Focus Article: INTRODUCING THE JOINT ACTION

The ageing of the population with the growing burden of chronic conditions and multimorbidity, is steadily increasing the demand for more extended and efficient care and a more intelligent outcome-based delivery of personalized care. Innovative solutions are needed to deliver efficient integrated person-centred services based on citizens’ needs through new technologies, products, and organisational changes. Digital innovation tools and services have the potential to facilitate and support these changes towards delivering more targeted, personalised, and high-quality healthcare to the population. The EU has initiated a variety of initiatives to address these difficulties, including the Joint Action (JA) on the implementation of digitally enabled integrated person-centred care (JADECARE).

JADECARE intends to reinforce the capacity of health authorities to successfully address important aspects of health system transformation, in particular the transition to digitally enabled, integrated, person-centred care. It is focusing on the transfer and adoption of four original Good Practices (oGPs) from their “Early Adopters” to 23“Next Adopters”. The oGPs concern integrated care, chronic conditions, multimorbidity, frailty and complex needs, self-care, prevention and population health, disease and case management. The project started on October 1st, 2020 and ends on September 30th, 2023.

The oGPs to be transferred are the Basque Health Strategy in ageing and chronicity: integrated care (Basque Country, Spain); the Catalan open innovation hub on ICT-supported integrated care services for chronic patients (Catalonia, Spain); the OptiMedis Model – Population-Based Integrated Care (Hamburg, Germany) and the Digital roadmap towards an integrated health care sector (Region of Southern Denmark, Denmark).

JADECARE involves 48 organisations from 17 European countries. During the JA, health authorities will improve knowledge in implementation and process evaluation methodologies including sustainability strategies.

In order to support the transfer the local environments for the implementation are analysed and prepared in a pre-implementation phase. The methodology of the implementation will allow the transfer in different contexts: socioeconomic, cultural, legal, models and maturity of health systems. A learning community is being created for developing, collecting and exchanging knowledge through “twinning actions” and dedicated seminars and workshops.

During the implementation, elements of sustainability are being addressed from the beginning. JADECARE’s long-term impact will be aided by incorporating stakeholders in governing bodies who can provide political support and guidance and commitment to integrated care.

JADECARE will impact European health systems by implementing innovative digital integrated care solutions and helping to change the care delivery model. It will lay the grounds for implementing integrated care on a large scale by demonstrating how to share successful practices and develop innovative/tailored approaches. This will also have an impact on healthcare professionals, patients, caregivers, general population, health authorities and the industrial sector.

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Focus Article: LEARNING FROM ORIGINAL GOOD PRACTICES: CORE ELEMENTS OF SUSTAINABILITY

In JADECARE, we have several different activities dedicated to supporting Next Adopters in their sustainability planning process. Making small steps from the very beginning of practice development and implementation, increases the potential to sustain each practice far beyond JADECARE.

Leaning on past experiences of “Early Adopters” in original Good Practices, we conducted in-depth group interviews with key representatives, who have a broad historical perspective on how sustainability of their practices was achieved. With their support, we have gained important insights, lessons learnt and recommendations for Next Adopters. The newly acquired knowledge is now available to all JADECARE partners by means of reports, webinars and other supporting materials.

While there are numerous contextual differences between countries/healthcare systems where the original Good Practices are implemented, there are three overlapping core elements of sustainability, that were commonly regarded as highly important.

• Policy environment: The practices are embedded in the national or regional policy frameworks (health strategies, policies, funding mechanisms) and strong vertical linkages were established between relevant institutions and networks. The important feature is also the presence of political consensus on the needs, objectives and strategies on how to achieve health system transformation, resilient to political changes.
• Sustainability of ownership: Each original Good Practice is complex, consisting of a variety of interventions and there are different governance structures that are responsible for its continuity. Sustainability is facilitated by high level policy individuals, managers and champions, regional/local health organisations and departments, and/or integrator companies which engage in various formal and informal networks.
• Culture of collaboration and consensus seeking: Culture as a set of beliefs, values, behaviours, perceptions and local conventions strongly influences practice implementation and its sustainability. Collaboration and consensus seeking across all stakeholders were recognized as imperative features of their local environments and a basis for assuring continuity of practices.

Our current initiatives in JADECARE use these results to frame and support sustainability planning process of Next Adopters, including the development of their Sustainability strategy and Action plan and building networks with their policy makers. In this respect, past experiences and successes of original Good Practices provide valuable, if not indispensable, support.

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