Digital solutions offer holistic care for patients with multimorbidity
Europe’s fragmented healthcare often leads to data gaps, inefficient resource use, increased costs and disjointed patient experiences. These challenges are compounded for patients with multiple diseases, as clinical specialities focus on individual issues, leading to duplicated provision as well as missed treatment and diagnosis opportunities. “Up to 65 % of people over 65 experience two or more long-term health conditions, with those from deprived areas at higher risk but with less care access,” according to Fred Kjellson, Carematrix PCP(opens in new window) project coordinator. “Chronic diseases cost the EU over EUR 700 billion annually. Of 2.2 million people in the Basque Country, for instance, 25 000 account for one third of health spending, and 75 000 account for half – the majority of whom are multimorbid.” Carematrix PCP’s two co-developed digital solutions help ensure more integrated and efficient patient care.
Solutions driven by need, not technology
Carematrix PCP was a pre-commercial procurement (PCP) project which challenged the market to develop solutions to address unmet healthcare needs, at the same time reducing the risk for developers as buyers share the costs of early-stage research and development. “Companies benefit from developing high-value solutions with ready potential healthcare customers,” says Kjellson from Innovation Skåne(opens in new window) in Sweden, the project host. Multi-country stakeholder engagement, alongside a formal Open Market Consultation(opens in new window), led to the exploration of five use cases: early detection of multimorbidity risk, interdisciplinary collaboration, personalised care, care continuity, and patient and carer participation. Solutions targeted at patients, clinicians and carers were developed through three phases. Nine suppliers participated in phase one (conceptualisation), five in phase two (prototyping) and two in phase three, with the demonstration of two digital solutions. Following the early identification of multimorbidity risks, the solution INCA(opens in new window) offers shared care plans (accessible via an app) which benefit from artificial intelligence (AI) analysis of electronic health records (EHRs) and patient-generated data. Clinicians are supported by tailored clinical guidelines and patients with gamification techniques to encourage compliance. Approaching multimorbidity as a coordination challenge unfolding across conditions and settings, the HOPE-CMX(opens in new window) platform uses AI-assisted pattern recognition for early risk identification, co-developing care plans accessible through an app for patients and web application for clinicians. Additional functions include secure chat, a digital library and graphic visualisation. “Imagine an elderly person currently seeing different specialists for diabetes, heart disease and depression. These platforms connect the holistic care dots, alerting clinicians when a patient’s combined risk profile increases or treatments conflict, while offering carers an overview of a patient’s situation across settings,” adds Kjellson.
Practice, procurement and policy for change at scale
In-person testing of both solutions involved 150 participants across Norway, Spain and Sweden, including 64 patients, 70 clinicians and 16 next of kin. The results from both early-stage solutions were encouraging, outperforming standard usability requirements. “Healthcare professionals highlighted the efficiency of having all information in one system, while patients and next of kin particularly valued improved care communication, guidance and continuity. One patient called it: ‘A step in the right direction toward patient-centred care’, adding ‘I don’t feel like just a body part!’” Kjellson notes. Carematrix PCP highlights PCPs as innovation drivers, also underlined in the Draghi report on EU competitiveness(opens in new window). The project furthermore supports additional EU objectives including the European Health Data Space(opens in new window), advancing the case for data interoperability across care settings. Carematrix PCP made a number of policy recommendations, especially through the 2CARE4EU White Paper(opens in new window). These include ramping up public-private co-financing partnerships, reduced administrative burdens, simplified ethical and regulatory approvals, and financial support post-project.
