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 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.

Public procurers in ProEmpower aim to procure a disease self-management solution to help meet the imminent threat of a diabetes epidemic. ProEmpower will make person-centred care reality - giving the patient the steering wheel - for optimal health outcomes. Very significant synergies will be reaped by supporting all 10 action areas of diabetes management in an integrated ICT solution. Early detection, personal decision support, self management and peer support are to be delivered from a platform with full interoperable and secure access to the necessary devices and health records. ProEmpower will apply the internationally acclaimed Chronic Care Model to specify support needs for type 2 diabetes 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 four procurement phases, comprising (I) an open market consultation supported by the European eHealth Competition, (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 200 patients and 40 professionals. Fully rolled out in the four countries, enabled by procurers with the authority and capacity in their countries and regions, ProEmpower will serve 12 million diabetes patients. Reductions in diabetes-related death, amputation, blindness and renal failure promise cost relief of € 53 billion over 7 years in the four countries. Suppliers can expect a turnover of € 5 billion a year. Proven ability to cover the four different health systems promises ProEmpower suppliers easy entry into other EU markets and beyond, a very strong contribution to overcoming fragmentation of demand and fostering the global market.

EURO-CAS, European eHealth Interoperability Conformity Assessment Scheme aims at maintaining and developing the adoption and take-up of testing the interoperability of ICT solutions against identified eHealth standards and profiles defined in the eHealth European Interoperability Framework (eEIF). The key deliverable is a sustainable Conformity Assessment Scheme (CAS) for Europe. Based on recommendations of the Antilope project and the state-of-art in interoperability testing in eHealth, EURO-CAS is committed to putting in place an operational CAS based on ISO/IEC 17025 that will meet the interoperability requirements of European eHealth projects as well as national and regional eHealth programs. This will allow testing the interoperability capabilities of products and services for a single digital market in eHealth in Europe in line with the Digital Agenda for Europe and based on international profiles and standards. The project will gather a multi-disciplinary consortium of high-level expertise, including organizations focused on implementing international standards as well as industry stakeholders and healthcare providers that will 1) review the state of the art of existing interoperability CAS, 2) collect the requirements and needs from cross border, national/regional levels, 3) establish the CAS for Europe with implementation guidelines and governance, 4) propose business models for the CAS for Europe, 5) validate results and foresee national/regional adoption, 6) inform and educate eHealth stakeholders and motivate industry and projects to participate in a European accreditation process. The CAS for Europe will provide a comprehensive framework completing the eEIF and aligned with the international CAS. Its flexibility will allow better sustainability and harmonization at European, national and regional levels.

Trillium-II steps forward with an outstanding consortium to further advance global Electronic Health Record (EHR) interoperability. Activities surrounding the International Patient Summary (IPS) standards can nurture digital health innovation, lower trade barriers, and advance patient safety & trust, bridging the gap between strategic intent and capability for action by Standards Development Organization (SDOs) striving for interoperability, quality, and safety through standards adoption. Trillium-II builds on the vibrant community of Trillium Bridge to: (a) Improve international interoperability of eHealth Systems in US, in Europe and globally (b) Accelerate establishment of interoperability standards in eHealth with validated open source interoperability assets and sharing lessons learned with SDOs (c) Facilitate secure, seamless patient summary sharing offering clarity and oversight. Trillium-II aims to bridge, harmonize, evaluate existing patient summary initiatives and guide emerging ones, leading the way toward one IPS standard by establishing a global community fostering the practice of digital health innovation with robust widely-used interoperability standards and joint pilots. Trillium-II objectives are measurable, realistic and achievable objectives: • Highlight the social value of IPS standards. • Bridge IPS initiatives with validated interoperability assets, sharing lessons learned with SDOs • Contribute to IPS Standards Governance under the JIC • Develop, Collect and Assess IPS Learning resources • Engage mobile Health companies and app developers with IPS standards • Foster innovation & inform health policy sharing IPS. Trillium-II will work with the workforce action, EU and US SDO platforms, large scale eHealth deployments, and emergency readiness exercises, to increase actionable interoperability of health systems in Europe the US and globally, nurturing innovation and fuelling creativity with effective use of standards and interoperability