>> However, unlike the cardio pilots in Berlin, the stroke pilots in East Westphalia-Lippe (OWL) can build on what already exists and do not have to start from scratch. The German Impact Foundation
anfall-Hilfe had already begun to develop a far-reaching concept for quality-assured case management (qCM) for stroke care in 2011. This meant that the first stroke controllers were able to start their work a year later, in 2012. This was followed in 2013 by a pilot project funded by the North Rhine-Westphalia Ministry of Health with 5 pilots and 300 included patients in east-western Germany.
falen lip. All of this experience was able to be incorporated into the “STROKE OWL” project, which was approved by the Innovation Fund with the 2nd funding wave (beginning of 2017). Brinkmeier today describes the innovation fund as a “blessing for the frustration-plagued IV scene”. Only through the size and media and political attention achieved with the million-dollar funding would there finally be a real chance to “initiate and anchor real progress in health care in Germany”. Although the official start of the project could only take place six months later, in October 2017, due to many necessary detailed discussions, after a nine-month preliminary phase (only five were actually planned), 17 stroke controllers have now been caring for more than 1,000 affected people in East Westphalia-Lippe since the summer of 2018 . This means that around 50% of the intended target population has been reached. In total, a maximum of only 2,000 stroke patients out of a total of around 6,000 to 7,000 strokes that occur in OWL each year can be included in the project.
The fact that more than 1,000 stroke patients are currently being cared for is a success in itself. The principle of voluntary cooperation generally applies to innovation projects, which means nothing other than that “the concept must not only be convincing in terms of content,” as Brinkmeier states. It is just as important to adequately reflect the respective interests of those involved (“hidden agendas”) in the project context. Or at least to ensure that the consideration of detailed goals neither hinders the implementation of the overarching project goals nor endangers the respective requirements of the members in the project. As Brinkmeier puts it, this is a very demanding task for the moderator, i.e. the consortium leader.
Here the German Stroke Aid Foundation, founded in 1992 by Liz Mohn as an independent foundation under private law, has an absolute advantage over all other consortium leaders that are currently involved in the 119 IF projects of the new forms of care: it is not an original part of the health system and therefore not a participant in the constant competition for the largest possible share of the supply budget. “We are solely committed to patient well-being,” says Brinkmeier, explaining the approach of the foundation, which had endowment capital of almost 70 million euros in 2018. This also means that if the foundation wants to make a difference, it will do it, no matter how long it may take.
The declared goal of the STROKE OWL project is to achieve a significantly lower rate of recurrences or secondary diseases as well as increased participation of those affected by using the pilot principle to be tested.
If the scientific evaluation carried out by the Faculty of Health Sciences at Bielefeld University (Prof. Greiner) in 2021 shows that these goals have been achieved, the pilot principle could become part of standard care. And there's more: The German Stroke Aid Foundation is, on its own initiative, beyond project financing from the fund, decoupling the curriculum for the central case management approach from the indication-specific one. The goal: to develop a case management model (CM) that has already clearly shown that it works in the project context.
The signs for this are already positive. As early as March 2019, the Federal Government's patient representative, Prof. Dr. Claudia Schmidtke, declared the implementation of patient guides a political goal. Nevertheless, the Stroke Aid does not want to wait until the complete evaluation report is on the table one day after the “Last patient out” status and at some point with the appropriate delay.
train is published. Following a possible project extension, this could not be the case until autumn 2022.
In addition, the “General Additional Provisions” of the Innovation Committee (ANBest-IF) at the G-BA only requires that the “funding recipient is obliged to report the result – at least in the factual content of the final report – within six months “to make it accessible to the specialist public in the Federal Republic of Germany in an appropriate manner after the project has been completed.” How and where and in what form remains completely open.
That's why the German Stroke Aid Foundation is already becoming politically active. On the one hand, the basic and, above all, advantages of pilot-based supply management are discussed with various decision-makers - stakeholders, those affected, the innovation committee in the G-BA, but also the executive branch and members of the federal and state parliaments. On the other hand, a pilot law is already being prepared, which - according to Brinkmeier, a member of the state parliament for the CDU in North Rhine-Westphalia from 2000 to 2012 - should clear the way for “one of the most far-reaching health and social policy projects of the next few years”. This is the comprehensive introduction of the then evident principle of health guidance. <<
by: MVF editor-in-chief Peter Stegmaier

Citation note: