empirica is in charge of evaluation as part of new EU funded project C3-Cloud: A Federated Collaborative Care Cure Cloud Architecture for Addressing the Needs of Multimorbidity and Managing Polypharmacy.

The challenge
Older age is associated with an increased accumulation of multiple chronic conditions: multimorbidity. More than half of all older people have at least three chronic conditions, and a significant proportion has five or more. Multimorbidity creates diverse and sometimes contradictory needs which challenge patients and the delivery of health services. Unfortunately, current European medical models (e.g. as directed by clinical guidelines) focus primarily on short and medium term interventions on the basis of single conditions, failing to integrate care planning well across providers and often overlooking the interconnected basis of chronic diseases. Polypharmacy induced by multimorbidity itself is an important factor that leads to significant follow-on problems for patients and costs to the healthcare system. Managing multimorbidity, through the current treatment methods, results in specialty silos and fragmented care. Hence, the over-arching societal challenge that motivates C3-Cloud is: How can we effectively care for and support multimorbid elderly patients through advanced ICT solutions?

The aim
C3-Cloud has a planned duration of 48 months during which it will establish an ICT infrastructure enabling a collaborative care and cure cloud to enable continuous coordination of patient-centred care activities by a multidisciplinary care team and patients/informal care givers. A Personalised Care Plan Development Platform will allow, for the first time, collaborative creation and execution of personalised care plans for multimorbid patients through systematic and semi-automatic reconciliation of clinical guidelines, with the help of Decision Support Modules for risk prediction and stratification, recommendation reconciliation, poly-pharmacy management and goal setting.

Active patient involvement and treatment adherence will be achieved through a Patient Empowerment Platform ensuring patient needs are respected in decision making and taking into account preferences and psychosocial aspects. Co-design and 4-layered multi-method multi-stakeholder evaluation will lead to a user friendly solution. To demonstrate feasibility, pilot studies will focus on diabetes, heart failure, renal failure, depression in different comorbidity combinations. Pilots will operate for 15 months in 3 European regions with diverse health and social care systems and ICT landscape, which will allow for strengthening the evidence base on health outcomes and efficiency gains.

Our role
empirica leads Work Package 9 on “Evaluation and Impact Assessment”, in which we define different approaches to evaluate the complex clinical, technical and organisational nature of the C3-Cloud components and pilot application. In addition, we develop an impact modelling tool to predict the impact of the application when implemented at scale. Work Package 9 will pursue continuous testing activities by professionals, patients and informal carers, that will assure the usability, quality and correctness of C3-Cloud components. User training workshops will be organised in this context and a model of the impact of C3-Cloud integrated care pilot application in relation to current scenarios will be elaborated.

The project receives funding from the Horizon 2020 Framework Programme of the European Union under grant agreement n-° 689181.
Partners
University of Warwick (UK)
SRDC (Turkey)
INSERM (France)
EuroRec (France)
empirica (Germany)
Medixine (Finland)
South Warwickshite NHS Foundation (UK)
Servicio Vasco de Salud: Osakidetza (Spain)
Kronikgune (Spain)
Örebro University (Sweden)
Region Jämtland Härjedalen (Sweden)
Cambio Healthcare Systems (Sweden)