Despite advances in technology and medical science, modern health-based projects are open to systemic failure due to many factors. These include I.T. developer's lack of awareness with regard to end-user needs, poor communication amongst all parties concerned and inappropriate or inadequate tests of the emerging system. Other issues may be external (e.g. political and legal) such as sharing of patient data and issues surrounding consent. The goal of this paper is to take a major health-based European model in current development and explore how it addresses the needs of four institutions in four different countries, and how it will meet their respective needs. The evaluation was designed within a Logic Model, and uses the Framework approach, and Q-Methodology to assess both impact and evaluation. Data will be collected through longitudinal semi-structured interviews and Q-scoring with principal stakeholders and developers at each stage of the project. This approach, recurring interviews with the same key players in the project, will help ensure that there is mutual understanding between I.T. developers and endusers of the system. The final system is meant to provide effective health-based decision support systems for policy makers.

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prophylactic CRT implantation in patients with preserved LV was addressed in the BIOPACE trial, however these results were not formally published and controversy still exists about the type of device to implant in patients with near normal LV function. 3 Our study describes the variability in our clinical practice given the split in PPM vs CRT in patients with near normal LV function. The increased age and mortality trend in the PPM group may reflect an increased frailty or co-morbidity compared with the CRT group. However, long term clinical outcomes are required in order to provide clarity on this important clinical decision.