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Joint Action to support the eHealth Network [JAseHN] [677102] - Joint Actions
Project abstract

The overall ambition from EU Member States (MS) is to better include eHealth into health policy and better align eHealth investments to health needs. A central aspect is the transferability of health data across borders of MS and therefore the organizational, technical, semantic and legal interoperability. In order to ensure progress and to bridge the gaps between the governance, strategy and operational levels, a dedicated mechanism for eHealth at EU level has been established: The eHealth Network was formally established in 2011 through the Commission’s Implementing Decision 2011/890/EU based on Art. 14.3 Directive 2011/24/EU and represents the highest decision-making body at EU political level. At a European level there is a strong need to maintain this mechanism and to ensure further common political leadership and ongoing integration of eHealth into health policy in order to continue developing eHealth services responding to health systems‘ needs and health objectives. This is the framework for the Joint Action to support the eHealth Network which is led by the MS and co-financed by the European Commission through a Joint Action.

Hence, the main objective of the Joint Action is to act as the main preparatory body for the eHealth Network. By doing so, the Joint Action aims to develop political recommendations and instruments for cooperation in the four specific priority areas that are specified in the eHealth Network's multi-annual work plan 2015-2018 and that were adopted by the eHealth Network in May 2014:
(1) Interoperability and standardisation,
(2) monitoring and assessment of implementation,
(3) exchange of knowledge and
(4) global cooperation and positioning.

Thereby, the Joint Action functions also as a platform for operational and strategic cooperation between MS on eHealth including their relationship with eHealth Stakeholder Groups and Standardization Organizations.

Summary of context, overal objectives, strategic, relevance and contribution of the action

The Joint Action to support the eHealth Network (JAseHN) was a project funded by the European Commission to act as the main preparatory body for the eHealth Network, the highest decision-making body of the European Union in the field of eHealth.

JAseHN was launched in May 2015 to take over the preparatory role of the “eHealth Governance Initiative” in order to maintain this overall mechanism and to ensure further common political leadership and the ongoing integration of eHealth into health policy.

JAseHN was operating from May 2015 until June 2018. It was objected to develop and submit several political recommendations and other instruments for cooperation to the eHealth Network regarding the Directive 2011/24/EU on the application of patients' rights in cross-border healthcare and the 2015-2018 Multiannual Working Plan of the eHealth Network, all aiming at orchestrated exchange of health data between EU Member States.

The sole objective of JAseHN was to develop political recommendations and instruments for cooperation in the four specific priority areas that are specified in the eHealth Network´s (eHN) Multi-Annual Work Plan 2015-2018 (MWP) namely:
(1) interoperability and standardization,
(2) monitoring and assessment of implementation,
(3) exchange of knowledge and
(4) global cooperation and positioning.

The content-related work packages 5, 6, 7 and 8 successfully delivered guidelines, frameworks, reports and other policy documents to the eHealth Network. Depending on its content and objective, these were presented to the eHealth Network for adoption, discussion or for information. The project coordinator (work package 1) guided the overall project and worked closely with the eHealth Network co-chairs. The work packages 2 and 3 provided general support for all work packages on a horizontal level in terms of dissemination and evaluation of interim and final results. Work package 4 focused on a structured involvement of eHealth stakeholder organisations acting on the EU level in the ongoing project work during the entire project duration. In total, JAseHN elaborated 50 deliverables, thereof 37 deliverables supporting the policy work progress and 13 delivereables supporting the operational horizontal work progress. Additionally, 27 sub-deliverables were worked out and used as interim work results.

Methods and means

In order to enable strategic discussions, monitor, coordinate and implement progress of work three committees were installed that are, partly, staffed with different experts from the JAseHN beneficiaries and deal with different sets of matters:
- The Coordination Group (CG) comprises the Coordination, all WPLs and Co-WPLs. The CG serves as a first entry point for alignment of work progress and communication before information will enter into both PSCs.
- The strategic Project Steering Committee (sPSC) comprises of one representative of each Associated Partner (AP) and Affiliated Entity (AE). The sPSC shall be convened 1 or 2 months prior to the eHN meetings. The sPSC primarily discusses the upcoming topics of draft agenda of the next eHN meetings and is assigned to do the final preparation and approval of all deliverables intended for the submission to the eHN. Through the establishment of the sPSC a structured involvement of strategic experts within the preparation of the eHN meetings is guaranteed.
- The operational Project Steering Committee (oPSC) comprises of one representative working at the operational level of each AP and AE. The oPSC shall be convened by PC according to needs, usually twice a year to report and decide on financial aspects. The oPSC deals with and decides on all administrative and housekeeping issues related to JAseHN, any possible amendments of the GA, of the CA, major changes in the working structure as well as any other issues related to the operational level of JAseHN.

To ensure best quality regarding content of regular deliverables and especially eHN-deliverables an elaboration process was established that is outlined in detail in the Governance Manual (D1.2). Through this elaboration process it is assured to have internal agreement about the content of all deliverables. In addition all deliverables need to undergo a QM procedure executed by WP3.
In the elaboration process for eHN-deliverables also specific stakeholder involvement is foreseen. During the drafting phase in the course of the elaboration process of the eHN-deliverables the respective TL need to decide upon the need of specific stakeholder involvement. TL has to address the necessity to WP4 that will further align with the respective stakeholder(s) in order to establish the connection.
Through a liaison process - implemented by WP4 in order to optimize the involvement of the EU level eHealth stakeholder organizations - those stakeholders interested in contributing and/or reviewing draft documents of JAseHN deliverables intended for the submission to the eHealth Network written and elaborated by the content-related work packages have the possibility to be actively integrated in the JAseHN elaboration process of eHN-deliverables.
Within the decision phase of the elaboration process of eHN-deliverables the TLs have to decide on how the review shall be done. This could be by the method of a f2f workshop, a TCon, email correspondence, etc.
In special circumstances an email-questionnaires can be used for conducting MS surveys, etc.

In order to ensure the implementation of the Project and the fulfilment of contractual obligations and further to minimize the risk of faulty production of deliverable, JAseHN implemented a mature and effective risk management. The Risk Manager participated in all CG meetings to figure out those risks with a high potential to deviate from the original delivery plan regarding time and content. After the identification of all risks the CG was in a position to take appropriate measures.


Work performed during the reporting period

- Work Package 1
Strategic Level
On the policy level, PC acted as the Member States’ co-chair of the eHN and thus contributed with relevant preparation and follow-up activities on the political high-level aiming to further guide Member States. Moreover, PC consulted the eHN sub-group with the elaboration of the eHN’s Multiannual Work Programme 2018-2021.

Operational Level
Project Coordinator (PC) continued acting as the intermediary between representatives from the European Commission (particularly DG SANTE, CHAFEA) and the JAseHN beneficiaries. All tasks assigned to the PC were performed as described in the Grant Agreement (GA), in the Consortium Agreement (CA) and in the Governance Manual (GM). As guardian of the finances the PC supervised financial reporting processes, especially guided the financial periodic reporting for RP2 towards CHAFEA and constantly monitored financial developments and potential risks as part of the PC’s financial management responsibilities.

Furthermore PC guided JAseHN Associated Partners to draft their Financial Statements for RP2 on the Participant Portal of the Commission. In this context PC also provided individual support for those Associated Partners that had problems with submitting and signing their Financial Statements.
Because of the need to extend the project duration by two additional months, especially because JAseHN was also responsible for the content wise preparation of the 13th eHealth Network meeting, that was held on 15th May 2018 in Brussels, PC prepared a 2nd amendment request to the Grant Agreement in order to enable preparatory work prior to and follow-up work after the meeting for proper and sustainable results.

In RP3 PC also continued with preparing all committee meetings, guiding discussions in the right direction, proposing decisions and preparing the agenda and the minutes and monitoring the implementation of the decisions taken at those meetings. In RP3 PC organized, prepared and chaired several committee meetings (oPSC, sPSC and CG). During RP3 two sPSC meetings were held in order to enable strategic discussions, monitor, coordinate final preparations towards eHN meetings, particularly on the project´s prioritization of work and towards the deliverables intended for the submission to the eHN for the 11th eHN meeting held in May 2017, the 12th eHN meeting held in November 2017 and also the 13th eHN meeting held in May 2018. During RP3 also three oPSC meetings were convened in order to brief the oPSC members about all important matters concerning the financial reporting, planning and monitoring, about the elaboration and preparation progress of regular deliverables and milestones of all horizontal WPs and to vote on financial and administrative issues where a collectively decision on the operational level was needed. PC also continued with initiating the updating of the timeline, the operational workplan following each CG meeting on a constant basis. PC also carried out the financial management and constantly monitored budget developments.


- Work Package 2
See under chapter "Dissemination and Evaluation activities carried out so far and results".


- Work Package 3
See under chapter "Dissemination and Evaluation activities carried out so far and results".

- Work Package 4
JAseHN’s aims for stakeholder liaison were to foster mutual awareness and to support stakeholder advisory processes, i.e. to
• Raise EU level eHealth Stakeholders awareness for plans and achievements of the eHealth Network and likewise raise network member awareness for positions of these stakeholders. One communication channel for this has been the regular reporting at the meetings of the eHealth Stakeholder group attached to EC reports on the eHN.
• Provide all EU level stakeholders with information on JAseHN deliverables foreseen to be tabled to the eHN inviting them to provide expertise and advice.
• Facilitate multi-stakeholder advisory processes e.g. in the form of worksh

The main output achieved so far and their potential impact and use by target group (including benefits)

KEY POLICY DOCUMENTS ELABORATED BY JASEHN AND ADOPTED BY THE eHEALTH NETWORK
• General Guideline on the electronic exchange of health data under cross-border Directive 2011/24/EU, with a
o Guideline on Patient Summary for unscheduled care
o Guideline on ePrescriptions and eDispensations
• (Legal) Agreement between National Authorities or National Organisations responsible for National Contact Points for eHealth on the Criteria required for the participation in Cross-Border eHealth Information Services
• Organisational Framework for National Contact Points for eHealth and several specific policy papers serving as main basis for the preparation, deployment and operation of the National Contact Point for eHealth
• Refined eHealth European Interoperability Framework (ReEIF)

KEY RESULTS ACHIEVED TOWARDS ESTABLISHING THE EHDSI
Among the 37 policy documents elaborated by JAseHN, 15 focus on prerequisites and key elements used for the establishment of the eHDSI, that was launched beginning of 2017. The majority of those documents dealing with the provision of the generic services in the participating countries under the eHDSI referring to the preparation, setting-up, deployment and operations of the National Contact Point for eHealth (NCPeH). Particularly, the following activities were carried out by JASEHN:
• Guiding the EU Member States application process for CEF funds
• Definition of a governance process
• Legal basis for the exchange of Cross-Border eHealth Information Services
• Policy papers shaping the grounds for the provision of generic services
• Guidelines for the Cross-Border eHealth Information Services patient summary and ePrescription/eDisepensation
• Support of the ongoing work of the eHDSI

With regard to the work linked to the "eHealth Digital Service Infrastructure" JAseHN generally built its work on the basis of outcomes and experiences resulting mainly from the epSOS and the EXPAND projects and the 1st eHealth Joint Action “eHealth Governance Initiative”. With regards to the eHealth Digital Service Infrastructure, JAseHN cooperated closely with the (future) implementation bodies of the eHealth Digital Service Infrastructure. Hence, facilitated the application process to receive funding from the Connecting Europe Facility Telecom programme for 21 EU Member States and supported the preparatory phase by delivering respective frameworks and policy documents linked to the preparation, deployment and operation of the National Contact Point for eHealth that forms the core of the eHealth Digital Service Infrastructure . Since 2017, JAseHN also supported the ongoing operational work of the Connecting Europe Facility eHealth Digital Service Infrastructure.
JAseHN updated already existing guidelines on Patient Summary for unscheduled care and ePrescription and eDisepensations that form the main reference documents for countries when it comes to the exchange of the cross-border eHealth Information Services. As legal basis for every country for the cross-border exchange of personal health data - a Legal Agreement between National Authorities or National Organisations responsible for National Contact Points for eHealth was provided by JAseHN.

JAseHN deliverables elaborated in the area of interoperability dealt with policies regarding electronic identification, authentication and trust services, electronic identification and health professional registries, to pave the way for a common and interoperable eHealth solution and with Member States alignment of standardisation and semantic interoperability as well as cooperation with the standards developing and profiling organisations . Deliverables elaborated in the area of monitoring and assessment of implementation focused on the assessment of the implementation of already existing guidelines dealing with patient summary and ePrescription and eDispensation. Deliverables linked to the area of exchange of knowledge deal with the sharing of national e

Achieved outcomes compared to the expected outcomes

The project JAseHN has successfully fulfilled its purpose: besides providing a continuous, stable professional support to the decision-making eHealth Network, most importantly achieved to be widely recognized as the main strategic level coordination platform of eHealth in the EU. As JAseHN achieved to set most of the framework of cross border health data exchange, now the new Multiannual Work Program of eHealth Network can focus on implementation and sustainability. Thus the upcoming 3rd Joint Action (eHAction) is not only continues to support the work of eHealth Network, but also focuses on implementing and further developing JAseHN results.

Dissemination and evaluation activities carried out so far and their major results

Dissemination activities during and after the Project:
During JAseHN´s life cycle WP2 produced several deliverables and carried out various dissemination activities.
The main WP2 activities focused on
- Setting-up project design and the house style
- Drafting the Communication and Dissemination Strategy (D2.1) and the Concept for a master plan for conferences at the European leven (D2.2)
- Designing and printing the project´s leaflet (D2.4.1)
- Programming the JAseHN Collaboration Site
- Programming and designing project webpage (D2.3)
- Elaboration of press releases
- Holding of Presentations during several conferences in order to disseminate project results
- Maintaining JAseHN Collaboration Site and JAseHN Webpage
- Creation of the D2.4.2 Laymen version of the final report
- Creation of final project folder

JAseHN results were presented regularly at different eHealth conferences.

The JAseHN Webpage http://jasehn.eu/ provides detailed information about the background, structure and objectives of JAseHN. Furthermore all eHN deliverables produced during project´s lifetime are made available under the documents/deliverables section in order to give the outside community access to these products. The JAseHN Website will be available for the next two years.

Evaluation of the Project:
Evaluation activities used a mixed methods approach, with multiple qualitative and quantitative approaches for data collection and analysis. In order to achieve the objectives of WP3, several steps have been taken.
The evaluation strategy that was elaborated by WP3 includes a multi-level analysis of the deliverables to ensure the achievement of the desired quality. To ensure timeliness and consistent quality of deliverables WP3 installed a Quality Management (QM) scheme. This ensured high and consistent quality of content by providing the quality assurance tools. WP3 carried out document quality controlls in close cooperation with the respective WP and TLs aiming to ensure consistent quality of the project’s deliverables. To ensure the quality of the grammar usage, WP3 has supported the process of conducting professional grammar reviews by an external agency that was contacted on demand.
The WP3 team was primarily responsible for collecting and analyzing data and further on for providing conclusions in the final report. Special attention was given to deviation from the work plan. Therefore, the Risk Management Framework, including risk identification and risk assessment, has been used.
The evaluation of WPs was realised using a qualitative methodology to assess the achievement of the proposed objectives and to highlight the main achievements of the WPs. Evaluation was based on the deliverables, achievement of the milestones and outputs of the tasks performed inside the WP. To evaluate the main achievements of the WPs WP3 developed questionnaires that were applied to WPL, findings were compared with WP3´s document analysis and results presented in D3.3 “Final evaluation report”.

The CG served as a first entry point for alignment of work progress and communication before information will enter into strategical committees such as the PSC and eHN. The WPLs + TLs reported regularly about their progress during the CG meetings (elaboration of deliverables, meetings held, future planned work) and together with the PC were discussed all actions needed to be taken. In the course of CG meetings, the evaluation of JAseHN results was done on a constant basis. WPLs and TLs had the opportunity to share their opinion on deliverables presented and topics raised. Other project partners gave their feedback in the course of deliverable review processes. In the course of these review processes, the committees’ oPSC and sPSC (where all project partners are represented) were asked to send comments. These review processes are repeated at least twice per deliverable. Last level to give feedback is at the policy level, through the eHealth network.
To ev

Details
Start date: 01/05/2015
End date: 30/06/2018
Duration: 36 month(s)
Current status: Finalised
Programme title: 3rd Health Programme (2014-2020)
EC Contribution: € 2 400 000,00
Portfolio: eHealth