Introduction

Health and care services in Europe are undergoing changes to adapt systems to a growing demand caused by ageing and the expansion of chronic diseases. This restructuring, which combines health and social care resources, involves the developing and testing of innovative solutions and eventually the large-scale implementation of the most successful practices.

The multitude of good examples developed throughout the EU has led to a realisation that a comprehensive scaling-up strategy is needed at European level. The European Innovation Partnership on Active and Healthy
Ageing (EIP on AHA), which brings together key stakeholders in this policy area and supports the good practices and References Sites developed by its partners, can act as a catalyst to foster scaling-up across regions and countries.

The EIP on AHA follows five steps for setting up an effective European scaling-up strategy. The first three constitute a ”what to scale up” element, while the remaining two constitute the ”how to scale up” part. These steps are shown in the following figure:

Source: European Scaling-up Strategy in Active and Healthy Ageing

Step 1: Building a database of good practices

The EIP on AHA has invested considerable effort in developing and keeping up to date a list of innovations and activities in active and healthy ageing happening all across Europe. The EIP on AHA Committment tracker allows anyone to check the progress of the activities in the context of the EIP on AHA as reported by the EIP on AHA partners themselves.

Step 2: Assessment of viability of good practices for scaling up

There exist a number of tools and methodologies for assessing the viability of good practices for scaling up, each focusing on different aspects but very much complementing each other. The Maturity Model developed within the EIP-AHA Action Group B3 is comprehensive, focusing on one action group which has allowed for the development of a strong community around the model, with available resource database of over 80 documented good practices. MAST (Model of Assessment of Telemedicine) is also comprehensive and multidisciplinary. It is familiar to many EU stakeholders as it is based on HTA and EUnetHTA, but is not as robust as the Maturity Model. MAFEIP (Monitoring and Assessment Framework for the EIP on Active and Healthy Ageing) was created against the backdrop that EIP on AHA data is generally scarce and scattered. Nevertheless, the tool also allows for adaptation to different interventions, populations, and care contexts, especially as a support to evidence-based decision-making processes. Following a relatively quick development, the tool now has a web interface and is being actively promoted for use within EIP on AHA. MAFEIP’s development is not meant to replace existing tools and methodologies, as it builds on existing practices and approaches (such as the Markov model and Eurostat indicators) to provide an agreed way of measuring impact.

The Scale AHA study conducted a review of over 10 tools and methodologies for supporting scaling up of innovations in AHA. The review showed that the tools share common elements and aspects. Due to the different context and the history of their development, the tools can be used for different goals (e.g. the maturity model for B3 specific innovations within AG B3). MAFEIP appears suitable for the assessment of any kind of innovation in health and care, and even beyond.

Step 3: Classification of good practices for replication

The EIP on AHA Commitment tracker collects a number of characteristics for each innovation activity in order to help classify innovations and facilitate partnerships for scaling up. This includes:

• General information: short description, objectives, organisations involved, contact person, geographic coverage,
• Action Group affiliation
• Activity type: commitment, synergy, collaborative work
• Results and Outcomes (indicators)

Step 4: Facilitating partnerships for scaling-up

The EIP on AHA has grown significantly since its founding, and has more than 1,000 partners who continuously seek to exchange knowledge and partner with other EIP on AHA stakeholders in Europe.

The European Commission supports the activities of the EIP on AHA through targeted funding – Horizon2020 and past programmes, organisation of events, twinning activities, etc.

The 2016 Transfer of Innovation Twinning Support Scheme by the Commission is a new concept that aims to de-risk investment in digital innovative ICT solutions by financing the exchange of knowledge and good practice in digital health solutions with high potential for replicability and scaling up.

Twenty pairs of originators and adopters of innovations were selected to exchange knowledge and expertise with financial support to cover the travel and accommodation costs of the twinning activities. The twenty pairs represent a variety of solutions being adopted by Reference Site organisations from 13 different European countries. In total, 43 organisations were involved in the 2016 twinning scheme. Twinning subjects include EHRs, ePrescription solutions, integrated health and social care ICT service platforms, homecare and telemonitoring, etc.

The level of twinning varies from pure knowledge exchange and training, over to adaptation, partial or full adoption depending on the twinning topic. First results of the twinnings show successful implementations. The scheme is in line with the objectives of the Digital Single Market’s mid-term review report, in particular, the priority related to large-scale deployment of innovations in Europe.

Step 5: Implementation: Key success factors and lessons learnt

The Scale AHA Final Report provides detailed analysis exclusive to the EIP on AHA, including barriers and success factors to scaling up digital innovations in AHA as reported by Reference Sites and Twinning Organisations, results and lessons learnt from the twenty twinnings, analysis of tools and methodologies to measure impact of digital solutions in AHA, and others.