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NEXES addressed the transfer of complexity from hospital to primary care and patient-home using ICT support. To this end, the project has assessed deployment of four innovative Integrated Care Services (ICS) for chronic patients (respiratory, cardiac and type II diabetes mellitus) including well standardized patient-centred interventions, namely:

  • Home-based wellness and exercise-training
  • Enhanced care for frail patients o Home hospitalisation and early discharge
  • Remote support to primary care for diagnosis and therapy Particular attention has been paid to co-morbidities and to the impact of frailty and complexity in the stratification of patient care.

The project (2008-2012) proposes specific strategies for deployment of ICS for chronic patients at EU level.

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