GATEKEEPER’s Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases Journal of Medical Internet Research
Abstract Methods Results Discussion Principal Results Conclusions Abbreviations Footnotes References Abstract Background The World Health Organization’s strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs. Objective We aim 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 the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring 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 socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence–based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors. Conclusions This paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space. Keywords: big data, chronic diseases, eHealth, healthy aging, integrated care, large-scale pilots
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Jordi de Batlle, Ivan D Benítez, Anna Moncusí-Moix et al.. GATEKEEPER’s Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases. Journal of Medical Internet Research. (2023). https://doi.org/10.2196/42187 Jordi de Batlle, Ivan D Benítez, Anna Moncusí-Moix, Odysseas Androutsos, Rosana Angles Barbastro, Alessio Antonini, Eunate Arana, Maria Fernanda Cabrera-Umpierrez, Gloria Cea, George Ε Dafoulas, Frans Folkvord, Ane Fullaondo, Francesco Giuliani, Hsiao-Ling Huang, Pasquale F Innominato, Przemyslaw Kardas, Vivian W Q Lou, Yannis Manios, Maria Matsangidou, Franco Mercalli, Mounir Mokhtari, Silvio Pagliara, Julia Schellong, Lisa Stieler, Konstantinos Votis, Paula Currás, Maria Teresa Arredondo, Jorge Posada, Sergio Guillén, Leandro Pecchia, Ferran Barbé, Gerard Torres, Giuseppe Fico
1Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain 2Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain 3Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece 4Unidad de Innovación, Servicio Aragonés de Salud, Hospital de Barbastro, Barbastro, Spain 5Knowledge Media Institute, The Open University, Milton Keynes, United Kingdom 6Biocruces Bizkaia Health Research Institute, Osakidetza, Barakaldo, Spain 7Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain 8E-health Department, Digital Cities of Central Greece, Trikala, Greece 9Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, University of Thessaly, Larisa, Greece 10PredictBy, Barcelona, Spain 11Tilburg School of Humanities and Digital Sciences, Tilburg, Netherlands 12Kronikgune Institute for Health Services Research, Barakaldo, Spain 13Innovation and Research Department, Fondazione Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Italy 14Department of Healthcare Management, Office of International and Cross-Strait Affairs, Yuanpei University of Medical Technology, Hsinchu, Taiwan 15Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom 16Warwick Medical School & Cancer Research Centre, University of Warwick, Coventry, United Kingdom 17Faculty of Medicine, Paris-Saclay University, Villejuif, France 18Medication Adherence Research Centre, Department of Family Medicine, Medical University of Lodz, Lodz, Poland 19Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China 20Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece 21Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece 22Cyens Centre of Excellence, Nicosia, Cyprus 23MultiMed Engineers srl, Parma, Italy 24Scientific Direction, Institut Mines-Telecom, Paris, France 25National University of Singapore, Singapore, Singapore 26School of Engineering, University of Warwick, Coventry, United Kingdom 27Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany 28Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece 29Innova & European Projects Office, Integrated Health Solutions, Medtronic Ibérica S.A. Madrid, Spain 30Mysphera S.L. Paterna, Spain 31See Acknowledgments 