From five feasibility studies to two field-tested solutions
Through three competitive procurement phases, CRANE narrowed five candidate solutions down to the two that were field-tested with real patients in Sweden, Norway and Spain.
A practical, evidence-based answer
What began in 2021 as a question — could people living with chronic conditions truly reach and control their own health data? — ended with a practical answer: yes, it can be built and successfully validated in real care environments. Across its lifetime, CRANE took an initial field of competing suppliers through a three-phase competition and arrived at two complementary, validated solutions — Data for Care and dHDSI — tested in real care settings with citizens and professionals in Region Västerbotten (Sweden), Extremadura (Spain) and Agder (Norway). Both are now continuing to mature through their suppliers’ own routes to market.
The project closed with its Final Demonstration on 17 March 2026, a two-hour online session in which the two contractor consortia showed, live, what citizen-centred digital health actually looks like — each presentation followed by questions from an audience of users, professionals and decision-makers.
Beyond the technology, CRANE leaves behind a value-based evaluation toolkit that any public buyer in Europe can reuse, a set of policy recommendations gathered in its positioning paper, and a body of evidence on what adoption really takes. Its central, and most durable, lesson: earning the citizen’s trust is the foundation everything else stands on — the spirit of the project’s motto, “In CRANE we trust”.
The two solutions that completed the CRANE journey
dHDSI — Decentralised Health Data Space Infrastructure
Coordinator: LCubed AB (iGrant.io)
dHDSI enables secure, citizen-centric management, exchange and use of health data across organisational boundaries, without centralising the data itself, built on three pillars: MyHealthEnabler, a citizen-facing wallet through which people collect, monitor and share their own health data on their own terms, with consent that can be granted, adjusted or revoked in real time; the CRANE Data Marketplace (also known as the Virtual Data Lake), a discovery and transaction layer where data stays at its source but becomes findable and exchangeable under governance conditions, without bilateral integrations between every pair of organisations; and a governance and interoperability framework grounded in eIDAS 2.0, the EU Digital Identity Wallet and ISO 27560-based auditable consent records.
By the end of Phase 3 the solution had transitioned from prototype to a near-production system validated in live environments, with scalable onboarding of new organisations to the Data Marketplace demonstrated with minimal integration effort, and interoperability with heterogeneous systems proven using open standards including FHIR and OpenID4VC.
Data for Care
Coordinator: Data for Good Foundation
Built on the DATA for GOOD (DfG) platform, the solution combines DfG Personal — a citizen-facing dashboard and Personal Data Space (wallet) through which people connect medical devices, wearables and third-party apps and manage consent and data sharing — and DfG Professional (CRANE Insights and the Virtual Data Lake), which lets analysts and service providers run secure, GDPR-compliant computation on blended datasets through Multi-Party Computation (MPC) without moving the underlying data. A neutral governance infrastructure provided by the DfG Foundation, reinforced by a blockchain-based architecture, ensures citizens rather than institutions control how their data is used, interoperable through standards including FHIR and HL7.
According to the contractor consortium, by the end of Phase 3 individual components of the solution reached a technology readiness level (TRL) of 7–9 (DfG Personal, DfG Professional, and its first connected digital services, Mysmaca and Cardiolyse), describing the result as “a state-of-the-art proven solution ready for commercialisation and large-scale deployment.”
What CRANE learned
The project’s most policy-relevant lessons, drawn from its positioning paper Citizen-Centred Digital Health in Europe, reach beyond the technology.
1. Technology readiness is necessary but not sufficient
Successful adoption depends on citizen engagement, professional acceptance, digital literacy, organisational change and integration with existing systems — and each demands investment of its own.
2. Europe is local
Running the same solutions in three countries meant working across different languages, healthcare practices and organisational cultures; what worked in one region could not simply be copied to the next. Adoption happens locally, one region at a time.
3. The legal dimension told the same story
Three countries meant three ethics and data-protection paths: what needed formal approval in one fell outside another’s rules. CRANE kept personal data within each country rather than move it across borders — a plain case for European harmonisation.
4. CRANE leaves behind a practical toolkit
A complete value-based evaluation method: citizens and professionals defined together what a solution had to deliver, those values became measurable indicators — including quality of life and strict data-protection compliance as non-negotiable — and every solution was assessed against them. Ready for any public buyer to reuse.
5. Validation is not the same as market readiness
At the project’s close the solutions — despite demonstrated value — had not reached the maturity wide deployment requires. The shortfall lies not with the project but with a structural gap in how Europe carries innovation from pilot to practice. It is the single most important lesson CRANE has to offer, and it motivates the recommendations that follow.
The suppliers reached the same conclusion independently. In their final reports, the consortia that completed validation argued that reaching real-world use needs a dedicated implementation project of two to three years, with proper budget for the human side: training, change management, integration, communication. Buyers and suppliers sat on opposite sides of this procurement for five years and ended up asking for the same missing instrument.
How to move forward
1. Build flexibility into the PCP instrument
Long, multi-country projects outlive the context they were planned in.
2. Align payments with suppliers’ costs
More frequent milestones or partial pre-payment would support the SMEs the instrument is meant to attract.
3. Add a market-readiness stage between PCP and PPI
A dedicated, modestly funded stage of 12–18 months would complete certification, integration and the adoption package.
4. Fund the full innovation cycle
Including the non-technical, organisational work of adoption — not only the technology.
5. Develop multi-stakeholder business models early
Who buys, operates and sustains the service should be answered during the innovation process, not left open at its end.
6. Fund and procure the trust layer itself
The citizen-side governance everything depends on has no owner and no funding route. Europe should recognise it as a procurable public capability.