Abstract EHMA 2025: HARMONICS Systemic implementation of harmonics high-value integrated stroke care: analysis from Catalonia and Portugal Context: The Harmonics project tackled silos between acute care and post-discharge, which lead to fragmented care and poorer health outcomes. Implemented across multiple healthcare providers and systems in Europe, it aimed to improve continuity of care, patient outcomes, and efficiency. This study examines adoption in Catalonia and Portugal, where high-value care methodologies for systemic transformation were applied. While a multi-provider, multi-system adoption began, systemic adoption may now be addressed using lessons learned. Catalonia transformation is being bottom up with strong participation from all stakeholders, while Portugal one is top down with health reform supporting it. Methods: The analysis used a mixed-methods approach, integrating PiPPi D5.4 outcome indicators to assess long-term impact and health system value. A gap analysis compared standard care with the Harmonics model in Catalonia and Portugal. Interviews with clinical professionals, technology partners, and health administrators, along with working group participation, informed the study. The multidisciplinary Core Team applied PiPPi results to define KPIs for the Girona pilot. Further interviews with clinical, IT, innovation, and economic departments ensured alignment with existing programs. AQuAS structured lessons learned to contextualize Harmonics' high-value care intervention for future systemic adoption. Results: The Harmonics project enhances stroke care through an integrated, holistic approach to reduce fragmentation and improve continuity. Personalized case management and the Nora digital platform improved follow-up, communication, and care pathway monitoring, while early psychosocial risk assessments enabled timely interventions. The Girona pilot successfully implemented primary care stroke case management, leading to expansion in three more health local areas. Key enablers for systemic adoption include alignment with strategic plans, robust business cases and healthcare interoperability. The project also tackled the complexity of integrating high-value care into health system operations by engaging multiple stakeholders and adapting to diverse healthcare contexts. Clinical maps, economic analysis and process mappings showcased the heterogeneity of health systems and the need for a multidimensional vision. Addressing current fragmentation, disconnected data and siloed services, Harmonics seeks to establish adaptable, replicable, and interconnected care pathways, guided by KPIs and evidence-based decision-making to achieve measurable impact across healthcare systems. Discussion: The Harmonics project enhances stroke care through an integrated approach, reducing fragmentation and improving continuity. Personalized case management and the Nora digital platform improved follow-up, communication, and risk assessment. The Girona pilot successfully implemented primary care stroke case management, leading to expansion in three more regions. Key enablers for systemic adoption include strategic alignment, robust business cases, and healthcare interoperability. The study highlights the importance of context-specific factors for equitable implementation of integrated stroke care. In Catalonia, the Catalan Stroke Plan will guide next steps, while Portugal’s NHS LHUs align with Harmonics’ goal of high-value integrated care. This favourable context supports a plan for systemic adoption in LHUs.
Cordero et al. (Wed,) studied this question.