Funds for digital health– how to bid with success

DHE organised an interactive webinar on 30th June with the aim of raising awareness about successful funding pathways in digital health in European regions. Two European Innovation Partnership on Active and Healthy Ageing Reference Site-awarded regions (in 2019) were interviewed about their successful practices and experiences with different levels of funding. The two were Aarhus Municipality/Region of Central Denmark and Liguria in Italy. Read more about the valuable lessons they have learnt through their years of project participation.

How the funding journey started

The two people representing the regional award-winners reflected on their municipality’s and region’s early successful experiences of obtaining European funding. They reflected on how it has materialised today.

The municipality of Aarhus, Denmark: Sonja Hansen, European project officer at Aarhus Municipality, highlighted her experience of early support for her work. When she started research and innovation collaboration at the Aarhus municipality’s Health and Care department in 2016, she got significant support from the Central Denmark European office in Brussels. The Brussels office had huge experience with European calls for proposals, networks, and partners already at that time. She started to attend conferences and info days. She also participated in networks which really helped the project journey to take off for the Municipality of Aarhus.

The municipality was then ready to start applying to funding programmes. Aarhus first applied to the ÖKS programme (Interreg), which is under the shared management of the Ministry of Business, industry and financial affairs of Denmark and the European Commission. The project, CareWareNordic has now been extended by one year thanks to its success. Since then, the municipality has participated in Horizon2020, several Interreg programmes (e.g., Baltic Sea, North Sea, Europe), Erasmus+, and Nordic Innovation. Very recently, it has taken part in the DHE twinning scheme, which is part of the DHE coordination and support action. It has permitted it to interact with Kerpape in France.

The region of Liguria, Italy: Serena Alvino, expert on professionals and users’ training and education in the field of health, from Liguria set the scene in her region. She explained that Liguria is heavily impacted by demographic change. 28.5% of its population is aged 65+ years old. The average age of a local resident is nearly 50. Liguria is a test bed for innovation in the field of active and health ageing, enabling testing in what will happen in other regions/countries in the years to come. Liguria has been a front runner in terms of digital innovations, telecare, and telemedicine. It has used mainly European Structural and Investment Funds (ESIF) for example. In 2015, the region decided to apply for the Reference Site award. This process has helped the region to pool its regional actors and know-how together, set up a local network, and create a clear understanding of what had been done in the past in Liguria in the field of active ageing. This was a very powerful driver to realise what the regional potentials were and map the needs for future funding.

Given the ageing context, the major challenges of the region of Liguria are to create conditions for older persons to stay at home, live an independent life as long as possible, and avoid hospitalisation. Some years ago, Liguria decided to invest into an innovative model of family and community nurses and integrate this new profession into the regional social healthcare system. To accomplish this objective, the region blended different forms of funding. It integrated national funds, European Union (EU) funds, and European Structural Funds. The CoNSENSo project was financed under the Alpine Space programme in 2016. The project aimed at developing and testing a health and social care model centred on family and community nurses. This experimentation was scaled up in Italy as the initiative was framed inside a national programme targeting the population in the inner areas. The next step was the definition of an EU profile and curriculum for family and community nurses through an Erasmus+ project, ENhANCE. One testing site was located in Liguria. With the involvement of the University of Genova, 44 family and community nurses were trained who obtained a certificate at the end of their training. They are currently working in the region.

The keys to success

The two interviewees reflected on at least six, ongoing, keys for success. The importance of networks and ecosystems was especially emphasised.

A successful application should be innovative and should be rooted in real needs and problems to solve. It is of enormous added value if you can demonstrate that the work is based on a previous project, collaboration or research. To do this, combining funding pathways and blending funding sources e.g., (regional, national, European) are important tools. This also enables a form of permanent collaboration with your partners, and to enlarge your network. The informal network built through project involvement is the primary source for building and obtaining new projects. Alignment with policies and strategies is fundamental. So too is the building of networks and ecosystems.

The role of networks and the ecosystem

Both interviewed Reference Site offered interesting insights into the role of networks and ecosystems. The local network, which was built thanks to the Reference Site application in Liguria and in Central Denmark were invaluable drivers of self-organisation, self-awareness, creating cohesion and stock-taking.

The Liguria region also supported other network-building initiatives. SI4LIFE, is a consortium of different stakeholders in the territory which plays the role of a regional hub supporting the quality of life of older adults and disabled people. Since 2015, it has been coordinating the Ligurian FRAGILE Commitment to the European Innovation Partnership on Active and Healthy Ageing and has submitted successful proposals such as that of the ENhANCE project. The Silver economy district is based on a Memorandum of Understanding between the region, the municipality, the chamber of commerce, and the university whose common goals are to foster innovation in the field of silver economy. The interdepartmental centre for longevity and active ageing is hosted by the University of Genova. The innovation of the centre lies in the fact that 13 faculties from the university collaborate to submit project proposals. The faculties come from very different disciplines (e.g., social sciences, economy, environmental sciences, and architecture).

The art of orchestrating the local network successfully is that everyone should feel that they are involved, have a role, and can bring something to the collaboration.

What impact to expect from projects

Further insights showed how impactful projects, and especially series of projects, can be in helping the transformation of health and care systems. Views were offered into the resulting impacts on the scene in Liguria, Aarhus, and a third site – Kerpape in France.

Liguria and Italy: Three chief impacts were experienced in Liguria. They relate to education and training including multidisciplinary training, and the importance of sustainability.

Projects can help change training and education. The Italian government passed a law in May 2020 that recognised for the first time the family and community nurses as a key profession in the healthcare system. As a consequence, the Liguria region formally adopted the national law with a regional decree, and extended the family and community nurses scheme to the whole of the region. The 44 trained family and community nurses are employed as a result of this 2020 law under the coordination of A.Li.Sa., the public enterprise responsible for the regional health service in Liguria and the mastermind partner of ENhANCE project. The Italian National Federation of the Nursing Profession has also recognised this new profession. The curriculum will be offered again at the University of Genova in the following years. Thirteen other Italian universities are also willing to launch a course based on this new curriculum, which was developed by the ENhANCE project.

The experience of the current (COVID-19) pandemic has pointed out the enhanced need for technology and community-based services. Future investments will be surely larger in these two directions. Personalised care plans are necessarily developed by multidisciplinary care teams, for which the appropriate multidisciplinary training schemes have to be developed and provided.

Overall, European Structural and Investment Funds, if well managed, are very important because they address actual needs in the territory. These funds can ensure continuity and sustainability to projects if the funding instruments are well aligned.

Aarhus and Central Denmark: Several impacts have been experienced in Aarhus. They relate to benefits for stakeholders, the building of business cases, twinning and international collaboration, and – last but not least – the implications for a region of organising a major international event.

The impact that CareWareNordic has brought to Aarhus was beneficial to a whole range of stakeholders. For companies, this came through springboards to assess the need of older citizens.For care professionals, it provided a better and sustainable education model, where they learned how to use technology more efficiently (these training sessions) will now be integrated into university curricula. In the long term, the project will have an impact on the working environment, and increase the wellbeing of older citizens. In turn, this affects the eco-system for the doctors, hospitals, education, and companies. Older citizens can now stay at home longer and their quality of life has increased.

Building business cases can energise future funding. Central Denmark builds business cases to see who will benefit from a specific project: nursing homes, citizens, and municipalities. It asks, for instance, out of the tested digital solutions which are the ones that are good business cases. With this evidence in hand, further future funding can be obtained because there are convincing data available on the innovation’s socio-economic and technological impact.

Aarhus has collaborated with other sites abroad. Another project that illustrates high societal impact was the DHE twinning project which Aarhus implemented together with Kerpape Rehabilitation Centre in France (REHAB-LAB). This collaboration was a full adoption twinning. It allowed Aarhus to learn how to co-design 3D-printed wearables with persons with disabilities. The idea and the results were so impressive that the Aarhus municipality has decided to dedicate local funding to extend this programme so that more disabled people can design their own wearables. This REHAB-LAB concept undoubtedly contributes to the well-being and better quality of life of citizens with disabilities. The Central Denmark region also has 3D-projects funded from regional budgets for printing devices in hospitals.

Events, as well as projects, can contribute to strong societal engagement. In 2019, Aarhus hosted the Active Assisted Living Programme (AAL) Forum. The whole city, and lots of citizens were mobilised into the organisation and hosting of the forum. The forum definitely brought new partnerships and collaborations to life. Hosting the AAL forum produced a very strong impact on the local ecosystems, and it also had important messages for the many hundreds of people who came to experience the Aarhus adventure in real life.

Both speakers highlighted for successful funding pathways first and foremost the need for building networks within the territory (like Reference Site health innovation ecosystems) and with other entities and regions. Secondly, that the project has to solve real problems and challenges. Projects have to be aligned with policy/strategy priorities. Finally, often, EU/interreg/twinning, etc funds serve to develop and pilot an innovative model but for the sustainability and roll-out local/regional/ESIF funds should be called upon.