Congestive Heart Failure Clinical Trial
Official title:
SmartCare Project: Joining up ICT and Service Processes for Quality Integrated Care in Europe
Against the background of the European Innovation Partnership on Active & Healthy Ageing,
SmartCare aims to define a common set of standard functional specifications for an open ICT
platform enabling the delivery of integrated care to older European citizens.
In the context of SmartCare, a total of 23 regions and their key stakeholders will define a
comprehensive set of integration building blocks around the challenges of data-sharing,
coordination and communication. Nine regions will then deploy integrated health & social
services to combat a range of threats to independent living commonly faced by older people,
while the others will prepare for early adoption, possibly in the framework of new ICT PSP
projects. In a rigorous evaluation approach, the deployment sites will produce and document
much needed evidence on the impact of integrated care, developing a common framework suitable
for other regions in Europe. The organisational and legal ramifications of integrated care
will be analysed to support long term sustainability and upscaling of the services.
SmartCare services will provide full support to cooperative delivery of care, integrated with
self-care and across organisational silos, including essential coordination tools such as
shared data access, care pathway design and execution, as well as real time communication
support to care teams and multi-organisation access to home platforms. In addition, they will
empower all older people according to their mental faculties to take part in effective
management of their health, wellness, and chronic conditions, and maintain their independence
despite increasing frailty.
The SmartCare services build on advanced ICT already deployed in the pioneer regions,
including high penetrations of telecare and telemonitoring home platforms. In SmartCare,
these platforms are to be opened to cross-sectorial care teams, improving the ability of
older people to better manage their chronic conditions at home and deal with their increasing
frailty. System integration will be based, whenever possible, on open standards' multivendor
interoperability will be strongly encouraged.
This trial will evaluate the functions and impacts of the SmartCare pilot services from the
point of view of the different principal roles/stakeholders, such as end users (care
recipients), voluntary and non-voluntary informal carers, formal care staff/professionals,
managers and fund-holders. Evaluation of integrated care service delivery processes (process
evaluation) will improve the current scientifically based knowledge base on barriers and
facilitators towards integrated care delivery.
Comparators were chosen to be current delivery of health and social care processes ('normal
care'), as provided by pilot sites individually. The project uses local scenarios as the
comparator in order to enable the evidence generated to contribute to local decision making
on using the technologies. Thus, the control groups were as similar as possible to the
intervention groups (receiving 'new care'). In addition, a number of possible confounding
factors were measured for all participants.
The overall aim of the scientific studies carried out in SmartCare is: To identify the
differences induced by implementing ICT supported integrated health and social care.
Any impact that ICT supported integrated health and social care might have on all users will
be the subject of analyses according to the framework presented in the MAST model (Kidholm et
al. 2012).
In addition, the objectives that will be tested in SmartCare are:
- Difference in number of contacts to health care.
- Difference in number of contacts to social care.
- Differences in use of health care services.
- Differences in use of social care services.
- Differences in costs.
- Differences in organisational aspects caused by implementing ICT supported integrated
care.
- Difference in end-user empowerment.
- Difference in end-user satisfaction.
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