In summary, NEXES was a deployment project aiming a transferring complexity from hospital to primary care and patient’s home with support of ICT. Its development has required a substantial degree of flexibility involving the application of principles of complex adaptive systems theory. It is of note, that recent reports1 on complexities of patients with co-morbid conditions fully endorse some of the methodological approaches taken in the design NEXES thus opening new avenues for generalization of the project outcomes.

Moreover, generation of novel federated business cases has been identified as a key element in the transitional phase from pilots to extensive adoption. The results of NEXES seem to provide a good basis for the extensive deployment in Catalonia and in different European regions.

The Final Workshop of the project held in Barcelona on April 25th 2012 led to the following conclusions:

  • Recognition that we face very similar challenges despite the heterogeneities observed among European regions.
  • Validation and deployment of novel integrated care services (ICS) for chronic patients should be our core activity. Successful adoption of those ICS will result in more efficient healthcare.
  • Information and Communication Technologies (ICT) plays a pivotal role as enabling tool for the change but it was not identified as the main driving force. Implementation of simple and robust technological solutions is a must to ensure extensive adoption.
  • Collaboration among regions was considered a key element to efficiently build-up the future landscape scenario for efficient healthcare in Europe.

1 Tinetti, ME Studenski, SA. Comparative Effectiveness Research and Patients with Multiple Chronic Conditions. N Engl J Med 364;26:2478-81,2011