Improving patients' outcomes & fragmented specialized care through a connected & advanced Multidisciplinary-Cardio-Metabolic-Clinic

Cardiometabolic diseases—hypertension (HTN), obesity, type 1 and 2 diabetes (T1DM, T2DM), coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and heart valve disease (HVD)—often coexist, are diagnosed late, and are among the leading causes of death and disability in Europe, accounting for over 4 million deaths annually and creating major clinical and economic burdens. Multimorbid patients face fragmented care due to disconnected pathways, unequal access, and lack of integration, personalization, proactivity, and digital support. IMPACT-MED addresses these gaps by designing, developing, and deploying an innovative, scalable, and people-centred Multidisciplinary Cardio-Metabolic Care (MCMC) framework, supported by a clinically enriched digital ecosystem combining mature (TRL>8) and innovative (TRL>5) technologies and services. It aims to build productive public-private collaboration, overcoming fragmented and siloed solutions, and preventing institution- or industry-driven models, ultimately enabling a people-centred continuum of care tailored to patients’ capacity (low, moderate, high) in suffering, coping, and managing cardiometabolic conditions. This transformative model supports proactive, continuous care through integrated health solutions such as AI-based risk stratification, predictive algorithms, remote monitoring, advanced imaging, and patient-centred data collection tools. Four use cases (UC1: AI-based BP management; UC2: remote monitoring post-MI; UC3: T1DM self-management; UC4: T2DM phenotyping and care) will operationalize and validate the MCMC models. The framework will empower patients, guide clinicians, optimize pathways, and support continuous disease management. IMPACT-MED will deliver a robust MCMC framework and share with the MCMC community an observatory dashboard with validated expansion and sustainability guidelines and a regulatory strategy to ensure long-term success and global scalability.