European Innovation Partnership on Active and Healthy Ageing. Action Group C2 Interoperable Independent Living Solutions

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1 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 June 2012

2 Agenda: Day 1: 21 st of June Registration and lunch Welcome and introduction from the EC Introduction of participants Presentation of mapping of commitments Discussion on major areas of activity First conclusions and summary Closing Cocktail and networking

3 Agenda: Day 2: 22nd of June Opening Presentations of outline action plan and monitoring framework Identification of Working Groups, major tasks and first allocation of participants Lunch Governance principles Logistics and infrastructure for working groups and action group Tasks to be performed before next meeting Conclusions and next steps Closing

4 Welcome and introduction

5 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

6 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

7 Three-step process stakeholder involvement Public consultation 524 submissions Steering Group Workshops Mapping of research Care&Cure Prevention, early diagnosis Active ageing & independent living Strategic Implementation Plan Steering Group 7 th of November 2011 Fiches with actions 127 submissions

8 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

9 Strategic Framework of the EIP on AHA Regulatory and standardisation conditions Effective funding Horizontal issues Evidence base, reference examples, repository for age-friendly innovation Marketplace to facilitate cooperation among various stakeholders Prevention, screening & early diagnosis Health literacy, patient empowerment, ethics and adherence Personal health management Prevention, early diagnosis of functional and cognitive decline Care & Cure Guidelines for care, workforce (multimorbidity, polypharmacy, frailty and collaborative care) Multimorbidity and R&D Capacity building and replicability of successful integrated care systems Active ageing & independent living 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 New paradigm of ageing Innovation in service of the elderly people Vision / Foundation Focus on holistic and multidisciplinary approach Development of dynamic and sustainable care systems of tomorrow

10 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

11 European Innovation Partnership Commitments FI ALL 261 Spain 63 Netherlands 34 Belgium 29 UK 27 SE Italy 26 Portugal 18 DK Germany 11 Denmark 8 IE UK NL PL France 8 Ireland 7 Greece 6 Finland 6 Sweden 4 BE LU DE AT Poland 2 Austria 1 Luxembourg 1 FR SL Malta 1 Slovenia 1 All Non EU 8 A1: Prescription and adherence PT IT A2: Falls Prevention Initiative GR A3: Functional decline and frailty B3: Integrated care for chronic diseases ES Invitations for Commitment C2: Interoperable independent living solutions Partners breakdown MT D4:Age friendly environments

12 Commitments / Reference Sites statistics A1: Adherence A2: Falls prevention A3: Functional decline B3: Integrated care C2: ILS D4: Age-friendly Commit Total Reference Site Reference Site Commit Total B3: Integrated care C2: ILS D4: Age-friendly A3: Functional decline A2: Falls prevention A1: Adherence

13 European Innovation Partnership Reference Sites DK 1 SE 2 FI Total: 54 candidate Reference Site applications 2 IE UK NL 1 DE 1 CZ NL 67 FR 1 SI 1 PT ES 14 9 IT 2 GR 2 Invitations for Commitment Partners breakdown

14 Introduction Interoperable Independent Living Solutions

15 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

16 C2: Objective Enhancing deployment and take up of interoperable independent living solutions based on open standards.

17 C2: Action ready to be launched Development of interoperable independent living solutions, including guidelines for business models.

18 C2: Deliverables 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 users.

19 C2: Envisaged Activities 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 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 ( users) to develop comprehensive socio-economic evidence on impact from innovation.

20 C2: Specific Conditions 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.

21 Aims of the meeting Interoperable Independent Living Solutions

22 Aims of the meeting 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

23 Introduction of participants Interoperable Independent Living Solutions

24 Mapping of commitments Interoperable Independent Living Solutions

25 Working Groups Interoperable Independent Living Solutions

26 C2: Possible Working Groups Interoperability and standardisation Implementation Socio-economic evidence

27 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

28 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

29 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

30 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

31 First conclusion and summary

32 Day 2

33 Agenda: Day 2: 22nd of June Opening Presentations of outline action plan and monitoring framework Identification of Working Groups, major tasks and first allocation of participants Lunch Governance principles Logistics and infrastructure for working groups and action group Tasks to be performed before next meeting Conclusions and next steps Closing

34 Action Plan 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?

35 C2: Objective Enhancing deployment and take up of interoperable independent living solutions based on open standards.

36 C2: Action ready to be launched Development of interoperable independent living solutions, including guidelines for business models.

37 C2: Deliverables 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 users.

38 Monitoring Framework

39 HLY At birth EIP Monitoring Framework +2 Healthy Life Years Triple Win Quality of Life Sustainability of Care Establish the link Innovation-based Competitiveness JRC: Theory & Modelling Outcome indicators Outcome indicators e.g: - Less hospitalisation - Less depressed people Process indicators Process indicators Input indicators e.g.: -Time -Money -Number of organisations Output indicators e.g.: -Number of regions involved -Number of patients involved -New services: 24/7-telephone Action Groups Individual actions Individual Actions

40 HLY At birth + Healthy Life Years Triple Win Quality of Life physical and cognitive function Sustainability of care systems facility/hospital admissions &cost of health services Innovation-based competitiveness Establish the link (theory & modelling JRC) Outcomes for model group (100 patients) Outcome indicators Process indicators Improved QoL and HLY 50% slower in cognitive function 5.1% of physical condition 70% slower in depression no of medications Input indicators Partners: a hospital, academia, social security entity, national research council, state local authority facility/hospital admissions 33% in hospital admissions and nursing home visits 65% in emergency room visits 50% in length of stay in hospital & nursing home cost of health services savings of 1000 euro per person per year 19% in community health services costs 48% in nursing home costs 34% in hospital expenses Output indicators Geographical coverage of the model: northern Italy + 15 replicated regions Target group: 100 patients X 15 = > 1500 Market growth Telehealth Telemonitoring EMRS Integrated care models Individual actions Replication of integrated social and health case management model for frail elderly people

41 Type of outcome indicators possible ideas HLY Quality of Life Rate of decline of suicide, depression; improved social interaction; increased physical activity. Sustainability of health systems Delayed institutionalisation; Reduced hospital, GP and home care visits; More initiatives with a positive return of investment for independent living solutions Innovation and Growth Number of favourable business/investment cases, public procurements, common service specifications.

42 Monitoring roadmap November 2012: Defined outcome and process indicators December 2012: First results process indicators March/April 2013: First results outcome indicators Start extrapolating October 2013: Start econometric modelling

43 Monitoring interpretation data Trends Not comparing countries / stakeholders Extrapolating Econometric modelling

44 Monitoring Action Group activity Identify contact persons for indicators Liaise with INFSO/SANCO Identify and provide relevant data

45 Activities

46 Working groups Interoperability and standardisation Implementation Socio-economic evidence

47 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

48 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 followup: 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

49 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)

50 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

51 Governance principles

52 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

53 Logistics and infrastructure 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

54 Marketplace for innovative ideas An interactive online platform, open to all stakeholders willing to get involved in the Partnership 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

55 Timetable and next steps 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?

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