An Integrated Solution for Sustainable Care for Multimorbid Elderly Patients with Dementia

CAREPATH proposes an ICT-based solution for the optimization of clinical practice in the treatment and management of multimorbid patients with Mild Cognitive Impairment or mild dementia.

Such solution is targeting a more complex multimorbidity scenario and follows an integrated patient-centered approach, in order to develop a flexible and modular system to deliver a best care, adapted framework for increasing the independence and Quality of Life (QoL) of multimorbid patients with dementia.The proposed solution exploits the IONIS, C3-Cloud and imergo®-ICP healthcare platforms (whose three coordinators belong to the CAREPATH consortium) and provides a holistic environment for both healthcare providers and patients, efficiently addressing the joint multimorbidity and dementia challenges.

To demonstrate and validate its results, CAREPATH will focus on combining multimorbid conditions, in different levels of complexity, and in combination with dementia.

As such, CAREPATH will consider conditions such as Diabetes, Hypertension, Heart failure, Atrial Fibrillation, Chronic Obstructive Pulmonary Disease, Asthma, or Chronic Kidney Disease.The CAREPATH pilots will take place in four European countries (Spain, Romania, Germany and UK) with diverse health and social care systems, ICT landscape/digital maturity of healthcare provision and dementia national programs.

The pilots will strengthen the evidence base on associated health outcomes and efficiency gains.CAREPATH will also elaborate on a methodology for computer interpretable clinical guidelines and computationally derived best clinical practice for the improved management of elderly multimorbid patients with dementia.

It will develop Quality Key Performance Indicators for such a guideline-driven clinical practice and patient-centered integrated care delivery.

In addition, the relevant health economic impacts of the solution, in terms of cost effectiveness and care provision inequalities will be assessed.