ROSIA has carried out the two remaining co-creation sessions, which proved to be particularly fruitful. As in previous cases, the objective was to explore and co-design solutions to current challenges in tele-rehabilitation from the perspective of the involved groups: application developers and healthcare procurers. Furthermore, in these two sessions, the objective was twofold, as they were also used to raise awareness of the solutions developed (RAISE and Rehabilify), with the aim of identifying new rehabilitation applications to incorporate into the Rosia platform and procurers who might be potentially interested in the solution. Once again, the sessions were held with the help of Eoh-for-Good.

Co-creation session with application developers

It was held on the 4th of September 2025. The specific objective of the session was to explore the ROSIA solution from the perspective of application developers, to gather feedback on the strengths, weaknesses and opportunities of the application, with a focus on its integration with existing solutions and the exploration of new business opportunities.

During the session, attendees demonstrated interest in identifying the value that the session could bring to their own organisations, ongoing projects and platforms under development, reflecting a high level of professional investment and relevance.

The workshop led to the following conclusions:

a) Regulation, governance and trust

• • • Compliance with European regulations (EHDS, GDPR, MDR) is essential for governance trust and patient safety
    • Certification of solutions must be checked by hospitals before they can be prescribed
    • Inspiration can be taken from international examples (EU, US, Denmark) to strengthen governance frameworks

b) Interoperability and standardisation

• • • Interoperability and standardisation (HL7/FHIR, ePROMs) are critical for access, fairness and scalability
    • Three top priorities identified: ease of use, funding and interoperability
    • The diversity of healthcare systems (public and private) must be considered
    • Importance of digital literacy and addressing the needs of older adults

c) Patient identification and payment models

• • • A national patient identifier is required in ROSIA (e.g., Portugal as an example)
    • Need to define a payment model for developers:
      • Public healthcare: framework contracts with centralised coverage
      • Private healthcare: alternative payment collection mechanisms
    • Proposal to create a ROSIA Identity & Integration SDK
    • Proposal for a ROSIA Institutional Marketplace & Financial Settlement

d) Data protection and privacy

• • • Strict compliance with data protection and data security for ROSIA and Revilify
    • Data belongs to the patient; once interaction ends, data must be sent back to hospitals
    • Possibility of pseudo-anonymisation of patients (ID without name)
    • Patients can decide which information to share (except email, which is mandatory)

e) Technical integration and ease of use

• • • • Need for an agile and flexible integration process, with different levels of integration for developers
      • Availability of APIs and webhooks for notifications and data exchange (e.g., prescription, patient follow-up)
      • Integration must be fast and without requiring developers to modify existing solutions

f) Funding and sustainability

• • • • Several funding options were discussed:
        • Direct patient payments (less viable)
        • European or external funding
        • Private sector financing (companies promoting or supporting solutions)
        • Contributions from ROSIA developers to attract apps to the platform
      • In the business plan discussions, different funding and scalability strategies were explored

A topic of particular interest centered on integrating the different elements into the ROSIA platforms, particularly with respect to information management and follow-up care for patients. The session concluded with participants expressing considerable interest in generating synergies and establishing collaborations with other actors, as well as in continuing to exchange ideas in the future.

Co-creation session with public procurers, buyers, demand-side and multipliers

It was held on the 12th of November 2025. The specific objectives were to tackle and address key challenges and barriers in contracting, financing and regulating the potential services that can offer ROSIA’s solution; and to enrich the ROSIA business model with direct feedback from participants.

Notably, we observed a tangible willingness to collaborate among multiple participants. This represents a direct and immediate impact of the co-creation session: several attendees agreed to continue the conversation and further explore potential collaboration opportunities in follow-up meetings after the session. Even some of them expressed interest in introducing pilots and offered their institutions willingness to see and test the project platform in real-world operation.

Some insights could be drawn from the healthcare procurers session, among which are the following:

🎯 Key challenges addressed:

• • • Barriers to adoption:
      • • Interoperability with existing platforms and applications is challenging, since there is a need to ensure that information is processed in a consistent manner so that it can be clearly understood by all users
        • Integration with healthcare systems entails costly burdens, given the necessary resources, time and effort required
    • Priorities vary depending on the buyer: while cost-efficiency and potential savings were acknowledged, the primary goal was seen as supporting patients to continue their treatment rather than generating profit. Nevertheless, a procurer health service will probably not invest in a tool unless it is stable and they see the cost-benefit
    • The need to consider European-wide integration in any business case or implementation plan

💡Collaborative solutions proposed:

• • • The potential role of AI in supporting integration efforts was highlighted
    • The next step should be achieving integration with electronic records, and increasing the flexibility of the platform to incorporate other apps (not just apps related to telerehabilitation)
    • Data protection requirements need to be addressed early in projects, and efforts should be made to strengthen digital literacy
    • Several participants noted the importance of moving solutions from scientific validation to pre-market readiness, including legal and contractual frameworks such as public–private initiatives, before healthcare providers can adopt them
    • Discussions manifested the need for a transformation of payment systems in non-profit institutions, reflecting broader considerations for adoption and scalability of innovative solutions

In conclusion, to achieve successful adoption of ROSIA platforms, the project should showcase the benefits both for the patients, in terms of continuity of their treatments, and for the healthcare systems, in economic terms, by developing a “bussines case”.

The project ROSIA (Remote Rehabilitation Service for Isolated Areas) is coming to an end in December. For this reason, we are organizing a policy workshop aimed at all stakeholders involved throughout its lifetime, with a special emphasis on the participation of representatives from the European Commission.

During the policy workshop, the main results of the pilot will be presented, including key exploitable results, along with lessons learned during the development of the project. In addition, issues related to certification (such as medical device certification and certification of applications integrated into the Rosia platform) will be discussed. Finally, some policy recommendations to improve the PCP process will be shared, based on the experiences of the partners and the synergies with other PCP projects.

The session will take place on December 2, 2025, from 10:00 AM to 11:30 PM CET (online).