Objectives of the service
The adoption of unhealthy lifestyles (e.g., sedentary behaviour, unhealthy diets, ...) and environmental factors (e.g., pollution) are leading to an increasing spread of chronic diseases for which there is often a tendency to underestimate the risk of complications. Furthermore, with respect to the particular historical period, a correlation has emerged between chronic diseases, pollution and COVID 19.
HeReMo is a mobile phone-based Health service able 1) to support patients already suffering from pathologies in the prevention of complications, through targeted and personalized recommendations; 2) to make citizens aware of the risk of onset of chronic diseases / comorbidities, through awareness of risk factors (sedentary life, unhealthy diet, pollution).
For these purposes, users receive a series of personalized, proactive advice adapted to their personal sensitivity. Such advice can be provided by health professionals or automatically by the system based on the information collected by the app.
Educating patients with chronic diseases, with personalized suggestions and with the support of their doctors, improving their lifestyles and habits.
With this solution, both the prevention and management of chronic diseases are addressed with the following mechanisms:
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personalized coaching
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lifestyle monitoring
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patient empowerment
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patient engagement
Users and their needs
European Healthcare system is facing a variety of challenges: demographic change, increasing chronic diseases, increasing demand for care, limited resources/budgets. These challenges have even been worsened by the unprecedented situation caused by the COVID-19 pandemic: emergency department overcrowded, screening process delayed, medical instruments unavailable, contagious spread among staff. HeReMo allows medical practitioners to continue taking care of their patients despite the challenging impacts of a sanitary crisis such as COVID-19 in a safe and effective way, while limiting the increase of their workload. HeReMo is primarily targeting the Italian healthcare community.
The solution targets people affected by chronic conditions, who are at risk to be infected by SARS-COV-2, patients whose anxiety could be contained once in contact with a doctor/institution but also people whose health condition must be monitored with particular attention (e.g. considering the need to identify as soon as possible COVID cases); the customers are the Healthcare providers (e.g. Local Health Authorities - ASLs -, General Practitioners - GPs - networks, hospitals, regional task forces, private HCPs who could adopt solutions tailored to their needs); the channel to reach the users are the Healthcare Professionals (e.g. GPs, clinicians). The use of the solution can obviously be extended beyond the COVID-19 case.
Service/ system concept
HeReMo performs environmental monitoring based on satellite parameters and sends feedback to patients and clinical staff in case of persistence in areas with high air pollution values. Such monitoring - combined with patients’ provided vital parameters and lifestyles - is carried out via smartphones and wearable devices, in order to provide the clinical staff a broader view of the contexts and conditions in which the patient is positioned.
HeReMo integrates data coming from different sources, including Data Clouds such as the ONDA DIAS (Earth Observation), and provides advanced analytics by integrating them with other data sources (e.g., meteorological data, demographic data).
HeReMo is made available to users through the following interfaces:
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a smartphone app to be provided to the patient. Through the app, the patient can (i) collect data on various factors (ii) receive motivational messages as to better adhere to the instructions provided by the clinicians
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a web application to be provided to clinicians. Through this portal, multidisciplinary teams can (i) assign and personalize objectives to patients, (ii) communicate with them, and (iii) visualize their data
Moreover, HeReMo offers a summary view, for epidemiologists and / or decision makers, through which they can view any correlation between the environmental parameters monitored in the area of interest and chronic diseases or COVID.
Space Added Value
Adoption of Space-based technologies and tools enables enhanced monitoring and coaching. In that sense, HeReMo leverages:
Satellite Earth Observation (SatEO)
Thanks to Copernicus Sentinel-5P observations, concentration information with global coverage can be obtained about relevant pollutants, such as Sulphur Dioxide, Nitrogen Dioxide, Ozone, Carbon Monoxide. Distributed by Copernicus Atmospheric Monitoring Service, the estimation of their concentration allows HeReMo to perform the computation of Air Quality Index.
Satellite Communications (SatCom):
HeReMo provides third party satellite communications solutions (like Broadsat SmartLnb and KonnecTIM-Eutelsat SA) to allow connectivity where terrestrial communication is insufficient, in order to enable remote monitoring through transmission of sensor data. In that way, patients will connect to the internet – via satellite - while at home transparently.
Satellite Navigation (SatNav):
Real-time position given by GNSS receivers embedded in the smartphones of the patients allows, through HeReMo mobile app, geolocalized pollution-related alerts, in order to prevent dangerous effects on their health with respect to their chronic diseases in particular for respiratory ones with the double goal of increasing the awareness of the patients and of the healthcare professional towards the habits of the patient as to frequent healthier areas.
Current Status
HeReMo collaborated with the ASL Foggia by interacting with their healthcare and IT staff. One of the key factors for the success of the project and its acceptance by our final user was the adopted co-creation approach of the solution with the involvement of these healthcare professionals since the very beginning. The project, finally, actively focused on analysing and gathering meteorological and COVID-related data.
Following the successful Design Review meeting held in July 2021, the project team prepared actively the final verification of the solution as well as the deployment of the pilot. In November 2021, the project successfully passed the Acceptance Review, during which the final users' interest in the solution was additionally emphasised. Once blessed by the ethical committee (in July 2022), the project entered the pilot stage for a duration of 5 months. The pilot was successfully completed in December 2022, and they have been involved almost 50 patients (precisely healed oncological individuals) and more than 7 healthcare professionals among nutritionists, psychologists and professional carers. Positive feedback was obtained from both patients and clinicians who particularly highlighted the benefits enabled by HeReMo thought the communication channel established among them. The positive feedbacks received by the pilot have been also magnified by the fact that HeReMo solution has been also selected by Engineering’s management, among the best assets produced by innovation projects, as worth to be further pushed in the healthcare market also outside of the COVID-19 context. In this respect, further investments have been planned to make the solution fully compliant with the new MDR regulation and then ready for any kind of chronic disease management. The Final Review meeting was successfully held in February 2022.
HeReMo, among the various features, provides summary views aggregating demographic and environmental (like pollution and weather) one, according to the territorial polygons defined by the Italian National Statistics Institute, as to inform its end users about the health environmental hazards.
