Life expectancy has increased greatly in EU countries over the past few decades, particularly for elder people living with chronic diseases and disabilities. Chronic diseases such as cancer, diabetes, and cardiovascular diseases, are the leading cause of mortality in Europe, and research suggests that complex conditions such as depression will impose an even larger burden in the future.
What these diseases have in common is their need for a long-term and complex care response, coordinated by different health professionals with access to the necessary drugs and equipment, and their extension into social care. Most health care today, however, is still structured around acute episodes and involves a multitude of actors.
“The efficient management of chronic conditions is a challenge to all healthcare systems worldwide. We need new models of care to guarantee that people still have a good quality of life, although they might suffer from chronic conditions,” says Dr. Janika Blömeke, Deputy Head of Research and Innovation at OptiMedis – a German company for management, analysis and research in health care.
She is part of the ADLIFE consortium, an EU Horizon 2020-funded project aiming to improve the quality of life and independence of elderly people living with advanced chronic conditions (Chronic Obstructive Pulmonary Disease and Chronic Heart Failure) through smart digital health and integrated care technologies.
The researchers involved in ADLIFE intend to extend the concept of integrated care. In the development of a digital toolbox, three platforms allow and encourage patients to play a more active role in managing their own health, and enable different care providers to collaborate and optimize multidisciplinary care activities. With that, ADLIFE focuses on the empowerment of patients and their caregivers by providing personalized and coordinated care planning with an early detection of care needs.
A personalized integrated care approach
These solutions would address one of the main challenges of the current health system, which is structured in different sectors and involves different healthcare providers, making patient record data transfer and health services delivery and efficiency difficult.
“Traditionally, care has been fragmented, leading people with heart failure to have multiple healthcare contacts with professionals, some involving admissions or visits to the emergency department. They have found themselves in situations where professionals demonstrate differing judgements and poor internal communication. These scenarios often result in contradictory instructions and messages to people with heart failure, leading to feelings of helplessness and frustration,” says Beñat Zubeltzu, a clinician who specialises in internal medicine and is involved in the project.
is to minimise all these negative aspects so that people can move through the healthcare system in a more user-friendly way. Recommendations to patients are made in a shared digital environment, easily accessible to patients and professionals. Ultimately, the aim is to enhance patients’ quality of life by improving symptom and pain control and slowing down the progression of the disease using smart technologies.
How does it work? The personalised care plan management platform
offers the development and use of dynamic, tailored, and integrated care plans that enable efficient collaboration and care coordination between multidisciplinary care teams Incorporated clinical decision support services
suggest personalised goal and intervention recommendations based on evidence-based clinical guidelines and the patient's medical summary. They allow healthcare professionals to respond quickly to changing needs by, for example, sending alerts to the physician.
To support patients in following and adhering to their care plans, ADLIFE provides a patient empowerment platform
to patients and their informal caregivers, to reinforce their capacity to take control of their circumstances, to adhere to the care plan and to achieve care plan goals (e.g., through reminders) and to be actively involved in the development and implementation of their care plan. Through the platform patients can access their care plans, upload data, communicate with the healthcare team, make appointments or access educational resources.
Before rolling out the technology, the digitally based integrated care ADLIFE model will be tested in seven pilot sites: one in Sweden, Spain, Germany, Denmark, Israel and two sites in the UK.
Research exploitation support through Horizon Results Booster
The ADLIFE researchers strongly believe that their findings can be scaled up to routine practices. However, adapting and integrating them into the clinical care system takes significant effort and involves additional stakeholders beyond the research or the clinical community.
One of the challenges the team faces is having several different countries and healthcare systems with different national, regional, and local needs and a diverse market context.
“It was already very useful because we had to prepare several different documents that helped the consortium figure out what our expectations and scaling up intentions are because so far, we focused more on the whole deployment phase and getting the tools ready,” Dr. Janika Blömeke says.
She believes that working on the exploitation of research early in the process, characterizing the key results, identifying the target groups and planning the revenue mechanism is very useful for envisaging the impact of the research and even identifying potential gaps or needs, especially in projects with various target groups and stakeholders. Also, good teamwork with partners sharing the same exploitation intention is key in successfully exploiting the ADLIFE digital platforms and achieving impact in healthcare systems.
The business plan development service supported the team further in identifying the best way of bringing the ADLIFE solution to the market. Here, they also looked into the activities that are needed after the end of the project to exploit the ADLIFE digital platforms and developed a first version of a lean business canvas.
This phase can also be challenging, as new pharmaceuticals and medical devices that can improve treatment for people with chronic conditions face difficulties in terms of marketing authorization, organisational adoption, and reimbursement. Hence, the exploitation efforts of the ADLIFE toolbox are heavily dependent on the rapidly changing landscape of European health service delivery systems and market entry and implementation of digital tool sets.
Dr. Janika Blömeke from OptiMedis AG at the 6th ADLIFE Plenary Meeting in Hamburg, Germany 14th and 15th of June 2023
Why is it important?
The global elderly population, which is more susceptible to chronic diseases, is steadily increasing. This has led to a silent epidemic of chronic illnesses that has received less attention compared to highly-publicized infectious diseases like HIV/AIDS or tuberculosis.
Based on the findings from the Survey on Health, Ageing and Retirement in Europe (SHARE)
, approximately 37% of individuals aged 65 and above, on average across EU countries, reported having at least two chronic diseases. Notably, women tend to report multiple chronic diseases more frequently than men, with an average of 41% for women compared to 32% for men. As expected, the prevalence of chronic diseases rises with age. Among individuals aged 80 and above, an average of 56% of women and 47% of men report having multiple chronic diseases across EU countries.
The economic consequences of such diseases are significant. Chronic illnesses have a detrimental impact on wages, earnings, workforce participation, and labor productivity. They contribute to early retirement, high job turnover, and disabilities. Moreover, these diseases impede household consumption and hinder educational performance, ultimately affecting the overall gross domestic product (GDP). As the expenditure on chronic care escalates throughout Europe, it consumes an increasingly larger portion of public and private budgets.
Many chronic diseases and conditions are associated with an aging society, but they are also influenced by lifestyle choices such as smoking, sexual behavior, diet, exercise, and genetic predispositions.