Objectives of the service
During the COVID-19 global pandemic, the large amount of infection cases and the emergency context in general, have pointed out some difficulties in the management of sanitary protocols, and in particular for:
- the detection of contagious patients (symptomatic, asymptomatic, paucisymptomatic patients);
- the monitoring and treatment of quarantined patients by General Practitioners (GPs);
- the containment of healthcare workers’ infection;
- the collection of epidemiological data.
In order to overcome these difficulties, Telemachus, intends to cover these following tasks:
- simplify the communication between patients and GPs by providing a screening and remote continuous monitoring tool to detect the main vital parameters and by preventing GPs and patients from cross-contagion.
- facilitate prompt medical response by implementing location-based services for emergency and by helping Health Authorities to intervene when a patient with critical vitals is detected.
- monitor the health conditions of healthcare workers in order to rapidly identify cases of infection and prevent the propagation inside hospitals
- collect and provide relevant data (vital parameters measurements, patients risk profile information, clinical data), filtered and validated by GPs, to health authorities in order to conduct epidemiological analyses.
Users and their needs
Italian Health Authorities and Hospitals, General Practitioners and patients are the three main users.
The main identified needs regarding the Health Authorities and Hospitals include:
- provide more accurate data for epidemiological purposes, such as modelling the propagation of outbreak and the interpolation with exogenous factors (e.g. environmental data);
- manage and possibly contain the increased demand of Healthcare services during the outbreak so as to continue providing an equal access to care to all patients;
- better manage the increased risk of infection among healthcare workers and avoid cases of infection propagation inside hospitals;
- monitor the conditions of self-isolated patients at home.
The main identified needs regarding General Practitioners include:
- facilitate early diagnosis, giving access to diagnostic tests primarily to symptomatic patients with high risk profile;
- respond to difficulties in managing ordinary tasks (due to exponential grow of plausible infected patients) and reduce risk of infection for General Practitioners (and consequently for patients);
- monitor patient’s health conditions and cover the lack of adequate tools to organize home care due to high demand.
The main needs of patients include:
- get a fair and equal access to care considering the difficulties to be hospitalised due to the saturation of emergency services caused by COVID19;
- be monitored (even in quarantine) and receive adequate care;
- reduce the risk to infect other people.
Service/ system concept
Telemachus system is based on an “hub and spoke” model, typically involving arrangements whereby one subject acting as a principal base (Health Authorities) providing centralised support or activities to satellite subjects (General Practitioners) which are connected to the principal base.
The patient can use both a mobile app and a smart bracelet in order to be monitored. The mobile app is a telemedicine interface helping patients to communicate with General Practitioners avoiding physical contacts. The smart bracelet has Bluetooth connectivity, also used for indoor positioning, GPS/Galileo for outdoor positioning and Heart Beat, SpO2, Body Temperature and ECG measurement, which are relevant physiological parameters to be monitored for most pathologies.
Both the mobile app and the smart bracelet are connected to a cloud server embedded with real-time analytics, machine learning and data history. A dashboard used by General Practitioners and Health Authorities is used to manage the collected data.
Space Added Value
Telemachus is making use of the latest developments in the field of Satellite Navigation (SATNAV) as the service benefits from a patented technology that utilises smartphone sensors and low-signal Bluetooth beacons (leveraged by physical models and A.I. algorithms), with the aim to address the following critical needs:
- contain the diffusion of contamination through the localisation and monitoring of infected patients in indoor contest;
- safeguard the healthcare workers’ health, by tracking their movements within the hospital departments and their potential contacts with infected patients.g
Telemachus is making use of localisation algorithm both for indoor and outdoor positioning, allowing a seamless switch between Bluetooth Low Energy (BLE) and the Global Navigation Satellite System (GNSS) signal. Wherefore, the interoperability between the GPS and Galileo is the enabler of the outdoor navigation tracking.
Moreover, Telemachus also takes advantage of the potential of the Teseo GNSS developed by STMicroelectronics. Hailed as the latest generation of ST's GNSS Integrated Circuits (ICs), Teseo III permits carrier-phase tracking with a reduced consumption of the device’s power whilst achieving advanced accuracy for tracking applications.
The smart bracelet of the system can hence support the Teseo III platform in order to guarantee exactitude and accuracy in outdoor tracking, as a result of the use of the most modern technology available through the Galileo infrastructure.
The On-site Acceptance Test was successfully concluded with ESA on 18 January 2021. The project team is now starting the pilot trials, which will last 6 months. The trials consist in validating all functionalities of the system in two different settings:
Setting A: HUB-AND-SPOKE FOR REMOTE TREATMENT
It will take place in the metropolitan area of Bari and patients will be monitored by their GPs. The main objectives are:
- Remote medical treatment (app)
- Biometric parameters monitoring (bracelet)
- Patients’ location detection in case of emergency
Setting B: INDOOR MONITORING INSIDE HOSPITALS
It will take place in Foggia Hospital and healthcare workers will be monitored by the Operation Centre. The main objectives of this Setting B are:
- Remote health status (app) and biometric parameters monitoring (wearable)
- Indoor location and contacts among subjects monitoring (by using BLE technology thanks to the installation of gateways and beacons)
Finally, epidemiological analysis will be conducted by the INMI (Istituto Nazionale per le malattie infettive - Spallanzani) with the aim to conduct:
- research and analysis on the clinical evolution of the virus.
- study on the virus transmission and propagation dynamics indoor.
Figure 1a, 1b, 1c and 1d - Bracelet Design