A Eureka Eurostars Innovation Initiative

Closing Europe’s Osteoporosis Treatment
Gap with an AI-Enabled Platform.

Across Europe, there are an estimated 23.8 million people considered high risk for a life-changing fracture due to osteoporosis1. Effective treatments are available to reduce this risk, but only a few people receive this potentially life-saving care with around 71% of eligible women not currently receiving preventative care1.

Current health systems struggle to provide preventative osteoporosis care for a number of reasons, including:

Osteoporosis itself is asymptomatic, so case-finding can be challenging.
Management can be complex, and care staff have limited capacity.
Care is long-term, and follow-up and patient engagement are needed to achieve the greatest benefit.

We are tackling these problems by combining ImageBiopsy Lab’s FLAMINGO AI fracture detection with Open Medical’s clinical workflow platform, Pathpoint®. In doing so, we deliver an end-to-end digital Fracture Liaison Service (FLS) solution that automatically identifies at-risk patients and supports effective, guideline-adherent management of long-term care.

Through this project, we also support participating FLS sites in demonstrating their value to patients and their health systems.

Get involved in the project

Osteoporosis is a metabolic condition that gradually reduces bone density over time, making bones fragile and far more susceptible to fragility fractures—broken bones resulting from low-energy impacts, such as a simple slip, trip, or sudden movement. Among the most common are vertebral compression fractures (VCFs), where a bone in the spine collapses. Because these fractures frequently occur without sudden trauma or obvious symptoms, patients often do not realise a fracture has occurred.

When fractures are identified, a Fracture Liaison Service (FLS) steps in as a specialised care team to assess the patient's underlying bone health and initiate preventative treatment. This project strengthens this care pathway by integrating automated AI fracture detection directly into routine hospital workflows. When patients undergo standard CT scans for unrelated clinical reasons (such as chest or abdominal imaging), FLAMINGO AI automatically analyses the scans for signs of undetected vertebral fractures. Confirmed cases automatically trigger an alert in Pathpoint® FLS, enabling clinical teams to rapidly evaluate at-risk patients and coordinate preventative care before a severe secondary fracture occurs.

Logo Bar
Funded by
Supported by

The Research Team

🇬🇧 United Kingdom

A clinician-led, healthcare technology partner founded by practicing NHS

Project Lead

Open Medical is the team behind Pathpoint, an award-winning, multi-specialty, workflow engine designed for care coordination, AI orchestration and EPR optimisation. Trusted by more than 200 healthcare organisations worldwide, the platform transforms end-to-end clinical and operational pathways to deliver smarter, faster care.

www.openmedical.co.uk

🇦🇹 Austria

An award-winning MedTech in musculoskeletal (MSK) AI

Partner

Founded in 2016, IB Lab develops CE-marked and FDA-cleared AI-driven imaging intelligence that digitises bone health diagnostics. Their specialised MSK-AI platform operates across 100+ hospital sites in Europe and the US, standardising x-ray and CT image analysis to enable early disease detection and preventative care.

www.imagebiopsy.com

The Problem

The Clinical Challenge

71% Left Unmanaged

71% of European patients who suffer a fragility fracture are never treated for the underlying osteoporosis, leading to preventable secondary fractures and severe loss of independence.

85% Silent & Undetected

Up to 85% of vertebral compression fractures (VCFs) visible on routine CT scans are never formally reported or diagnosed, leaving high-risk patients entirely unnoticed.

The "Fracture Cascade"

A missed vertebral fracture dramatically increases the risk of a devastating secondary hip fracture within 1–2 years.

The Service Challenge

Manual & Fragmented Workflows

Current Fracture Liaison Services rely heavily on manual triage, fragmented communication, and siloed diagnostic systems. This leads to diagnostic delays, missed referrals, and lost patient follow-ups.

Administrative Overburden

FLS teams spend 30–60 minutes per patient on manual data collection and national audit reporting. This heavy administrative workload diverts valuable time away from direct clinical care.

The Infrastructure & Capacity Constraint

FLS teams are expected to prove their clinical and financial value before receiving the funding needed to build the digital infrastructure to do so. This leaves many services trapped without the data required to secure long-term investment.

Our Solution

An End-to-End, Closed-Loop FLS Pathway

Combining automated AI detection with executable clinical guideline orchestration to bridge the treatment gap.

Pathpoint FLSHandover Confirmed cases are passed to Pathpoint FLS via structured data transfer, triggering the clinical workflow. RoutineCT Scan Patient undergoes CT imaging (abdominal, chest, spine) in the course of standard care for unrelated indication. FLAMINGO AIAnalysis FLAMINGO analyses the CT scan, automatically detecting VCFs² for subsequent clinical confirmation. FLS Triage& Diagnostics FLS team manages initial triaging, DXA³, and other diagnostic work-up through digitally integrated workflow. Treatment& Follow-Up FLS team manages treatment, patient communication, structured follow-ups and specialist escalation.
FLS Triage& Diagnostics FLS team manages initial triaging, DXA³, and other diagnostic work-up through digitally integrated workflow. RoutineCT Scan Patient undergoes CT imaging (abdominal, chest, spine) in the course of standard care for unrelated indication. FLAMINGO AIAnalysis FLAMINGO analyses the CT scan, automatically detecting VCFs² for subsequent clinical confirmation. Pathpoint FLSHandover Confirmed cases are passed to Pathpoint FLS via structured data transfer, triggering the clinical workflow. Treatment& Follow-Up FLS team manages treatment, patient communication, structured follow-ups and specialist escalation.
Pathpoint FLS Handover Confirmed cases are passed to Pathpoint FLS via structured data transfer, triggering the clinical workflow. Routine CT Scan Patient undergoes CT imaging (abdominal, chest, spine) in the course of standard care for unrelated indication. FLAMINGO AI Analysis FLAMINGO analyses the CT scan, automatically detecting VCFs² for subsequent clinical confirmation. FLS Triage & Diagnostics FLS team manages initial triaging, DXA³, and other diagnostic work-up through digitally integrated workflow. Treatment & Follow-Up FLS team manages treatment, patient communication, structured follow-ups and specialist escalation.
1 VCF: A small fracture or collapse in one of the bones of the spine, often caused by bone weakness (osteoporosis). These frequently happen without sudden trauma or severe pain.
2 DXA: Dual-energy X-ray Absorptiometry — a scan used to measure bone density.

Outcomes & Benefits

For Patients:

Early & Silent Detection: Identifies hidden spine fractures early, often before severe symptoms are felt using CT scans already being performed for other medical reasons.

Protecting Long-Term Mobility: Connects patients with timely, preventative bone care to protect physical strength, maintain independence, and lower the risk of severe future injuries like secondary hip fractures.

Clear, Connected Care: Ensures hospital scan results are automatically passed to specialists who can guide patients and families through simple testing and treatment options without unnecessary delays.

For Healthcare Services:

Automated Workflow & Triage: Seamlessly routes AI-flagged vertebral compression fractures directly into integrated FLS management software, eliminating manual search bottlenecks.

Reduced Administrative Effort: Drastically cuts manual data entry time for patient evaluations and simplifies national audit database reporting.

Actionable Health Economic Evidence: Provides participating pilot sites with an independent Health Economic Evaluation to build a validated, site-specific business case for long-term local commissioning.

Pan-European Impact & Economic Projections

Evaluating the broader clinical, societal, and financial potential of integrated FLS care across Europe

Diagnostic Gap Closed
15% → 100%
Bridging the diagnostic gap by identifying the 85% of vertebral fractures that currently go undetected on routine scans.
Clinical Impact
>20,000 Secondary Hip Fractures Prevented
Target annual reduction in severe secondary hip fractures across European health systems through proactive screening and guideline-aligned care coordination.
Economic Savings
€500 Million Annual Healthcare Savings
Potential direct cost avoidance for EU and UK health services by reducing emergency admissions, secondary surgical interventions, and prolonged post-fracture care.

Current Evidence

91%

VCF Flag Rate:

FLAMINGO automatically identifies and routes 91% of vertebral compression fractures (VCFs) from routine CT scans directly to a radiologist worklist or FLS pathway.

90%

Treatment Initiation Rate:

Based on 1-year Pathpoint FLS cohort data, 90% of assessed, eligible patients enrolled in Pathpoint FLS initiated treatment.

7–14

Additional Patients Identified per Week:

A site running 3 CT scanners could identify between 7-14 additional high-risk patients per week.

30–60

Minutes Saved per Patient:

Pathpoint FLS saves 30–60 minutes of admin time per patient assessment and cuts national audit database submissions from 20 minutes per patient down to just 10 minutes a month.

How can you get involved?

Healthcare Organisations

We are actively seeking 4–7 European and UK hospital sites with active FLS pathways to join as live deployment partners. Participating sites receive fully funded access to FLAMINGO AI and Pathpoint FLS, complete onboarding support, and a site-specific Health Economic Impact report to support long-term local funding.

Get Involved

Patients, Carers & Public

We are inviting patients, carers, and community members to share their views and experiences through our Patient and Public Involvement workshops. By joining us, you will help design our patient-facing materials, improve how healthcare teams communicate with patients, and make sure fracture care always keeps patient needs first.

Get Involved

Societies, Leads & Charities

We are looking for clinical leaders, professional society representatives, and patient advocacy organisations to join the Project Advisory Board. As an advisory member, your insight will help guide the project’s strategic direction, exchange best practices, and support the future of digital osteoporosis care across Europe.

Get Involved

Meet the Team

Piush Mahapatra

Dr Piyush Mahapatra

Chief Innovation Officer, Open Medical

LinkedIn
Ain Nizar

Nurul Ain Nizar

Senior Research Associate, Open Medical

LinkedIn
Christoph Götz

Dr Christoph Götz

Chief Operating Officer, ImageBiopsy Lab GmbH

LinkedIn
Tim Hoogenboom

Dr Tim Hoogenboom

Product Manager, ImageBiopsy Lab GmbH

LinkedIn

News & Resources

This project has received funding from the Eurostars-3 joint programme co-funded by the European Union's Horizon Europe research and innovation programme. The work was supported by national funding from Innovate UK and the Austrian Research Promotion Agency (FFG).

Company

Explore

Address

CP House, 97-107 Uxbridge Road,
W5 5TL, London, United Kingdom

Address

Zehetnergasse 6/2/2
1140 Vienna, Austria

© Open Medical Ltd