The journal of nutrition, health & aging

, Volume 20, Issue 10, pp 1024–1033 | Cite as

DG connect funded projects on information and communication technologies (ICT) for old age people: Beyond Silos, CareWell and SmartCare

  • W. Keijser
  • E. De Manuel-Keenoy
  • M. D’Angelantonio
  • P. Stafylas
  • P. Hobson
  • G. Apuzzo
  • M. Hurtado
  • J. Oates
  • Jean Bousquet
  • A. Senn


Information and communication technologies (ICT) are promising for the long-term care of older and frequently frail people. These innovations can improve health outcomes, quality of life and efficiency of care processes, while supporting independent living. However, they may be disruptive innovations. As all European member states are facing an increasing complexity of health and social care, good practices in ICT should be identified and evaluated. Three projects funded by DG CNECT are related to Active and Healthy Ageing (AHA) and frailty: (i) BeyondSilos, dealing with independent living and integrated services, (ii) CareWell, providing integrated care coordination, patient empowerment and home support and (iii) SmartCare, proposing a common set of standard functional specifications for an ICT platform enabling the delivery of integrated care to older patients. The three projects described in this paper provide a unique pan-European research field to further study implementation efforts and outcomes of new technologies. Below, based on a description of the projects, the authors display four domains that are in their views fundamental for in-depth exploration of heterogeneity in the European context: 1. Definition of easily transferable, high level pathways with solid evidence-base; 2. Change management in implementing ICT enabled integrated care; 3. Evaluation and data collection methodologies based on existing experience with MAST and MEDAL methodologies; and 4. Construction of new models for delivery of health and social care. Understanding complementarity, synergies and differences between the three unique projects can help to identify a more effective roll out of best practices within a varying European context.

Key words

e-health ICT integrated care clinical pathway health technology assessment predictive model change management Beyond Silos CareWell SmartCare 


  1. 1.
    Bousquet J, Jorgensen C, Dauzat M, Cesario A, Camuzat T, Bourret R, et al. Systems medicine approaches for the definition of complex phenotypes in chronic diseases and ageing. From concept to implementation and policies. Curr Pharm Des. 2014;20(38):5928–44.PubMedGoogle Scholar
  2. 2.
    Bahler C, Huber CA, Brungger B, Reich O. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Serv Res. 2015;15:23.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Orueta JF, Garcia-Alvarez A, Garcia-Goni M, Paolucci F, Nuno-Solinis R. Prevalence and costs of multimorbidity by deprivation levels in the basque country: a population based study using health administrative databases. PLoS One. 2014;9(2):e89787.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Frandsen BR, Joynt KE, Rebitzer JB, Jha AK. Care fragmentation, quality, and costs among chronically ill patients. Am J Manag Care. 2015;21(5):355–62.PubMedGoogle Scholar
  5. 5.
    Clarfield AM, Bergman H, Kane R. Fragmentation of care for frail older people—an international problem. Experience from three countries: Israel, Canada, and the United States. J Am Geriatr Soc. 2001;49(12):1714–21.PubMedGoogle Scholar
  6. 6.
    Nolte E, Knai C, Hofmarcher M, Conklin A, Erler A, Elissen A, et al. Overcoming fragmentation in health care: chronic care in Austria, Germany and The Netherlands. Health Econ Policy Law. 2012;7(1):125–46.CrossRefPubMedGoogle Scholar
  7. 7.
    Janse B, Huijsman R, de Kuyper RD, Fabbricotti IN. The effects of an integrated care intervention for the frail elderly on informal caregivers: a quasi-experimental study. BMC Geriatr. 2014;14:58.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Gustafson DH, Sr., McTavish F, Gustafson DH, Jr., Mahoney JE, Johnson RA, Lee JD, et al. The effect of an information and communication technology (ICT) on older adults’ quality of life: study protocol for a randomized control trial. Trials. 2015;16:191.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Peetoom KK, Lexis MA, Joore M, Dirksen CD, De Witte LP. Literature review on monitoring technologies and their outcomes in independently living elderly people. Disabil Rehabil Assist Technol. 2015;10(4):271–94.CrossRefPubMedGoogle Scholar
  10. 10.
    Banta D, Behney CJ. Medical technology: policies and problems. Health Care Manage Rev. 1980;5(4):45–52.PubMedGoogle Scholar
  11. 11.
    Bingefors K, Pashos C, Smith M, Berger M. Health Care Cost, Quality, and Outcomes: ISPOR Book of Terms. Lawrenceville, NJ. International Society for Pharmacoeconomics & Outcomes Research,; 2003.Google Scholar
  12. 12.
    Drummond M, Sculpher M, Torrance G, O’Brien B, Stoddart G. Methods for the Economic Evaluation of Health Care rogrammes. Oxford: Oxford University Press, 2005.Google Scholar
  13. 13.
    Ross J, Stevenson F, Lau R, Murray E. Exploring the challenges of implementing e-health: a protocol for an update of a systematic review of reviews. BMJ Open. 2015;5(4):e006773.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Wood J. Complexity Avalanche -Overcoming the Threat to Technology Adoption. 2009:ISBN: 978-0-9842130-0-9.Google Scholar
  15. 15.
    Glasgow RE, Phillips SM, Sanchez MA. Implementation science approaches for integrating eHealth research into practice and policy. Int J Med Inform. 2014;83(7):e1–11.CrossRefPubMedGoogle Scholar
  16. 16.
    Connelly K, Laghari K, Mokhtari M, Falk TH. Approaches to understanding the impact of technologies for aging in place: a mini-review. Gerontology. 2014;60(3):282–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Haux R, Hein A, Kolb G, Kunemund H, Eichelberg M. Five years of interdisciplinary research on ageing and technology: Outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)—an introduction to this Special Issue on Ageing and Technology. Inform Health Soc Care. 2014;39(3-4):161–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Haux R, Hein A, Kolb G, Kunemund H, Eichelberg M, Appell JE, et al. Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies—outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL). Inform Health Soc Care. 2014;39(3-4):166–87.CrossRefPubMedGoogle Scholar
  19. 19.
    Hattink BJ, Meiland FJ, Overmars-Marx T, de Boer M, Ebben PW, van Blanken M, et al. The electronic, personalizable Rosetta system for dementia care: exploring the user-friendliness, usefulness and impact. Disabil Rehabil Assist Technol. 2014:1–11.Google Scholar
  20. 20.
    Meiland FJ, Hattink BJ, Overmars-Marx T, de Boer ME, Jedlitschka A, Ebben PW, et al. Participation of end users in the design of assistive technology for people with mild to severe cognitive problems; the European Rosetta project. Int Psychogeriatr. 2014;26(5):769–79.CrossRefPubMedGoogle Scholar
  21. 21.
    Dimitrova R. Growth in the intersection of eHealth and active and healthy ageing. Technol Health Care. 2013;21(2):169–72.PubMedGoogle Scholar
  22. 22.
    Hernandez C, Alonso A, Garcia-Aymerich J, Grimsmo A, Vontetsianos T, Garcia Cuyas F, et al. Integrated care services: lessons learned from the deployment of the NEXES project. Int J Integr Care. 2015;15:e006.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Frenk J. Reinventing primary health care: the need for systems integration. Lancet. 2009;374(9684):170–3.CrossRefPubMedGoogle Scholar
  24. 24.
    Ling T, Brereton L, Conklin A, Newbould J, Roland M. Barriers and facilitators to integrating care: experiences from the English Integrated Care Pilots. Int J Integr Care. 2012;12:e129.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Polanco NT, Zabalegui IB, Irazusta IP, Solinis RN, Del Rio Camara M. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation. Int J Integr Care. 2015;15:e026.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Kidholm K, Ekeland AG, Jensen LK, Rasmussen J, Pedersen CD, Bowes A, et al. A model for assessment of telemedicine applications: mast. Int J Technol Assess Health Care. 2012;28(1):44–51.CrossRefPubMedGoogle Scholar
  27. 27.
    Kodner DL, Kyriacou CK. Fully integrated care for frail elderly: two American models. Int J Integr Care. 2000;1:e08.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Anell A, Glenngard AH. The use of outcome and process indicators to incentivize integrated care for frail older people: a case study of primary care services in Sweden. Int J Integr Care. 2014;14:e038.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    de Stampa M, Vedel I, Bergman H, Novella JL, Lechowski L, Ankri J, et al. Opening the black box of clinical collaboration in integrated care models for frail, elderly patients. Gerontologist. 2013;53(2):313–25.CrossRefPubMedGoogle Scholar
  30. 30.
    Kasteridis P, Street A, Dolman M, Gallier L, Hudson K, Martin J, et al. Who would most benefit from improved integrated care? Implementing an analytical strategy in South Somerset. Int J Integr Care. 2015;15:e001.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Barker K. Commission on the future of health and social care. A new settlement for health and social care: final report. The King’s Fund, London. 2014;(Available at: [accessed 23.07.15]).Google Scholar
  32. 32.
    Leichsenring K. Developing integrated health and social care services for older persons in Europe. Int J Integr Care. 2004;4:e10.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Humphries R. Integrated health and social care in England -Progress and prospects. Health Policy. 2015;119(7):856–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Hendy J, Chrysanthaki T, Barlow J, Knapp M, Rogers A, Sanders C, et al. An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator. BMC Health Serv Res. 2012;12:403.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Sanders C, Rogers A, Bowen R, Bower P, Hirani S, Cartwright M, et al. Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study. BMC Health Serv Res. 2012;12:220.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Savage GT, van der Reis L. A Dutch and American commentary on IT in health care: roundtable discussions on IT and innovations in health care. Adv Health Care Manag. 2012;12:61–74.CrossRefPubMedGoogle Scholar
  37. 37.
    Reinhardt UE. The disruptive innovation of price transparency in health care. JAMA. 2013;310(18):1927–8.CrossRefPubMedGoogle Scholar
  38. 38.
    Jarvis D, Burney P. ABC of allergies. The epidemiology of allergic disease. BMJ. 1998;316(7131):607–10.PubMedGoogle Scholar
  39. 39.
    Law M, Morris JK, Wald N, Luczynska C, Burney P. Changes in atopy over a quarter of a century, based on cross sectional data at three time periods. BMJ. 2005;330(7501):1187–8.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63 Suppl 86:8–160.CrossRefPubMedGoogle Scholar
  41. 41.
    Bousquet J, Schunemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, et al. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol. 2012;130(5):1049–62.CrossRefPubMedGoogle Scholar
  42. 42.
    Bousquet J, Addis A, Adcock I, Agache I, Agusti A, Alonso A, et al. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J. 2014;44(2):304–23.CrossRefPubMedGoogle Scholar
  43. 43.
    Bousquet J, Schunemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW, et al. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): The new generation guideline implementation. Allergy. 2015.Google Scholar
  44. 44.
    Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466–76.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2016

Authors and Affiliations

  • W. Keijser
    • 1
    • 2
  • E. De Manuel-Keenoy
    • 5
  • M. D’Angelantonio
    • 2
  • P. Stafylas
    • 2
    • 3
  • P. Hobson
    • 4
  • G. Apuzzo
    • 6
  • M. Hurtado
    • 10
  • J. Oates
    • 10
  • Jean Bousquet
    • 7
    • 8
    • 9
    • 12
  • A. Senn
    • 11
  1. 1.University TwenteTwentethe Netherlands
  2. 2.Health Information Management Spain S.L.BarcelonaSpain
  3. 3.University of MacedoniaThessalonikiGreece
  4. 4.Regional Agency for Public Health and Social Well-beingBelfastNorthern Ireland
  5. 5.Kronikgune, Basque Center for Health Services Research and ChronicityRonda de AzkueBarakaldoSpain
  6. 6.A.A.S. n.1 «Triestina» / Local Health Authority n.1Friuli Venezia Giulia RegionTriesteItaly
  7. 7.University HospitalMontpellierFrance
  8. 8.MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-RoussillonEuropean Innovation Partnership on Active and Healthy Ageing Reference Site; INSERM, VIMA: Ageing and chronic diseases. Epidemiological and public health approaches, U1168ParisFrance
  9. 9.UVSQ, UMR-S 1168Université Versailles St-Quentin-en-YvelinesVersaillesFrance
  10. 10.Health Information Management, S.A.BrusselsBelgium
  11. 11.EC-CNECT-H2European CommissionBrusselsBelgium
  12. 12.CHRU MontpellierMontpellier Cedex 5France

Personalised recommendations