoperable independent living solutions based on open standards.

C2: Objective

Development of interoperable independent living solutions, including guidelines for business models.

C2: Action ready to be launched

• By 2015: Availability of key global standards and validated implementations of interoperable platforms, solutions and applications for independent living.

• By 2015: Availability of evidence on the return on investment of these solutions and applications, based on experience involving at least 10 major suppliers, 100 SMEs and 10.000 users.

C2: Deliverables

Monitoring Framework

Process indicators

Input indicators e.g.:-Time-Money-Number of organisations

Outcome indicators e.g:- Less hospitalisation- Less depressed people

Quality of Life Sustainability of Care

Innovation-basedCompetitiveness

+2 Healthy Life Years EIP Monitoring Framework

TripleWin

Outcome indicators

Individual actions

HLYAt birth

Output indicators e.g.:-Number of regions involved-Number of patients involved-New services: 24/7-telephone

Processindicators

Individual Actions

JRC: Theory & Modelling

Action Groups

• Establish the link

Input indicators Partners: a hospital, academia, social security entity, national research council, state local authority

Integrated care models

Improved QoL and HLY

50% slower in cognitive function 5.1% of physical condition70% slower in depression no of medications

Quality of Life

physical and cognitive function

Sustainability of care systems

facility/hospital admissions &cost of health servicesInnovation-based competitiveness

+ Healthy Life Years

TripleWin

Outcome indicators

HLYAt birth

Output indicatorsGeographical coverage of the model: northern Italy + 15 replicated regions

Target group: 100 patients X 15 = > 1500

Processindicators

Replication of integrated social and health case management model for frail elderly people

facility/hospital admissions33% in hospital admissions and nursing home visits65% in emergency room visits50% in length of stay in hospital & nursing homecost of health servicessavings of 1000 euro per person per year 19% in community health services costs48% in nursing home costs34% in hospital expenses

Market growth

TelehealthTelemonitoringEMRS

Individual actions

Outcomes for model group (100 patients)

• Establish the link (theory & modelling JRC)

• HLY Quality of LifeRate of decline of suicide, depression; improved social interaction; increased physical activity….

• Sustainability of health systemsDelayed institutionalisation; Reduced hospital, GP and home care visits; More initiatives with a positive return of investment for independent living solutions

• Innovation and GrowthNumber of favourable business/investment cases, public procurements, common service specifications….

Type of outcome indicators – possible ideas

• November 2012: Defined outcome and process indicators

• December 2012: First results process indicators

• March/April 2013:First results outcome indicatorsStart extrapolating

• October 2013:Start econometric modelling

Monitoring – roadmap

• Trends

• Not comparing countries / stakeholders

• Extrapolating

• Econometric modelling

Monitoring – interpretation data

• Identify contact persons for indicators

• Liaise with INFSO/SANCO

• Identify and provide relevant data

Monitoring – Action Group activity

Activities

Working groups

• Interoperability and standardisation

• Implementation

• Socio-economic evidence

Interoperability and standardisation• *Interoperability• Devices; Platforms; Technology; Applications; Business models;

Architecture: reference and impact; Ad hoc Integration; Functional stable Ecosystem and value chains within this system; Standardise Semantic discussion and interoperate; Repository of interoperable specification/standardisation

• *Database• Make concrete: Medical health data, Social care records;

Database: personal data, services delivered when by whom; Data protection and data privacy , social network; Database: conflict of interest user-provider

• *SME and investment• Investment together SME

• *Best practices

Implementation• * Patient empowerment, behavioural transformation and user friendly• Empowerment: Information and promotion development stage; Health literacy; User choice;

Paying customer and providers: marketplace; Where can you find info; Matrix of needs; Adaptability and flexibility: every person gets what he/she needs; Put user in centre: design on ergonomy; Trusted environment: certification; Barriers: social, acceptance,…./Behavioural transformation; Smart technology;

• *Health care providers• Workflows: changing, supporting; Installation and integration skills: Maintainability and follow-

up: reliability; Providers behavioural transformation

• * Stakeholder cooperation• Stakeholder cooperation: Involvement of stakeholders: Partnership building; Conflict of

interests

• *Policy• Engagement of experts; Policies; Political awareness; Scaling up strategies

• *Procurement• Innovative procurement: change law/legislation and New public private investments models;

Training on procurement; Business models

• * Legalisation• Liability and legal obligations; Support legacy systems

Socio-economic evidence• * Sharing evidence• Where find evidence, Link different type of evidence, Sharing knowledge

• * Evidence and procurement• Evidence about what works and procurement

• * Methodology • Cost benefit analysis/business model; Business model innovation workshops;

Innovative framework evidence: looking at impact: economy and social, innovation on new jobs and growth; Assessment of the whole process; Methodology: new HTA methods and policy HTA; Return of investment (social and economic): types of people looking; New capital venture model / crowd-funding; Quality of data; Baselines; Speed getting evidence back

• *Monitoring • Tools for measurement; Template monitoring and indicators; Common key

Performance indicators

• * Closed versus open interoperable systems• Return of Investment: Closed versus open interoperable solutions

(competitiveness)

Other topics•* Stimulating innovation in itself•* Permission free innovation, Experimental areas/topics

free of/flexibility legislation, Basis new legislation•* Keeping attached other action groups/exchange across

actions•* Involvement stakeholders not represented like patient

organisation, health providers•* Put patient in centre•* Terminology: patient, end-user•* Dissemination / best practices /mutual learning

Governance principles

• AGs establish their own working methods and governance, with EC as facilitator and supporter

• Governance structure • The rules of engagement based on the following

principles:• Openness and partnership – common willingness of all

partners to cooperate with other relevant partners.• Coordination – reporting and participation of a

representative(s) in the coordination meetings of the Action Group

• Reporting – regular reporting from the Action Group's meetings, progress of actions and deliverables to be made public

• Evaluation – outcome of actions to be evaluated, and results made public

Governance principles

Ways for AG members to work with each other

• Marketplace as document repository

• Marketplace online discussion fora

• Available resource for synthesis and drafting of documents

Logistics and infrastructure

An interactive online platform, open to all stakeholders willing to get involved in the Partnership

https://webgate.ec.europa.eu/eipaha/

For those who:

are interested in the EIP, but not yet ready to submit a Commitment to a Specific Action

wish to find partners, build networks and develop a Commitment

are eager to be kept up to date with initiatives, events, and share with others what is on the agenda

offer innovative ideas and expertise which they are ready to share with wider public through social media and the discussion fora

Marketplace for innovative ideas

• Conclude on governance structure and WG organisation by mid/end of July

• WGs deliver own "plans" by early September

• Synthesis of WG plans by 20 Sep?

• Draft action plan by 20 Sep?

Timetable and next steps