Expected impact

1. Evidence of the benefits of delivering adequate information regarding personalised risk prediction, prevention and intervention, based on proof of concept and involvement and specified roles of relevant stakeholders

Despite the availability of effective intervention options, long-term benefits of cardiac rehabilitation (CR) are often disappointing due to low uptake and/or nonadherence. Especially, patients with advanced age or multiple comorbidities often display high nonadherence rates during the cardiac rehabilitation programme, with related need for a targeted intervention. In TIMELY, patient motivation, selfefficacy, and engagement leading to activation are considered the most important predictors of healthy longterm lifestyle changes and adherence. Thus, patient activation is a primary outcome of the TIMELY intervention and will be assessed before the intervention, at the end of the intervention and at follow-up six months after the intervention. One of the secondary outcomes is health literacy, assessed before rehabilitation and at six-month followup.

2. Clear improvements of outcomes for individuals, care systems and wider society from prevention measures and interventions based on personalised early risk prediction in comparison with current practices

Secondary prevention which will be provided in TIMELY with an eHealth, AI platform, is effective in reducing total and cardiovascular mortality and hospital admissions. Evidence also points towards beneficial effects on exercise capacity and health-related quality of life (QoL). These benefits appeared to be consistent across chronic CAD patient categories (including those at risk) and intervention types (comprehensive and exercise only) and independent of setting (centre based, home or combined) and publication date.

3. Usefulness and effectiveness of integration and coordination of interventions in new health and care pathways based on person-centred early risk prediction, prevention and intervention models

TIMELY aims to further reduce cardiovascular morbidity and mortality by increasing uptake and fully integrating secondary prevention and cardiac rehabilitation. Despite a class I A indication in major contemporary ESC guidelines, referral and uptake of cardiac rehabilitation remains low in Europe. The EUROASPIRE IV survey illustrates that only half of eligible coronary patients were referred and a minority attended a cardiac rehabilitation programme. Integration of the patients’ perspective and tailoring of the programmes based on patients’ preference which is one of the cornerstones of the TIMELY intervention may help to increase uptake and provide incentives to cardiologists for prescribing maintenance CR programmes. By 2024, TIMELY can be a certified eHealth solution for CR, i.e. a novel care pathway for patients with CAD.

4. Realise large-scale collection of user-generated data in compliance with data protection, privacy and security rules and principles

TIMELY aligned with the Communication on Digital Transformation of Health and Care in the Digital Single Market identifies three priorities:

  1. TIMELY will enable citizens to access their health data across the EU through their personal apps in which the important information related to their disease will be available also across borders.
  2. The TIMELY-Net platform will promote collaborative research by enabling researchers and other professionals to pool resources (data, expertise, intelligent analytics and storage capacities) across the EU and increase their knowledge on the effects of cardiac rehabilitation in the long term. Integration with EOSC will also be a priority for TIMELY.
  3. TIMELY provides the digital tools to empower people to look after their health, identify risks early enough to react, stimulate prevention and enable communication, feedback and interaction between patients and caregivers and healthcare providers.