Objectives of the service
The CARES service addresses the challenges faced by whoever must deal with the current pandemic caused by the COVID19 outbreak, offering a solution to remotely monitor the health condition of patients quarantined at home.
The utilization of the CARES service contributes to:
- Decrease the exposure of medical personnel to contamination sources, by allowing health professionals to be virtually "close to patients", without direct physical contact with them.
- Limit the exposure of patients to the hospital environment (shorter or no visits), which also reduces the saturation of these infrastructures.
- Reduce or avoids movements of equipment and people (medical personnel and patients).
- Increase the number of patients who can be monitored more effectively by the same medical personnel, saving time and resources.
- Provide psychological support to Covid-19 positive patients in quarantine via regular interactions with medical professionals.
Users and their needs
The key user segments targeted by the CARES service are:
- Public and Private Health Organizations;
- General Practitioners (Family Doctors);
Medical authorities are interested in:
- Patients’ health conditions
- Healing course
- Post-infection medical history.
CARES will enable a better protection of the medical personnel, decrease the need for personal protection equipment and allow for a quick monitoring of geographically dispersed patients.
As a result, CARES will contribute to support the national healthcare system to cope with the negative impacts of the COVID19. The Coronavirus pandemic is indeed stressing the resilience and the effectiveness of the health response nationally and saturating the capacity of hospitals.
The following interested users are involved in the CARES field trials:
- Regione Lombardia, (regional government);
- ISS (Istituto Superiore di Sanità), body of the Ministry of Health;
- Azienda Sanitaria Universitaria Giuliano Isontina, Italy;
- Azienda Servizi Persona Cosenza, Italy;
Service/ system concept
The system is composed by a healing telemonitoring platform placed at a patient’s house which collects vitals data transmitted to a data centre twice per day. The medics can access this database to monitor the healing course of the patient via a simple web interface directly from the place of work. This system is designed to collect data on a large geographical scale and in the proposed prototype version, it is used as a concept demonstrator to experiment procedures and methods to be adopted now and in the future development of the pandemic.
The concept can easily be scaled up to manage large numbers of people across wide areas, to the extreme of a full country’s population, subject to the number of Healthcare platforms deployed on the territory.
CARES is based on the use of an integrated hybrid communication system, mixing terrestrial (cellular networks and cable internet) and satellite communication methodologies. This approach allows the CARES service to be reliable and to have a large coverage anywhere in the world, from big urban areas to remote locations. The Italian territory presents such situation as well on countryside and mountains, where cellular networks is supposed to cover the area but proves in fact to be poor or absent. Satellite communications allow to cover blind spots while offering as well backup network capabilities.
The main nodes of the CARES monitoring system include:
- HMCU = Health Monitoring & Communication Unit. This device is the main data generator; each quarantined patient has a HMCU installed at home to monitor vital parameters twice per day.
- A SATCOM system based on a geostationary satellite (Thuraya-2), which always keep its position in the sky by orbiting around the earth at its exact pace. In this way the coverage provided by the satellite is always available
- DCP&D = Data Collection Processing & Distribution. Once the vital parameters have been collected the DCP&D analyses the vitals and warns the doctors with an alarm, if necessary
- GPRS communication network. When available, the standard GPRS network can provide a reliable communication mean to reach the DCP&D.
Space Added Value
The added value of satellite connection to medical telemonitoring is meant to overcome any connectivity constraint may exist in any territory. The goal of this service is to connect patients and medics so that the medical authorities manage the workload and the challenges of a pandemic, no matter the location. After a few months, the pandemic has reached millions of people and remote areas where standard communication systems may not be sufficient to ensure equal access to care.
CARES is enabling medical telemonitoring everywhere, also where:
- no terrestrial communication infrastructure has been deployed yet.
- local cellular networks are not reliable
SATCOM also allows the CARES service to support other possible use cases where terrestrial infrastructures have been locally or totally disrupted (e.g. wars, natural disasters).
The project started on 01 July 2020. The Baseline Design Review has been conducted on 28 September 2020, confirming the needs from the users, as well as the architecture of the system and the technological choices. The SATCOM system has been chosen after a trade off on several satellite terminals.
The integration between the nodes of the system is tested. The Factory Acceptance Test has been successfully performed and concluded on 7 January 2021. The pilot test is being organized and scheduled for February 2021.