Implementing Personalised, Digitally Supported, Value-Based Care for Myocardial Infarction Patients in Rijeka – A Co-Design Approach in Value Creation

This study, part of the ValueCare project (No. 875215), was initiated to address the complex needs of older people due to chronic conditions, focusing on personalised, value-based care to enhance their health outcomes and quality of life. Understanding that traditional healthcare models often overlook the unique challenges faced by older people, this project was adjusted to older individuals who have experienced myocardial infarction in pilot site Rijeka. The intervention was a collaborative effort involving older people (65+), healthcare professionals, informal caregivers, and organizational experts (managers). The project adopted a co-design methodology highlighting the active involvement of the target groups. This approach ensured that the development, implementation, and monitoring of the intervention were shaped in accordance with the insights and experiences of those directly involved in the Personal and Public Involvement (PPI) process, i.e., co-design activities. The intervention included comprehensive care plans which contained medication adherence, physical activity, and healthy nutrition segments, all adapted to each participant's specific needs. The usage of a cloud-based integrated digital solution enabled the monitoring of participants’ progress throughout the intervention as well as reaching the goals set together with healthcare professionals and informal caregivers via the outcomes-based shared-decision making process. Self-reported outcomes will be analysed in two-time point: at baseline and post-intervention after 12 months. Those outcomes include health-related quality of life, wellbeing, quality of life, frailty, lifestyle behaviour, loneliness, physical functioning, fear of falling, adherence to medication, and social and health care utilization. The differences in outcomes between intervention (N=120) and control group (N=120) will be analysed using logistic and linear regression tests. This project highlights the effectiveness of personalized and co-designed public health interventions in improving the lives of older people that experienced myocardial infarction. It underscores the value of PPI in developing healthcare solutions that are truly responsive to patient needs and contribution to the definition, implementation and adaptation of future public health interventions related to the value-based approach. The next steps include expanding this model to other demographic groups and health conditions, continually refining the approach based on patient feedback, and exploring digital solutions to further personalize and streamline care delivery. The overarching goal remains to embed this patient-centred approach more deeply within the public health system.