Optimal - pre project

The project goal was to develop a protocol for a «light house» grant application directed at the Norwegian research council covering the major e-health challenges in current day Norway.

Primary objective

To radically transform care delivery for persons with multiple Long-Term-Conditions (LTCs) leveraged through ICT tools that promote a paradigm shift from profession-centric and reactive care to personalized, pro-active and coordinated care. The new service improves population health, care experience and cost-effectiveness.

Secondary objectives

To develop:

  • An interoperable health information architecture across a fragmented e-health and organizational system that supports health analytics, digital process support, capture of patient- and sensor data, while respecting data safety and stakeholder trust.
  • Tools that digitally support patients’ 1) voicing of their personal realistic goals for care, 2) participation in virtual care teams, 3) pro-active prevention of clinical deterioration.
  • Strengthened competitiveness in Norwegian e-health enterprises through improved products, evidence of benefit and documented business models.

Summary of the OPTIMAL project

For persons with multiple long-term conditions (multi-LTC), today’s healthcare is dysfunctional in ways that current ICT-infrastructures mirror and solidify. This patient group receives re-active, profession-centric and single disease care that not only causes human suffering; it is also extremely costly.

Radical and brave system-level re-design is required to change care from profession to person centric, from re-active to proactive, and from fragmented to coordinated, team-based care. Key to this transformation is ICT tools that activate the right resources at the right time in the right place with the right kind of information and decision support. OPTIMAL has 3 transformational and synergistic social and ICT components:

  1. Individualized care enabled by e-tools that help develop and communicate a) realistic personal goals, b) a personal care plan that is aligned with personal goals, and the result of a shared decision making process based on an evidence based recommended care pathway, and c) a patient evaluation. 
  2. Integrated team care supported by e-tools that identify team members (including the patient) and motivates collaboration through both asynchronous and synchronous sharing of information concerning patient defined goals, team member care-plan activities and team coordination.
  3. Proactive care built on e-tools that a) alleviate health illiteracy and support self-management/ involvement and b) facilitates remote follow-up by non-intrusive self-reported/ sensor data collection that feed into clinical and predictive models, which alert patient and /or providers about a preventable risk in alignment with personal goals.

OPTIMAL aims at a world leading position in knowledge based transformation of health care delivery in line with political goals for person-centered, high quality care. We are an interdisciplinary team of experts within ICT, health and business development. OPTIMAL has a strong buy-in with public and commercial organizations the e-health ecosystem.

The application was submitted the 17. Feb 2016. We received a negative response on the 29 april 2016.

Project partners

Sintef, NTNU, UNN, Trondheim kommune, Tromsø kommune, IMATIS, CheckWare, DIPS, TellU, OUS, Købehavns Universitet, IBM, Harstad kommune, OpenEHR, MedRave, Helse Nord RHF, ITACA, Cerner, Norinnova, Furst AS.


The Norwegian Research Council and Norwegian Centre for E-health Research.

External project participants

Workpackage leaders: Jarl Reitan, F Strisland, L Kayser, M Moe, H Garaasen, M Rumpsfeld, T Normann.

Project manager

Project participants

Last updated

23 July 2020