5 public procurers from 4 countries will procure innovative ICT-enabled monitoring solutions to improve health status and optimise hypertension care. HSMonitor will make person-centred care reality - giving the patient the steering wheel - for optimal health outcomes. The procurers have set a comprehensive framework for requirements and solution design consisting of 9 building blocks in three domains, to be addressed in an integrated ICT-enabled hypertension care solution. HSmonitor will apply the internationally acclaimed Chronic Care Model to specify support needs for hypertensive patients at all stages. Self-management and treatment will be supported by personalised guidelines and making the best use of clinical data. In this way a quality culture in healthcare will be fostered and learning healthcare systems made reality. Suppliers will be rigorously evaluated after each of the procurement phases, comprising (I) an open market consultation, (II) specification of architecture and system aligned to requirements of patients, peers and providers, (III) prototype development and testing with end-users and (IV) effectiveness proven in a trial with 500 patients and 150 professionals. Fully rolled out in the procurer countries, enabled by procurers with the authority and capacity in their countries and regions, HSMonitor will serve 31 million patients with hypertension. Reductions in hypertension-related complications promise cost relief of € 5 billion over 7 years in the five procurer countries. Suppliers can expect a turnover of € 1 billion a year. Proven ability to cover the four different health systems promises HSMonitor suppliers easy entry into other EU markets and beyond, a very strong contribution to overcoming fragmentation of demand and fostering the global market.

The CSA will enhance the safety of cross-border healthcare through interoperable ePrescriptions. epSOS solved the message transfer problem, but encountered 2 serious “delivery” problems: the univocal identification of medicinal products (MPs) dispensed abroad, and substitution challenges. Global SDOs (WHO, HL7, IHTSDO, ISO/CEN, GS1), EU regulatory agencies (EMA), MS Competent Authorities, major stakeholders (industry, health professionals, patients) harmonise their related efforts to deliver • common data models - expanding upon epSOS and existing standards (ISO/IDMP) - for prescribed MPs • a common meta-vocabulary for unambiguous definition, description, and identification of MPs • rules to harmonise practices of therapeutic and economic substitution • a roadmap for post-project actions and implementations • policy recommendations for the EU-USA road mapping process (MoU) Work will link to related research & innovation activities of SDOs, epSOS, policy and regulatory processes (eHealth Network), the three other PHC34 projects. WP1 develops a concise conceptual framework, including use case scenarios where the identification of a MP is an issue, including pharmacological and pharmacokinetic attributes, clinical indications and risks. WPs 2 address the identification and description of the pharmaceutical products, considering implementability as essential. WP3 investigates the situation in MSs with respect to substitution, and explores options for substitution. Each track develops a set of concrete solutions and road map recommendations, validated by experts in F2F meetings and workshops in WP4. Fostering exploitation by MS regulatory agencies and communication of results is the duty of WP5. The project involves national competent authorities, SDOs and stakeholders not part of the core team at an early stage to assure the practicability, acceptance and trust in the solutions developed. The CSA lasts 2 years involving 8 beneficiaries and about 25 expert organisations.

VALUeHEALTH will establish how eHealth interoperability can create and deliver value for all stakeholders, for a sustainable market in scaling up cross-border services. We will develop an evidence-based business plan for interoperability, beginning with CEF support and then sustainable revenue streams for developing and operating self-funding priority pan-European eHealth Services beyond 2020. Our rich multi-stakeholder consortium of experienced partners and funded experts will fuse many essential viewpoints to action the work and importantly endorse and champion our business plan to ensure sustainability of the CEF beyond 2020. Starting with use cases already proposed for the CEF by the eHealth Network, we will adopt a robust methodology to prioritise additional use cases relevant to Member States for cross-border and also within border health needs. We will design a business model and multiple stakeholder Value Propositions for European-scale interoperability, construct the multisided market needed to sustain investments in CEF services and perform Cost Benefit Assessment and risk assessments. We will analyze costs for delivering the prioritised use cases, developing and maintaining the required assets and derive a costed deployment roadmap for generic and healthcare-specific services. We will provide a gap analysis of standards, specifications and translations plus their priority and estimated cost. We will collate success strategies for promoting EHRs, and of organisational changes needed to capitalise on richly interoperable EHRs, as a roadmap of scale-up adoption strategies, incentives and funders. Finally, we will integrate and validate these results in a definitive Business Plan and Sustainability Strategy for public-private investment in digital eHealth services, as clear guidance to the CEF on how it may construct its digital service infrastructure Building Blocks for health, to ensure maximum value and optimal sustainability beyond 2020.

The project partners share a vision of a borderless European digital health innovation ecosystem, deeply rooted in the UNITE regions. A European ecosystem that can tackle the challenges and capture the opportunities of the demographic transitions and the emerging “silver economy” in full. A borderless ecosystem which brings together key stakeholders from a diverse set of regions, from the private sector, the public sector, academia and the civic society. An ecosystem encouraging and enabling entrepreneurship, and pushing the local start-ups to scale up, and importantly an ecosystem that naturally facilitates and opens up new interregional European value chains. The project brings together a wide and diverse group of regional and national ecosystems that reach the borders of European geographical, economic, cultural and care system diversities. A group of regions with a complementing bundle of challenges and aspirations to reach, assets to mobilise and barriers to overcome together. It makes use and builds upon the EIT Digital Strategic Innovation Agenda for Digital Wellbeing, which is directly aligned and supports the regions’ RIS3 and long-term strategies, serving as the basis for the UNITE cofunding commitments and joint activities plan. The partners’ vision to unite the open, borderless, regionally-anchored European digital health innovation ecosystem calls for an UNITEd intervention that: - Connects the fragmented value chains, dispersed ecosystems and pockets of excellence and regional specialisation ambitions; - Fosters the co-learning between the ecosystems and enables growing together; creates strategic and tactical examples of interregional value chains and digital solutions; and - Elevates the nexus of strategies between the regional ecosystems and the global digital health networks and opportunities in long-term.

The eStandards CSA is proposed by HL7, CEN TC251, & IHE, leading Standards Organizations (SDOs), and is supported by the eHealth Network, ISO TC215, GS1, IHTSDO, IEEE11073, and IMIA to advance eHealth interoperability and global alignment of standards with seven objectives: 1. Join up with Stakeholders in Europe and globally to build consensus on eHealth standards, accelerate knowledge-sharing, and promote wide adoption of standards. 2. Deliver an evidence-based Roadmap for alignment, iterative consolidation, and broad acceptance of eStandards that is endorsed by SDOs, the eHealth Network, the providers, and the Industry. 3. Contribute to the eHealth Interoperability Framework use cases focusing on clinical content modelling for different paradigms and embed a Quality Management System for interoperability testing & certification of eHealth systems. 4. Collect evidence and provide guidance on the coexistence of competing or overlapping standards in large-scale eHealth deployment nationally and cross-border. 5. Participate in EU/US MoU roadmap actions as the international patient summaries standard. 6. Explore socio-economic aspects of eHealth interoperability, revisiting the language for user-vendor interaction that embodies ‘co-making’ in trust, collaboration and long-term engagement. 7. Align across PHC-34 to nurture innovation, sustainability & growth under CEF and beyond contributing to Key actions of the Digital Agenda 2020. The proposal’s ambition is to strengthen Europe’s voice and impact, while reinforcing the bridges established with the EU Patient Summary guideline across the Atlantic in Trillium Bridge and among MS with epSOS, eSENS, Antilope, and EXPAND. The eStandards Roadmap and associated evidence base, a white paper on the need for formal standards, and two guidelines addressing how to work with: (a) clinical content in profiles and (b) competing standards in large-scale eHealth deployments will be pragmatic steps toward alignment and convergence.