Self management of health and disease: citizen engagement and mHealth

Specific challenge: Empowering citizens to manage their own health and disease will result in more cost-effective healthcare systems by improving utilisation of healthcare, enabling the management of chronic diseases outside institutions, improving health outcomes, and by encouraging healthy citizens to remain so.

Several clinical situations would be prevented or better monitored and managed with the participation of the patient him or herself. Care sciences may complement the medical perspective without increasing the cost. This requires research into socio-economic and environmental factors, dietary impact and cultural values, behavioural and social models, attitudes and aspirations in relation to personalised health technologies, mobile and/or portable and other new tools, co-operative ICTs, new diagnostics, sensors and devices (including software) for monitoring and personalised services and interventions which promote a healthy lifestyle, wellbeing, mental health, prevention and self-care, improved citizen/healthcare professional interaction and personalised programmes for disease management. Support for knowledge infrastructures is also required, as well as the combination of predictive personalised models with personal health systems and other sources of data.

Scope: Proposals may focus on patients or healthy persons or both. Health management should be addressed in a holistic approach, from healthy lifestyle, dietary habits interlinked with disease management, and adherence to medical plans, placing the patient in the centre and putting increased emphasis on health education, patient empowerment, secondary prevention and self-management of individual conditions, including co-morbidities and frailty. Implementation of programs or applications for different target populations to capture gender- and age-dependent differences in health, behaviour and handling of devices should be included.

Proposals are invited which address this specific challenge by focusing on only one of the two elements below:

(i) citizen engagement in health, wellbeing and prevention of diseases.

Proposals shall enable individuals to become co-managers of their health and wellbeing (including physical and mental wellbeing, equality, health literacy, life style factors such as nutrition and smoking) with the help of ICT, tools and personalised services. The focus should be on the following elements:

• The creation of a supportive environment for healthy behaviour including support to behavioural change e.g. mathematical, dynamic modelling of behaviour with quantitative, testable models especially in real world settings and application of the sciences in designing interventions or game based physical training with motion tracking based feedback;
• Health promotion, health literacy and disease prevention;
• The development of a multi-stakeholder ecosystem (of health and care professionals, patients, nutrition - and pharmaceutical industries, public healthcare authorities, health IT, mHealth actors, health insurers and regulators, etc…) to develop a 'co-production of health' business model – an evidence based, general, alternative way of creating and augmenting personalised health, supported by information exchange and utilisation and;
• A migration path towards comprehensive solutions that could be incorporated into health care processes.

(ii) mHealth applications for disease management

Proposals should focus their research on application development for disease management with the following characteristics:

• Strong emphasis on co-designing and user needs as a key driver;
• Knowledge management systems to analyse and compile the data collected by applications on individuals’ health and activities in order for such information to be used by the persons themselves, health professionals and public health monitoring authorities;
• Guidance for patients, care-givers, families and patients' social environment on chronic disease management supported by mHealth;
• Patient adherence to and compliance with medical recommendations
• Economic aspects of encouraging secondary prevention and addressing avoidable negative health and wellbeing outcomes;
• Screening for pre-frailty states
• Public health or health promotion interventions addressed to large sectors of population through mHealth applications and;
• Co-operative ICTs to support co-operative management of health and disease among patients and eco-health systems.

The Commission considers that proposals requesting a contribution from the EU of between EUR 3 and 5 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

Expected impact: In both cases (i) and (ii)

• Improved self-management of health, disease prevention, management of diseases and/or expenditure.
• Strengthened evidence base on health outcomes, quality of life, care efficiency gains and economic benefits from the use of ICT in new care models, in compliance with data protection requirements.
• Increased confidence in decision support systems for wellbeing and disease / patient management.
• Strengthened evidence and improved knowledge about individuals’ behaviour related to wellbeing, disease prevention or management facilitating the creation of new personalised behavioural health interventions.

For (i) only

• Validated programmes for health promotion and disease prevention
• Ecosystem and new business models for promotion and co-production of health

For (ii) only

• Improved service offering and business concepts and models
• Impact in several of the following facets of mHealth e.g. patient safety, contribution to or revision of (guidelines of) relevant legal frameworks, medical guidelines, harmonisation (across borders), standards, co-ordination of therapies, recognition of mHealth as a reimbursable cost, improved accessibility, liability, inter-operability, more reliable connectivity, patient empowerment, improved patient-health professional interaction, maturing personalised health systems, sustainability, usability and user-acceptance.
• Improved interaction between patients, their relatives and care givers, facilitating more active participation of patients and relatives in care processes.
• Improving the management of disease by reducing the number of severe episodes and complications.
• Increased level of education and acceptance by patients and care givers of ICT solutions for personalised care.

Type of action: Research and innovation actions