Background Coordination of care plans between healthcare sectors and efficient management of patients (pts) with co-morbidities is of large demand. Rheumatoid arthritis (RA) pts are at increased risk of cardiovascular diseases (CVD). Different stakeholders are potentially involved in the EULAR recommended management processes. Optimized orchestration of accumulated information is of major importance to ensure data quality, meaningful management processes and cost effectiveness. A newly developed information and communications technology (ICT) platform within the Horizon2020-funded PICASO-project (www.picaso-project.eu)will support a continuum of care from hospitals and outpatient clinics to the home.
Objectives Explore challenges to provide an efficient ICT integrated solution across many healthcare professionals working for various organisations and potentially crossing national borders that complies to privacy and regulatory constraints allowing more efficient care management. Suitable system architecture and appropriate features require identification of target users' user requirements. PICASO platform will be developed and trialed with pts and clinician. The proposed system architecture will be evaluated for suitability for a larger scale rollout.
Methods Projects' pre-defined clinical and technological driven work packages started. Various stakeholders (e.g. pts, local data security and IT representatives, health care insurances' representatives, clinicians) were integrated in the design phase. A PICASO ethical board including external members (e.g. Chair of the Standing Committee of PARE) addressed ethical and legal concerns.
Results Current work-flows for the care plan management including stakeholders' hand-over procedures were elaborated. Vision scenarios (n=11) and To-Be Use Cases (n=18) addressing solutions including home monitoring were developed (1). A comprehensive list of user requirements (currently n=87) resulted. Detailed system architecture descriptions are stipulated. Ethical issues and how to handle these, in particular data-protection and -privacy challenges were pre-assigned as these affect platforms' architecture. PICASO ethical principles and guidelines were stated (2). The platform is under development. The first trial running over nine months including RA-pts will start in spring 2017. First experiences will be reported at EULAR.
Conclusions Considering the needs of a highly valued, specialised health care system relevant To-Be Use Cases, numerous user requirements and EU-wide ethical and legal issues were gathered to serve as basis for appropriate design, development and implementation of the ICT platform. Software development will take place in iterative cycles followed by prototypes' thoroughly evaluated by real end users investigating usability and acceptance. The platform will become available for RA-pts in routine care but also for wider applicability in Rheumatology and other chronic diseases.
PICASO Consortium (2016), D2.1 Scenarios and Use Cases for Integrated Care. http://www.picaso-project.eu/download/4894.
PICASO Consortium (2016), D3.3 PICASO Ethical Guidelines. http://www.picaso-project.eu/download/520/;both last accessed 27/01/2017.
Acknowledgements This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 689209.
Disclosure of Interest None declared