1. Compilation of indicators

     

    An initial list of indicators is composed from literature, in particular from the MAST framework, and from existing indicators collected at the regions.

  2. Structure in domains/subdomains

     

    In contrast to existing frameworks, the ACT evaluation framework is not meant to evaluate and compare technologies. In fact, technology is only one of the many aspects to consider in the evaluation of CC&TH deployment. Therefore, we restructure existing indicators to fit with the areas of patient stratification (WP5), care coordination (WP5), patient adherence (WP6), and outcomes (WP7). Within each area we will structure the indicators by domains, and if relevant, subdomains.

  3. Selection of domains/subdomains

     

    The selection of domains and subdomains is initially driven by the indicators found in literature and the indicators that are already collected in the regions. These provide a first pointer of which aspects are important within the ACT areas. The framework of domains and subdomains is then further refined in accordance with the regions and work packages.

  4. Test indicators collection/availability

     

    The process of indicators selection is a small feasibility study using two outcome indicators. Here we test local procedures and regulations with respect to data collection, with the purpose of detecting bottlenecks and risks in the data collection and analysis process in an early phase. After the test collection regions should be familiar with the following questions. Which systems contain relevant information? Is there a need for cross-databases query and data aggregation? Do we have permission to access these systems? Is the effort as expected? Can we share the data with external partiers (Philips Research)? The data attributes, data scheme, and transfer for the test indicators are defined in agreement with WP3.

    In the framework of domains, subdomains and indicators, indicator availability is provided by the regions in relation with the selected coordinated care programmes. Availability not only addresses the presence of the indicator, but also the effort to obtain the indicator. The goal is to reduce the full list of indicators to a feasible list of indicators that can be collected by the regions throughout the ACT programme. However, we also acknowledge the need for missing indicators that are desired and make sense conceptually, but not (yet) collected, or difficult to obtain. A potential outcome of ACT is to stimulate the collection of those indicators.

  5. Homogenization of Indicators

     

    Each feasible indicator is carefully defined to ensure a consistent data collection in all regions that allows comparison across regions and within the regions in the analysis phase. During the homogenization phase, we review the framework to detect and solve duplication of indicators in different work packages too.

  6. Baseline selection

     

    The baseline selection describes the indicators for the domains and subdomains that we consider for the baseline assessment. This step includes agreement on the data schemes and transfer mode for the collection.

  7. Prioritisation

     

    In this next phase, criteria for ponderation of the contribution to the domains/subdomains per indicators and of the global WP per domain is agreed. In this way we can have a graphical representation of the WP per region and be able to zoom in and out to the level of domains/subdomains and indicators.

  8. Selection of targets

     

    For each of the baseline indicators regions provide targets for the outcomes that will be assessed and reported in the baseline assessment and for the future assessments during the programme. This way we can use a traffic light representation to show the distance to the target optimal values per indicator and per domain/subdomain and per WP.

  9. Data collection

     

    Here agreed indicators for the domains and subdomains relevant for the baseline assessment and future assessments will be collected according to agreed indicator definitions, data scheme, and transfer mode.

  10. Baseline assessment

     

    The baseline assessment represents and analyses collected data for 2012. Actual outcomes and (deviations from the) targets were reported to the regions.

  11. Iterations assessment

     

    The iterations represent and analyses collected data in 2013 and in some cases in 2014. Actual outcomes and (deviations from the) targets were reported to the regions. The assessment also includes analysis on the evolution of outcomes. The relation between drivers and outcomes is the final step of the ACT.