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.