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All EU28 countries, Norway and Iceland, run Integrated Care Initiatives (ICI) in efforts to address the new demographic challenges, reduce costs and improve health outcomes. As part of a study commissioned by Chafea and DG SANTE, Optimity Advisors has conducted an extensive review and mapping of ICI across Europe, to assess the level of penetration and adoption of ICI in the 30 countries and evaluate the level of maturity of several healthcare systems. This has allowed to examine the extent of the use of digital tools in ICI. The aim of this presentation will be to look at the relationship between theory and practice, assessing whether assessments of a country's healthcare system in terms of its Digital Health maturity is reflected in its number of digitallyenabled ICI. For each country, the Study Team, in collaboration with researchers from all included nationalities, has identified 573 ICI and analysed their characteristics and implementation. Considering the different elements of the selected initiatives, it was possible to assess the extent to which Digital Health was included in each country. Additional desk research and the use of the Scirocco Maturity Assessment Tool (which has "information and e-Health" as one of its 12 assessment criteria) have then allowed to examine whether a correlation between the number of digitally-enabled ICI per country and the maturity of their integrated care systems exists. Our research has shown that all EU28 countries, Norway and Iceland, have implemented e-Health Strategies. The review found that IC strategies, policies and projects are present in all 30 countries, although their characteristics, depth and breadth of integration are varied. However, based on our repository of ICI, only 79, out of the 573 ICI retrieved, included a digital component. This translates to less than 15%, spread across 18 countries (Spain (16); UK (11); Lithuania (9); Italy (6); Germany (6); Czech Republic (5); Belgium (5); Greece (4); Finland (4); Slovakia (3); Hungary (2); France (2); Cyprus (1); Iceland (1); Norway (1); Croatia (1); Denmark (1); Austria (1)). Contrary to our assumptions, the assessment of integrated care system maturity did not always reflect the number of ICI with digital components retrieved in the repository. For example, while stakeholders from Denmark and Iceland, have self-assessed their "information and e-Health" domain as highly advanced, both countries only have one digitally-enabled initiative listed in the repository. Moreover, while the evidence around integrated care shows that Digital Health is a key component of an integrated system, in practice less than 15% of all the retrieved ICI had a digital component in it. There is therefore a lack of clarity on whether ICI working on health and social care programmes and strategies see e-Health and m-Health as central elements of the integration, or if Digital Health is rather perceived as an additional and complementary element that would assist, rather than drive, their projects. Additional research focusing on the role of Digital Health in practice and on how to raise the Digital Health profile in the ICI landscape across Europe should be considered. [ABSTRACT FROM AUTHOR]

Optimity Advisors conducted the study "Health system performance assessment - Integrated Care Assessment", commissioned by Chafea and DG SANTE, assessing: (i) the state of integrated care (IC) implementation in the EU28 Member States, Norway and Iceland; and (ii) developing an evidence-based Integrated Care Performance Assessment (ICPA) framework. The framework, supported by an Excel tool, was co-designed with stakeholders across Europe. The ICPA tool will be tested by members of the European Innovation Partnership on Active and Healthy Ageing (EIPonAHA), B3 Action Group on Integrated Care. From a review of literature in 24 languages, an extensive mapping of 560 IC initiatives in 30 countries and the maturity assessment of 12 health systems, we inferred that IC strategies, policies, models and projects are present across Europe, but their characteristics, depth and breadth of integration vary considerably. Taking this heterogeneity into account, the framework was codesigned drawing on user-centred design and agile methodologies. Following an iterative approach with regular stakeholder engagement (questionnaires, video-conferences, peer-review webinars, presentations at events, and a validation workshop), experts and practitioners helped us determine which indicators sourced from existing performance assessment frameworks were considered "core" to IC assessment, with the rest proposed as "optional" indicators in the performance assessment model. The core indicators selected were categorised under four domains - Advancement of integration; Use of care services; Health outcomes; Experiences of care- with a fifth overarching domain considering financial issues. Indicators have been re-worded and redefined to make them applicable across the wealth of IC initiatives while offering measures for international comparison. The heterogeneity of the context in which IC initiatives operate in Europe was a key challenge for the development of a framework that had to be relevant and potentially used in all included countries. This was addressed by providing an additional Excel-based ICPA tool offering flexibility in the use of the framework and allowing users to adapt indicators to their context. The tool allows users to compare performance to a set target for each indicator in the ICPA framework. The use of the ICPA framework and tool will help healthcare systems across Europe to further develop their IC system - based on their current state and context - and could significantly help them achieve better health outcomes and care experiences. The use of user-centred design and agile methodologies are proved methods of finding useful solutions to common challenges. Our research indicates that these principles also apply in the area of health performance assessment and can support IC implementation. Without user engagement, there was a risk that the output of the study would not provide the value sought. As IC evolves, the framework will need to be updated and adapted to new circumstances. Further user engagement and testing is recommended to ensure usability. With the research concluded, the framework and tool will need to be tested in practice through the involvement of members of the B3 Action Group of the EIPonAHA. Preliminary results will be resented at ICIC19. A web-based tool could facilitate uptake and data collection and analysis. [ABSTRACT FROM AUTHOR]

Background: Funded by the Third EU Public Health Programme, Optimity Advisors has followed up on the work carried out by the Health System Performance Assessment HSPA Expert Group in the development of an assessment framework for integrated care. The study conducted has assessed the level penetration and adoption of integrated care in the EU28, Norway and Iceland, and the level of maturity of several health systems at national, regional and local level. Through engagement with stakeholders in the integrated care field, a new, user-friendly framework for the performance assessment of integrated care has been co-developed and further validated by Optimity Advisors, DG SANTE i.e. Directorate-General for Health and Consumers of the European Union, CHAFEA Consumers, Health, Agriculture and Food Executive Agency and stakeholders across the integrated care community in the 28 Member States, Norway and Iceland. The Integrated Care Performance Assessment Framework was developed based on previously validated frameworks, such as the WHO 2015 framework People-centred and integrated health services: an overview of the evidence. Aims and Objectives: The main objective of this workshop will be to communicate the preliminary results and the experience of using the framework to assess the performance of a number of integrated care systems at local, regional and national level. Format: The agenda for the workshop will be as follows: Introduction to the methodological approach and preliminary outputs of the framework, by Optimity Advisors and DG SANTE; Presentation by one or two representatitves of integrated care projects who have contributed in the co-design of the framework explaining the design process; Demonstration of the use of the framework by representatitves of integrated care projects, who will show how to obtain a performance profile for integrated care systems; Group discussion on the different conditions in different health systems that can enhance, or limit the adoption of the framework, and on what could be done to minimise the barriers and maximise facilitating conditions; Conclusion by the facilitators on future steps to address the issues raised by the attendees, and final remarks. Target audience: We envision the target audience of the workshop to be comprised of individuals who have an integrated care performance assessment need, including health managers, policy makers, and other stakeholders that are directly involved in decision-making actions within integrated health systems. Learnings/Take away: By the end of the session, we expect attendees to i have an understanding of a new way to assess the performance of integrated care systems, ii develop a performance profile and actionable roadmap for performance improvement of an integrated care system of their choosing. [ABSTRACT FROM AUTHOR]