Connected IN-4-AHA tools and outputs

Authors: Lucia Saborido and Gisela Garcia-Alvarez, CSG Cluster Saúde de Galicia

As IN-4-AHA is coming to an end we want to emphasize the bigger picture and analyze the connections between tools and outputs of Working Packages (WPs) Innovation Scaling Model (WP3), Test and Validation Activities to Design Scalable Solutions (WP4) and Impact Assessment and Governance Data (WP5) as well as the digital tools developed along this project.

We could say that WP3 is the backbone ensuring long-term cooperation within the healthcare ecosystem by building a connected knowledge base that considers existing solutions and provides a validated model for the co-design process of innovation in the healthcare and social care sectors. A participatory design review and participation in workshops have been carried out that offered a set of tools to engage the end users of the innovative solutions and allow an exchange of views among all stakeholders.

This network of stakeholders involved in the health and social context, are the ones that have been selected to carry out the testing and validation activities to design scalable WP4 Solutions Accessibility mapping and adoption of services and products, where end users are elderly people and their formal and/or informal caregivers. In addition, service providers have used the tools shown in participatory design workshops such as the Decide method, priority mapping, and impact effort mapping to decide the scope of testing. To define the profile of the elderly people who participate in the tests according to each of the projects selected in the open call for living labs, goal-setting workshops have been used. For the testing phase in the living labs, tools such as the Understand method, the Assumption Collecting method, Service Map and Five Why’s have been used to collect feedback from end users. Other tools used in WP4 task 4.2 have been focus groups to map end-user accessibility where families, professionals, seniors and members of the IN-4-AHA consortium have participated.

The business coaching portion of the living lab tests from WP4, T4.1Living Lab Scaling Up and Innovation Manual, has used several participatory design tools such as the Evaluate method, the Ideas method, the Framing method and the Storyboards method.

For WP5 Impact assessment and governance data, a wide range of participatory methods have been used to gather information from stakeholders. In addition, a survey of the service providers selected in the open call has been carried out to explore their use of impact assessment and a map of data management practices. WP5 and WP3 Innovation Scaling Model held a joint participatory workshop to present the initial structure of the Data Management Guide.

Success for a public-private collaboration, analyzed under task 3.2, is based on mutual understanding of goals and how to achieve them, having a joint agreement on success indicators at the end of the project, and having clear expectations about what will happen if there is success. In addition, strong institutional support helps the dialogue between the public and private sectors to have a better collaboration. This collaboration is also reviewed in WP6, T6.3 Investment strategy implementation, where one of the activities is to promote the culture of cross-border impact investing through public and private procurement of innovation.

In summary, the factors that help innovation succeed is that the unmet challenge or need is demand-driven and the solution must be developed jointly between the demand side and the supply side as co-creation. In addition, innovation must adapt easily to daily routines, be easy to use and be reliable. This relates to the T4.1 playbook in Chapter 2 which explains what scaling innovation is and the importance of understanding the customer’s problem. Also in the conclusions of the playbook one of the principles that could help startups is to involve all relevant stakeholders where the recipients of AHA solutions are not only elderly end users, but also those in their environment. This includes family members, national, regional, and local governments, care providers, and other service

The Innovation Scale-Up Model and Roadmap consists of five phases, starting with general information gathering (LEARN) and followed by concentrated efforts to prepare for a pilot project (PLAN). After testing the solution in the target market (PILOT), it is necessary to evaluate all the information collected and establish a detailed plan to implement scaling (PREPARE). Only when proper preparations are made is it reasonable for the solution owner to enter the large-scale target market (RAMP-UP).

In the LEARN phase, the deliverable 3.1 Principles of the participatory design process through participatory design methods and tools has been taken into account. In addition, the participation of all stakeholders and the identification of end users of the deliverable  is also relevant. 4.2  Mapping accessibility and adoption of services and products  and the deliverable 4.1   Living Lab Testing and Innovation Scale-Up Manual,  Questionnaires addressed to service providers have also been taken into account,  service users and facilitators due to the importance of the person-centered approach to contribute to the successful adoption of the solution found in the deliverable 5.1 Review of existing monitoring tools. For the financial part, the information in 6.1 Evaluation of the preparation of the investment has been taken into account.

In the PLAN phase, a review of the legal and regulatory environment of the markets is made, so the  data governance guide of deliverable 5.3 has been taken into account. In addition, the innovation evaluation questionnaire for end-users has also been taken into account.  Se refers to the main factor contributing to successful adoption which is the person-centered approach present in the deliverable 4.2 Mapping accessibility and adoption of services and products and the deliverable 4.1 Living Lab Replication and Innovation Handbook.

In the PILOT phase, a small-scale adoption of the solution is carried out and the learnings and protocols of the deliverable 4.2 Accessibility mapping and adoption of services and products and the tool that measures the focus present in innovative solutions together withthe deliverable 4.1 Manual of extension of tests and innovation of Living Lab is taken into account.

In the PREPARE phase the company of the innovative solution must establish a tactical plan to initiate and execute a large-scale implementation in the target market. Reference is made to the information in Living Lab’s Deliverable 4.1 Testing and Innovation Extension Manual.

In the RAMP-UP phase, innovation has entered the target market and all components already evaluated in the previous phases must continue to be monitored and evaluated. Reference is made to Living Lab’s 4.1 Testing and Innovation Extension Manual.

At a cross-cutting level and common to all phases, information on the guidelines of the innovation assessment framework of deliverable 5.2 has been used. Reference is also made in all phases to the investment resources present in the deliverable 6.2 Long-Term Investment Plan.

The development of the roadmap for the implementation of the innovation scaling model has been made a reference document for all stakeholders involved in scaling up innovative solutions in the field of health and care that is also relevant for the preparation of policies, investment strategies,  communication and promotional activities. For the overall description of the process, goals and expected outcomes and indicators relevant to the success of the scaling process, the AHA’s 5.2 Innovation Assessment Framework and the 5.3 Data Governance Guidelines deliverable have been taken into account. For recommendations on public-private partnership, reference is made to deliverable 3.2 Recommendations on public-private partnership.  Content of the deliverable 6.1 Evaluation of the disposition of the investment and the content of the playbook of the deliverable 4.1 have also been taken into account. In addition, an analysis of accessibility and adoption of the solutions and a review of the content of the focus groups has been carried out, referring to the deliverable 4.2 Mapping of accessibility and adoption of services and products and the deliverable 3.1 Participatory design.

The Scale-Up Model digital tool has been developed from the 3.3 Innovation Scale-Up Model and Roadmap, which is intended for companies whose innovative solution already has feasibility testing at local, regional or national scale, but whose ambition is to expand into new international markets. The model also serves as a tool for industry support organizations: clusters, accelerators and others, so that they can help their members throughout the enlargement process.

Digital tools developed at IN-4-AHA

The participatory design process toolkit is a support tool to create value in small and medium-sized enterprises to evaluate their innovative solution. It is also an interesting tool for policymakers and health authorities as it helps to understand why innovative solutions need to be implemented.

 And also this tool helps investors to better understand the potential of the innovative solution and to participate in the development of the solution from an early stage.

This tool has been made thanks to the contents of the deliverables 6.2 Long-term investment plan, which explains the development path for digital health solutions classified as medical devices, the deliverable 4.1 Living lab testing and innovation playbook (chapter 2), the deliverable 3.1 Principles of the participatory design process and the needs of the large-scale innovation process in the health and care sector,  the deliverable 4.2 Accessibility mapping and adoption of services and products and the deliverable 5.3 Data governance guidelines.

The living labs testing tools for enterprises are in the digital version of deliverable 4.1 within the playbook.

  • The Living Lab Test Preparation tool allows innovators to define their goals, needs and expectations for living lab testing and has been conducted through a series of interviews with living lab coordinators in the IN-4-AHA project.
  • The Living Lab Test Preparation: Solution, Prerequisites and Testing Needs tool serves to acquire information about the pilot solutions and has been conducted through a series of interviews with living lab coordinators in the IN-4-AHA project.
  • The Estimating the values of person-centred care tool helps estimate the values of person-centred care that should be taken into account for the adoption of innovation. This tool collects the opinions of the participants in the focus groups carried out within the deliverable 4.2 Mapping accessibility and adoption of services and products.
  • The Technology Readiness Assessment (TRL) tool serves to describe each TRL (Technology Readiness Levels) and provides checklists to determine if the technology is in that specific TRL.

Enterprise extension tools are also found in the digital version of deliverable 4.1 within the playbook.


Guest blog: Healthy Aging Innovation Will Require A Lot of Collaboration, Testing and Strategic Long-term Thinking

Guest blog written by Tjaša Zajcwho moderated the IN-4-AHA final conference.

Tjaša is an internationally recognized digital health moderator and speaker focused on global healthcare digitalization. She is the founder and host of Faces of digital health podcast, which is consistently ranked among the top digital health industry podcasts. She also works as business developer at the healthcare IT company Better, and is a patient advocate.

The rapid aging of the global population is unquestionable. At the same time, innovators working on solutions for active and healthy aging often face struggles in getting funding and partnerships. Startups need to know the healthcare economics, policy and regulation well, and health and social care providers need to be open to testing, creating living labs and uptake of solutions. These were just a few conclusions mentioned at the closing conference of the 2-year IN-4AHA project, which took place in Tallin on 7 December.

The innovation Networks for Scaling Active and Healthy Ageing (IN-4-AHA) project runs from January 2021 until December 2022, and is funded under Horizon 2020. It connected key European stakeholders who looked at opportunities and challenges in the AHA space related to the current policy landscape and the environment in the EU.

Innovators in the field of healthy aging or healthy living – may it be startups, healthcare or social care providers – face many barriers in their success. In Europe, healthcare systems are fragmented and diverse, making it very difficult for solutions to scale across borders. Because the field of healthy and active aging is severely underfunded, public funding mechanisms play an important part in encouraging new ideas.

The IN4-AHA project looked at three aspects of innovation for healthy aging: investment readiness, innovation scale-up model, and long-term investment plan. “You can’t google your way into the market,” said Andreas Palm, Management Consultant at CIVITTA, a leading independent management consultancy in Emerging Europe, about why collaboration and networking are important for companies when trying to succeed in the market.

In the introductory keynote, Piret Hirv, IN-4-AHA project leader and Manager at Tehnopol/Estonian Connected Health Cluster, emphasized that for solutions to see an uptake on the market, they need to be based on co-creation & person-centredness – meaning that they look beyond the needs of the individual but encompass her broader values, mindset, and motivating factors. With the rising amount of data and its strict regulation, governance is becoming a key issue for many organizations, was discovered through the project.

One of the outputs of the IN-4-AHA project is also a data governance guidebook.

In the closing panel, speakers discussed the future of aging and healthy living. Some of the final policy recommendations of the IN4AHA project include: boosting smart and more accessible funding covering all innovation stages, more harmonized regulatory and reimbursement frameworks to support AHA innovation, support and innovation development approach based on co-creation and participatory design in real-life environments, boosting trust & awareness for health and care professionals and citizens, better connect AHA innovation community, making the most of existing platforms and initiatives.

In 2020, life expectancy in the EU was 83 years for women and 78 for men. The number of healthy life years at birth was estimated at 64.5 years for women and 63.5 years for men in the EU. So on average, women spend almost 20 years with disability, and men 14 years, according to eurostat. There is much room for improvement in reducing the years with disabilities.

Nele Labi, Vice-chancellor for Innovation, Estonian Ministry of Social Affairs, encouragingly said that while we live in very uncertain times, trends around migrations, lifestyle, and aging are known, which should be encouraging for those invested in changing healthy living.

Blog: IN-4-AHA at European Week of Active and Healthy Ageing 2022 (Gdansk)

Ageing - the only true democracy

IN-4-AHA presence at EWAHA 2022

The European Week of Active and Healthy Ageing (EWAHA) is an annual event organised as part of the AAL (Active Assisted Living Program) co-financed by the European Commission. 

The EWAHA is an initiative of the AAL Programme, which aims to improve the quality of life for older people and to strengthen the industrial opportunities in the field of active and healthy ageing through the usage of Information and Communication Technologies (ICT).

EWAHA 25-26-27 October 2022 was the final edition of the European Week of Active and Healthy Ageing, building on 14 years of legacy of the AAL Association’s AAL Forum, sharing knowledge and showcasing innovation at all levels in the active and healthy ageing sector. 

The event was hosted in the beautiful city of Gdańsk. The IN-4-AHA team presented an exhibition booth and met with stakeholders within the active and healthy ageing community, among which several interesting startups with innovative solutions. This was also a great opportunity to share some of the outcomes from the IN-4-AHA project toolkit and roadmap for scaling.

The programme of EWAHA 2022 consisted of interactive workshops, discussions, plenary sessions, exhibitions, and match-making activities. The focus of this final conference was to reflect and evaluate the last decade of the AAL legacy but also open the door to the future and see how we can address tomorrow’s challenges in the European agenda for ageing.

The Mayor of Gdansk, Aleksandra Dulkiewicz opened the event at the European Solidarity Centre, followed by an unexpected appearance from Lech Wałęsa, the former president of Poland, a Nobel piece laureate and the man who spearheaded the Solidarity movement in the 1980s.

The pandemic has changed the landscape in which we all work permanently. The advantages of digital solutions have now been verified and made of use by necessity, and we no longer live in a world where people must be persuaded of the benefits of digitalisation.

At the IN-4-AHA booth we met with many innovative solutions to simplify active and healthy ageing. One example was Robert Huber, CEO for Bellurbis, presented how a clean homescreen provides you with an easy to use smartphone, without excluding the apps you want and need. An additional feature for insecure smartphone users is the possibility to install Easierphone assistant, to provide support remotely on someone else’s Easierphone. Robert has been using Easierphone himself for the past two years, to make sure that this is not only an app for the elderly but also includes all functions needed for everyone.

Another company was German Xtrpy were Michaela Stauch has come up with a fall detection that has a nice design and looks more like jewelry or fit bit, which helps increase the usage of automatic fall detection. 

Both are examples of  simple solutions but clever ideas how to improve the lives of elderly and their caregivers.

Niclas Forsling, working for the Nordic Welfare Center is exploring solutions how to keep the Nordic welfare model up to speed by adding digital solutions built into infrastructure in the less populated parts of the Nordic countries. Start – HEALTHCARE AND CARE AT DISTANCE (

Ageing is something that affects us all“the only true democracy”, as one speaker put it. The final plenary session, hosted by AAL’s Nicola Filizola, focused on the legacy, bringing perspectives from across the board and hinting at how the themes carried for so long by different programmes will be carried forwards in the coming years. One theme that has developed and risen in prominence through the years is the so-called ecosystem approach, which is now taking a central position in discussions about how to bring our health and cares systems forward into the future so that they can help people live happy, active, and independent lives as they grow older. This concept has reached maturity at just the right time as the AAL Programme starts to wind down. The ecosystem approach recognises that silos must be broken down and deeper collaborations are encouraged.

Lech Wałęsa, former President of Poland, speeching at EWAHA 2022
Monica Yngwe and Christina Bergstrand, EIT Health Scandinavia
Iván Rarís, Cluster Saúde de Galicia
Written by: Christina Bergstrand, EIT Health Scandinavia

IN-4-AHA final conference “Boosting the scale-up of innovation for Active and Healthy Ageing”

After two years of hard work and collaboration by the IN-4-AHA project consortium partners, Cluster Saúde de Galicia, CivittaPraxisEIT Health ScandinaviaProud Engineers, XAMK, University of Porto Competence Center for Healthy and Active Ageing Porto4Ageing, SIH EEIG – Slovenian Innovation Hub, and EUREGHA – European Regional and Local Health Authorities, under the guiding leadership of Tehnopol, our project comes to an end. We celebrated our achievements during the final conference on 7 December. The event took place at the Arvo Pärt Centre in idyllic Laulasmaa, Estonia, and was streamed online so people from all over Europe could join. The whole conference was moderated by Tjaša Zajc.

The day started with welcoming words from European Commission Vice-President for Democracy and Demography, Dubravka Suica. Next, Piret Hirv, IN-4-AHA project leader at Tehnopol/Estonian Connected Health Cluster introduced the IN-4-AHA project, the challenges to be tackled and how the consortium chose to approach these. Emphasizing the co-creational character of IN-4-AHA, she explained: “From the beginning, we designed the project around the core concepts of person-centeredness and end-user involvement”.

Nele Labi, Undersecretary General for Innovation at the Estonian Ministry of Social Affairs, further set the mood with her keynote speech on how to bring innovation to service provision in health and care, sharing valuable insights into the Estonian case. “Innovation is not just about ideas, but about execution”, she said, adding that “to create more room for innovation we need to start sharing our data”. In line with this statement, the potential of data and data sharing proved to be a recurring topic throughout the day for speakers as well as members of the audience. 

Below you will find a brief summary of the main take-aways from each panel. The full recording is also included and will remain available for you at any time, should you wish to recap part or all of the IN-4-AHA final conference. At the end of this article, you can find the full recording of the conference and other interesting project resources to browse through.

The European investment landscape in the field of AHA
Andreas Palm, Senior Consultant, CIVITTA, IN-4-AHA WP6
Piret Hirv
, Project leader IN-4-AHA, Tehnopol/Estonian Connected Health Cluster
Annika Szabo Portela
, Managing Director, EIT Health Scandinavia

  • The European AHA market is growing and likely to remain stable over the coming years
  • Smart combinations of public funding in early development stages and private funding in later stages are needed to boost innovation
  • Living Lab testing can help gain market access
  • Focus on the development of needs-based solutions
  • Find partnerships and experts to support your innovation process
  • Investment readiness assessment & long-term investment plan


Evaluating innovation, Living Labs, and the potential of person-centeredness
Gisela Garcia Alvarez, Managing Director, Cluster Saude de Galicia, IN-4-AHA WP4
Anni Kurmiste, Health Policy Analyst, Praxis Think Tank, IN-4-AHA WP5
Nick Guldemond, Professor healthcare and public health at Sechenov Medical University and Leiden University Medical Center in the Netherlands, Expert Member WHO Working Group Digital Health
Victor Stephani, Chief of Staff, HelloBetter

  • Living Lab environments offer real world testing conditions and opportunities for co-creation with end-users.
  • Person-centeredness of an innovation correlates with the potential for uptake, meaning a higher degree of person-centeredness leads to increased potential for adoption.
  • Evaluation should be incorporated into all stages of innovation development from beginning to end, preferably including a measure of person-centredness.
  • Only needs-based solutions are worth developing further.
  • Person-centeredness is a necessary component for certification within the German DiGA system – potential example for other countries.
  • Overview of existing evaluation toolkits, IN-4-AHA innovation assessment framework, evaluation toolbox, living lab testing & innovation scale-up playbook.

Harmonising regulations – Health data for Active and Healthy Ageing
Hille Hinsberg, Product Manager, Proud Engineers, IN-4-AHA WP5
Liina Joller-Vahter, Project Manager, EIT Health Scandinavia, IN-4-AHA WP2
Jukka Lähesmaa, Consulting Officer, Ministry of Social Affairs and Health, Finland
Karolina Mackiewicz, Innovation Director, ECHAlliance

  • Data governance one of the main challenges to be tackled in digital transformation of health
  • Efforts to harmonise legislation, e.g. through the upcoming European Health Data Space, prompt necessary revision of companies and organisations’ data governance structures
  • Several Nordic countries are in the vanguard of digitalisation, for example Estonia with its sophisticated eGovernment structure where citizens control all their data on a single platform. Furthermore, Finland has aggregated all data related to health and social care under the Finnish Social and Health Data Permit Authority instead of letting them reside within the separate institutions collecting these data.
  • Surveys from ECHAlliance have shown people are ready and willing to share health data, we now need secure systems to enable this.
  • IN-4-AHA Data Governance Guidebook.

Active and Healthy Ageing and Living in Europe: present and future
Michele Calabro, Director, European Regional and Local Health Authorities, IN-4-AHA WP7
Donna Henderson
, Head of International Engagement, Digital Health and Care Directorate, Scottish Government
Nele Labi
, Vice-chancellor for Innovation, Estonian Ministry of Social Affairs, Estonia
Mihkel Tedremaa,
Co-founder, TempID

  • EU level is moving from Active and Healthy Ageing towards concept of Active and Healthy Living, signaling a life-course approach not tied to any specific age bracket but rather focused on health prevention and promotion of active, healthy lifestyles.
  • Harnessing the potential of data access and data sharing are crucial for the future of health and social care.
  • Co-creation and consistent stakeholder engagement are essential to ensure person-centeredness, and by extension uptake of innovative solutions.
  • Innovation is not just about ideas, but most importantly about execution.