C3-Cloud work plan and progress

The work plan of the C3-Cloud project is divided into a series of work packages which are responsible for different activities in the project.

Work package 1 deals with project management. It looks after making sure the whole work plan proceeds smoothly, troubleshooting any issues that arise, reporting on progress to the European Commission, financial reporting and supporting internal communications amongst the project partners. [Read more about WP1]

Work package 2 coordinates the information and the channels used to communicate about the project, its progress and results to organisations and communities across Europe, and internationally. It looks after the design and content of the website, and supports all of the partners with producing materials for conferences and academic papers. This work package also considers how the results of the project, especially its technology solutions, can be adopted more widely by companies and healthcare systems after the project is over, and how research can continue to improve on the results we produce. This work package make sure that the ownership rights of all of the partners is protected when licensing the C3-Cloud software to other companies and health services. [Read more about WP2]

Work package 3 deals with the design of the C3-Cloud technical architecture. It is responsible for interpreting the usage scenarios of the various stakeholders, consolidating them into concrete technical requirements, and subsequently into the architectural blueprints of the infrastructure. [Read more about WP3]

Work package 4 considers how the health systems in the three pilot site countries, the clinical teams and other professionals working in the hospitals and general practices involved, will need to work differently when using C3-Cloud solutions. It has examined how care for patients with multi-morbidity is carried out today, so it can work out the changes that each site will need to make in order to deliver better, more integrated and more patient empowered care. It will eventually publish recommendations for other health systems wishing to adopt the C3-Cloud solutions, so that they can do so smoothly and make best use of C3-Cloud technology. [Read more about WP4]

Work package 5 is responsible for designing and building the patient empowerment platform. This is the application that will be used by patients and their caregivers for self management of multiple health conditions, and for tracking their preventive health and lifestyle activities. It is also responsible for producing educational materials, such as a video, to help explain the problems associated with caring for patients with multi morbidity and how C3-Cloud is seeking to offer a better way of supporting such patients. [Read more about WP5]

Work package 6 is responsible for developing the software that connects C3-Cloud to the electronic health records at each of the healthcare organisations involved in the study, for developing the software to integrate data from different database representations and terminologies. It is also responsible for building all of the security features needed to ensure that only authorised staff can access the records of each patient, and the audit trail that keeps a record of every access to the system that is made. This work package will also make sure that all of the databases are secured against unauthorised access, and that all of the communications occurring between computer systems are encrypted. [Read more about WP6]

Work package 7 is responsible for building the software that will be used by clinicians to design care plans, personalised in collaboration with patients, and track the progress of each patient whenever their care is reviewed. This work package will also communicate to the patient empowerment platform (developed by work package 5), and is therefore responsible for integrating all of the software that makes up the C3-Cloud solution. [Read more about WP7]

Work package 8 looks after the three pilot sites that are assessing the successful use of the C3-Cloud solutions. It is responsible for the definition, from a user perspective, of the requirements of the pilot application to improve the care of multi-morbid patients. This WP will also define the requirements of the C3-Cloud Components implementation in each site by considering the differing characteristics of each pilot. Eventually it also covers the deployment and operation of the C3-Cloud pilot application to real life settings, according to the deployment options in the three pilot sites. [Read more about WP8]

Work package 9 is leading the evaluation and impact assessment of the study. It is responsible for designing questionnaires and other assessment methods that will be used to establish the usability and use made of the C3-Cloud solutions at the pilot sites, and how clinicians and patients found the experience of using the applications. The evidence from the studies, analysed through this work package, is essential to help demonstrate the value of C3-Cloud’s approach and solutions, to justify wider adoption across Europe. [Read more about WP9]

Work package 10 focuses on ethics. Its role is to make sure that the design of the software, and the design of the pilot studies, meets legal and ethical obligations, and is approved by all of the appropriate bodies, at each site. [Read more about WP10]

These work packages are being undertaken by a consortium of twelve partnering organisations, including universities, healthcare providers and industry. You can find out about these twelve partners here.

Progress made over the first two years of the project (May 2016 – April 2018)

    1. The structures and processes for the management of the project have been set up, in terms of management groups for administrative and scientific work, communication, stakeholder advisory group, ethics committee to oversee and support the project activities. A quality assurance plan has also been developed and used for monitoring the project and its activities.
    2. A dissemination plan for the project has been developed, including the website and communication channels (e.g. Twitter, ResearchGate). Dissemination at conferences and workshops is frequently taking place.
    3. An initial business plan for exploitation of project results has been developed and updated, with further details on market analysis. This will be refined in subsequent years.
    4. The design of the technical architecture of C3-Cloud has been completed. A systems design document was produced, with key communication interfaces among system components and their interaction workflow, and extensive information modelling. Co-production between technical and clinical teams has been crucial to this design.
    5. Patient pathway and organisational model development and change management for using the tools developed in C3-Cloud have been extensively analysed. Initial guidance has been developed for new patient pathways and corresponding personalized care plans.
    6. The Patient Empowerment Platform (PEP) has been developed. Self-management training materials for increasing patient adherence to care plans have also been collated. PEP prototypes have been completed. Integration work with the integrated care plan with other C3-Cloud components is now well advanced.
    7. The Interoperability Middleware has been designed and developed to provide a solution to address the technical, semantic and privacy/security interoperability challenges. HL7 FHIR (1) profiles have been defined for describing the data elements and structural mapping and terminology mapping services (Health Terminology/Ontology Portal) are used to transform the local IT system data into the C3-Cloud FHIR format and align local vocabularies to existing standards. The security and privacy architecture for C3-Cloud has also been completed.
    8. NICE (UK) (2) clinical guidelines for the 4 diseases considered in the project (diabetes, heart failure, renal failure and depression), and in the context of multimorbidity, have been studied. 43 logical flowcharts have been developed that model the clinical recommendations from the guideline text documents. These have been used in the development of clinical decision support (CDS) services.
    9. Based on the guideline flowcharts from clinical guidelines for the 4 different chronic conditions, 52 reconciliation rules for multiple disease combinations have been developed by identifying the synergies, cautions and contradictions of the relevant recommendations. Implementation of drug-drug and drug-disease interaction services are being considered reusing existing reliable drug-drug and drug-disease interaction databases.
    10. The Personalised Care Plan Development Platform (PCPDP) care plan management functionalities, specified during the requirements analysis and design phases, have been completed to a large extent. Early integration work has already started with PCPDP, PEP, some CDS services and the Interoperability Middleware components.
    11. For the pilot application development, requirements have been elicited from early in the project to understand the landscape in the 3 pilot sites. Additionally, the design of the pilot application has been completed. The deployment requirements of the C3-Cloud high level components to be implemented have been defined.
    12. For the evaluation of the C3-Cloud components and the pilot application, protocols have been developed for the 4 layers of evaluation in the project (e.g., component and application test plans, usability evaluation, etc.).
    13. The three sites are each obtaining local Ethical Committee approval for the C3-Cloud study.

These work packages are being undertaken by a consortium of twelve partnering organisations, including universities, healthcare providers and industry. You can find out about these twelve partners here.

1- Fast Healthcare Interoperability Resources, published by Health Level Seven. Please see https://www.hl7.org/fhir/overview.html
2- The National Institute for Health and Care Excellence. Please see https://www.nice.org.uk/