Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 12, 2022
Open Peer Review Period: Sep 12, 2022 - Nov 7, 2022
Date Accepted: Feb 26, 2023
(closed for review but you can still tweet)
GATEKEEPER's Strategy for the Multinational Large-scale Piloting of an eHealth Platform: a Tutorial on How to Identify Relevant Settings and Use Cases.
ABSTRACT
Background:
The World Health Organization strategy toward healthy ageing fosters person-centred integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms capable of accommodating and interconnecting multiple of these systems while ensuring secure, relevant, and trust-based data sharing and utilization. The H2020 project GATEKEEPER aims to implement and test an open source, European, standard-based, interoperable, and secure framework serving broad populations of ageing citizens with heterogeneous needs.
Objective:
To describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform.
Methods:
The selection of implementation sites and reference use cases (RUCs) was based on: (i) the adoption of a double stratification pyramid reflecting the overall health of target citizens as well as the intensity of proposed interventions; (ii) the identification of a set of principles guiding the selection of implementation countries and sites; and, (iii) the elaboration of some guidelines for RUC selection, aiming to ensure clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities.
Results:
Seven European countries were selected covering Europe’s geographical and socio-economic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented with three Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems including healthcare organisations and partners from industry, civil society, academia and government. RUCs covered the whole spectrum of chronic conditions, citizen complexities and intervention intensities while privileging clinical relevance and scientific rigour. These embraced: lifestyle-related early detection and tailored interventions; management of chronic obstructive pulmonary disease exacerbations; predictive modelling of glycaemic status in diabetes mellitus; treatment decision support systems for Parkinson’s disease; predicting decompensations in Heart Failure; primary and secondary stroke prevention; multi-chronic elderly patient management; management of High Blood Pressure; and management of COVID-19.
Conclusions:
The presented approach, provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks or platforms.
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