Creating value in patient-centred care by aligning the supply chain with service provision: Experiences with RITMOCORE

An ageing European population translates into a steady growth in the demand for pacemakers. Budgetary constraints in healthcare systems call for innovative solutions to meet this rising demand while safeguarding the quality of care. The current approach generally consists in reducing the price per device by aggregating buys, but this creates a misalignment in the value chains of suppliers and healthcare providers. Clinicians, already overworked, do not have access to technologies that could significantly decrease the time required per patient in the follow-up stages of the care pathway. Patients, on the other hand, receive lower-quality follow-up in a care pathway that is already fragmented and where general practitioners lack the necessary information to provide them with comprehensive care. RITMOCORE, a Public Procurement of Innovation (PPI) project funded by the European Union under Horizon2020, was set up in 2016 to transform the care pathway of patients suffering from bradycardias and implanted with a pacemaker. The model proposed by RITMOCORE posits a shift from buying devices to buying services, where payments are outcome based (thus distributing the risk between the parties) and where services are supported by advanced information and communications technology (ICT) systems that make remote monitoring possible.