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Pilot Sites
Pilot Sites

Mondo Libero

Mondo Libero Onlus will act as a Pilot site. As that it will contribute mainly to WP3 (Service Demonstration) and WP4 (Service Validation & Assessment). Moreover, it will perform Evaluation of the proposed Systems’ Clinical Value. As the title of the centre implies they focus on prevention and have fully equipped facilities for the detection of early risk factors such as carotid intima thickness. Mondo Libero is often frustrated though by the variability in response to treatments such as diet control, exercise and medications, and they understand that part of it, is due to genetic factors and therefore welcome this pilot in their clinic.
They will be coordinating the project within their clinic and working directly with Sciona. Within the group and in agreement with Sciona they will select the patient profile to recruit into the study. A health care assistant will be appointed to help with the actual selection of the patients and the explanation to them of the trial purposes and what would be involved from the patients’ point of view. They will select patients based on their medical profile and their willingness to take part in the full process including the follow-ups. The healthcare assistant will be in charge of organising the visits, helping the patients with the Sciona questionnaire, and coordinating the results of the study. The patients will be seen by Mondo Libero’s physicians who will prescribe the therapy and be responsible for the follow-up. Regarding this aspect they will maintain close contact with Sciona to discuss the personalisation of the therapy according to genetics, to provide feedback on the Sciona system of report delivery and follow-up advice

Klin Biochem

The Department of Clinical Chemistry and Pharmacology (KLINBIOCHEM) will act as one of three pilot sites. The main task of the pilot sites is to perform the evaluation of the proposed systems’ usability and clinical value. A specialist in internal medicine, Markus Look, who already gained experience in projects directed at personalized medicine including working with preventive gene polymorphism analyses and analysis of biomarker, will join the department for the study.
According to the title of the market validation study - “An integrated high secure cross border platform for preventative healthcare incorporating genetic and lifestyle analysis” – the main objective of the survey will be selection of patients who display early risk factors for cardiovascular disease, e.g. high blood pressure, elevated LDL-cholesterol and/or low HDL-cholesterol, elevation of homocysteine, increased inflammatory and coagulation biomarkers, such as interleukin-6 and hs-CRP, fibrinogen, who are accessible to life style adjustments (exercise, diet, cessation of smoking etc.) and medical intervention.
The pilot site KLINBIOCHEM selected the criterion of obesity for the testing of the consortium’s service. Therefore, a case-control study comparing two groups, non-obese vs. obese individuals with respect to their genetic variation, biomarker and life-style habits, will be performed.
Intended final outcome of the EUROGENE project as a whole is improvement of an individual’s and/or physician’s decision making process regarding methods of intervention through diet, exercise, medication and also by means of early identification of risk constellations on a genetic level. Since integration of genetic data into the physician’s or the individual’s decision making process is a novel issue, the presumptions which will be made on the basis of genomic information have yet to be fully validated in the ongoing worldwide scientific process.
Once properly communicated to the patient, knowledge of putative genetic risk-constellations may eventually motivate the patient to introduce significant life-style changes, compared to what is presently achieved in disease prevention without genetic information.
The assets of the Department of Clinical Chemistry and Pharmacology regarding the project include:

Close contact to all medical disciplines present on the university campus and in the region, in order to recruit study participants and to gather information regarding interests of potential stakeholders
Optimum facilities for storage of blood samples for re-analysis and assessment of a wide range of biomarker, such as HDL/LDL-cholesterol homocysteine, B-vitamins, insulin, interleukin 6, hs-CRP, fibrinogen and others. Biomarker levels will be evaluated along with the genetic variants and life style patterns of the participants of the pilot study
As a governmental institution, the department is highly trustworthy with respect to acceptance of genetic testing by the general public. However, an ethics committee’s approval, which is obligatory, will be applied for and the department will not appear as a commercial contractor.
If the survey proves successful in testing the technical capabilities of the system, which is a priority in this phase of the project, further contacts to expand the system could be made with other stakeholders (practitioners and clinics) who are treating and counseling the relevant target groups.
This, however, will also depend on the acceptance of the “tool” of preventive gene analysis by these stakeholders, the society as a whole and most importantly on the pending legislation processes in Germany.

Barbastro HCA

The BHCA is responsible for the public health care services in the eastern half of the Spanish province of Huesca. The BHCA covers all assistance levels: primary, specialized, socio sanitary and mental. The BHCA provides health care services to 100.000 inhabitants within a geographic area of 7.500 square kilometres. Population density is very low, being very dispersed though many villages sparsely populated. The orography of the zone very hard, does not help in order to have good communications; especially in the north part where the Pyrenees Mountains have their main peaks.
The BHCA is divided in fifteen geographic areas called “zonas de salud” (literally “health care zones”). In each of such “health care zones”, there is a Health Care Center that provides ongoing primary health care services to the citizens. Second level (specialized) health care services are provided by the General Hospital, placed in the geographical centre of the geographic area, Barbastro. This Hospital has two branches: one located in Monzón and a second one in Fraga, both covering certain specialities. Besides there is a socio sanitary centre located in the far South of the territory.
The BHCA heads on towards a scenario where an outstanding health care service is provided through the optimum management of public resources allocated whilst reaching a high level of customer satisfaction, fully backed by the citizens. Besides, all and every professionals working for the BHCA are motivated and highly involved in achieving this objective.
The objective is to provide an “end to end” health care service to the citizens and residents within the BHCA geographical area, by ensuring their easy and quick access to the service, understood as: promotion of healthy ways of life; prevention and protection against physical, environmental and biologic factors; provision of any care required in an illness situation; whilst keeping the highest degree of autonomy and insertion of patients in their environment and in the society in order to meet all his/her needs and expectations in terms of personal health.
The hospital has 160 beds available in the hospitalization area. Surgical area has 5 operating theatres. Ambulatory care is provide through offices in the hospital itself as well as in two specialized delegations, located 17 and 75 km away from the main site, respectively.
Medical specialized services available at the hospital are:
Internal Medicine, Cardiology, Gastroenterology, Geriatrics, Pulmonary Disease, Neurology, Medical Oncology, Paediatric, Rheumatology.
In the primary health care area there are 14 health care centres and 136 offices.
The health care sector has made a revolution in the way of managing the gap between the two levels of health care assistance, primary assistance and specialized assistance through the deployment of two strategic project, which the Aragon’s Health Service (Servicio Aragonés de la Salud) is now replicating through the rest of the organization.
The first project consisted on the development of a powerful intranet for the sanitary sector allowing the integration of the different IT systems available in the two levels of health care assistance (primary and specialized), which has been the starting point for the existence of the single record for patient shared among primary, specialized and sociosanitary attention. This approach has improved the availability and accessibility of the clinic data and improving consequently the assistance quality.
Also, a telemedicine system has been deployed allowing the daily contact and the sharing of knowledge among the different professionals in the health care area (practitioners, specialist, nurses, etc.)
Role in the Project
Our geographical area has traditionally depended on the primary economic sector. During centuries, basic food has been based in the kitchen garden, the farmyard, the olive oil and the wine, elements that have played a key role in our population diet; what today is known as Mediterranean diet. In this geographic area a big percentage of the population is elder people, being the average age higher than for the total of Aragon or Spain.
The dietetic advice oriented to maintain the health and prevent the nutritional shortages, as well as the degenerative sickness, are currently a frequent reason for a medical consultancy. Also, some patients need a therapeutic diet as a part of the treatment issued to attack their sickness.
The IT systems integration, a good coordination among the different levels of assistance and the high level of usage of the new technologies in the BHCA are the key reasons for it to become an appropriate scenario for the development of new health care programs developed by multidisciplinary teams.
Considering all these peculiarities and within the program of assistance to elder people we are going to focus our attention on their diet, trying to postpone the ageing process and improving his/her quality of life, whether at the physic, psychological or social level.
In order to get the maximum benefit from this program, it would be very convenient to have available some software tools with and inference machine tools that could provide dietetic consultancy based on the constitutional and environmental information provided by the patient.

The program is leaded by a multidisciplinary team compound by general practitioner, a health technician, a geriatrician, community nurses, a specialist in biostatistics and the adequate admin support.
In order to achieve the maximum from the proposed program, the initial scope will be targeted in two different “zonas de salud” (health care zones): one located in an urban area and another one belonging to the rural world

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