ValueCare Project: A comprehensive and personalized solution to improve the care, wellbeing and quality of life of the older people

Valuecare project: value-based methodology for integrated care supported by ICT” funded by the Horizon 2020 Program of the European Commission (Nº 875215) whose main objective is to improve the care and quality of life of older people with cognitive impairment, frailty or multiple chronic diseases by providing personalized value-based integrated (social and health) care supported by a robust, secure and scalable digital solution. The development of the ValueCare integrated care approach and the development of the ValueCare digital solution has followed a co-design process involving citizens and social and health professionals and has been validated in 7 pilot studies in different European countries (Spain, Croatia Greece, Italy, Ireland, Portugal and the Netherlands). Specifically, in the pilot in Valencia (Spain) the objective is to improve the care and quality of life of both the older people (over 65 years old) who suffer from frailty and their families through the application of value-based methodologies supported by the ValueCare digital solution that integrate social and health care from a personalized perspective in which a unique care plan is offered for each elderly person according to their needs/health outcomes. From October 2020 to February 2021, the Valencia pilot researchers conducted a process of co-design to develop the integrated value-based concept and digital solution to support a personalised care pathway for frail older people. A total of 52 participants were engaged in 28 different co-design activities. All agents participating in the delivery of care were involved (older people, formal and informal caregivers, social and health care professionals, ICT experts, hospitals Managers, municipal social care services, among others). Co-design activities were adapted to the Covid-19 situation, combining in-person and virtual meetings with a reduced number of participants, as for example, online focus groups with professionals, mixed focus groups with older people and professionals, in-person interviews with older people, deep interviews with informal caregivers, just to mention a few. The researchers of the Valencia pilot prepared a report in which all the results of the co-design sessions were collected. The results collected in the co-design sessions were transcribed, translated into English and reported in a single report to be sent to the project coordinators as responsible for the ValueCare concept and to the technology partners as responsible for the development of the ValueCare digital solution. Following the development of the ValueCare application, a total of 120 older people were trained in the use of the application. Each of these persons belonging to the intervention group completed an evaluation questionnaire developed by the project partners and used in all pilot sites. In this way, according to the socio-health outcomes, a comprehensive and personalized care plan was created and made available in the app that could contemplate a total of 4 care pathways: nutrition, physical activity, pharmacological treatment and psychosocial prescription in addition to providing participants with information on community and social services. In addition, through the app, health care professionals and researchers could send messages with recommendations and goals tailored to the needs and interests of the older people and monitor the care plan. The intervention period for each of the participants was 12 months. During the first months of the intervention a second co-design session took place with a total of 211 participants from different backgrounds. Older people, caregivers, stakeholders, managers, social and health professionals, etc. contributed their vision regarding the ValueCare concept and the digital solution to be considered in the development and life cycle of the project. Again, the results of this round were reported to the technology partners so that they could adapt the ValueCare digital solution according to the input of the target groups. Valencia pilot is targeted to older adults with mild to moderate frailty, and their families, from one of the vulnerable districts covered by Health Department Valencia- Clínico-Malvarrosa Area. The ValueCare digital solution is not conceived as a medical device but as a support device to improve the social and health care provided to elderly people with mild to moderate frailty. The application is to be used as a device to suggest a comprehensive and personalized care plan to each participant, prescribed by the researchers and primary care physicians to the participants based on the participants’ socio-health outcomes, physician judgment and personal interests of the participants. The application allows the elderly to access personalized information, as it has access to videos and scientific texts on physical exercise, cognitive stimulation, healthy habits, etc., as well as information on existing health and social services in their neighborhood that both professionals and researchers progressively update according to the evolution of the participants. In this way, both health professionals and researchers can access the application to check the information on the activity of the patients, and can adapt the integrated and personalized health plan according to the evaluation of the participants. Volume-based healthcare has proven to be ineffective in addressing the progressive increase in population aging, chronic diseases, the rise of information and communication technologies and the economic inability of healthcare systems to meet these challenges. The ValueCare project developed within the framework of value-based care is the clear example that healthcare must be transformed towards efficient models of care, in which the volume of services provided does not prevail over the health outcomes of patients. Achieving an optimal relationship between the costs of care and the outcomes achieved by patients is possible if we improve the coordination of health and social systems and rely on the fact that patients could be interested in participating in the design and subsequent use of systems that allow them to receive better health and social care and better access to health services, as this would undoubtedly promote an improvement in the health, well-being and quality of life of the entire population, as well as improve staff satisfaction and greater efficiency in the use of resources and the coordination of care.