A digital, pervasive and intelligent system of care and prevention

Introduction to the project

The COVID-19 pandemic, with mobility restrictions and limitations to face to face encounters also in the healthcare sector, has led to the development and adoption of telemedicine platforms and solutions to overcome such restrictions and provide care to people in need. Such solutions and platforms, however, have often been developed in a proprietary manner and vertically for the specific medical branch.

e-CARE proposes a unifying approach to the future of healthcare by studying, designing and testing a shared architecture for a digital health system implementing the vision of pervasive care and prevention, through an interoperable IT platform able to support diverse verticals and integrating digital support to care, Artificial Intelligence, and IoT.

e-CARE is a strongly multidisciplinary project bringing together IT, legal, social, management and economics expertise as well as several areas of medicine. The project is partially funded by the Università degli Studi di Milano, PSR 2021 Line 6 GSA (Grandi sfide di Ateneo), and responds to the theme “Prevention, sustainability and efficacy of care: a distributed virtual hospital for Italy”.

Objective

A “virtual hospital” implemented first at regional level, designed for extension at national level is the overarching objective of e-CARE: the hospital of the future, digitally connected with the peripheral system of pharmacies, clinics, nursing homes, as well as with the homes of citizens and patients.

Development of a digital infrastructure for the virtual hospital

The COD-20 platform, owned by the Università Statale di Milano, provides the shared infrastructural level on which vertical applications are developed and tested. COD-20 is interoperable with the regional and national systems and will be further evolved within e-CARE. In particular, the platform will be enriched with AI algorithms, specific to the various clinical specialties.

Experimental development of vertical clinical pilots

The concept of virtual hospital and the underlying digital platform will be validated by means of clinical pilots in diverse clinical areas. The pilots will also define requirements towards the COD-20 platform in terms of data management and artificial intelligence in support of clinical decisions. Data collected through clinical pilots will fuel the AI algorithms.

Evaluation of management, socio-economic impacts, and legal aspects

Clinical pilots will be instrumental for the evaluation of the e-CARE system and its impacts. A multi-dimensional dashboard will be created with indicators for the evaluation of the different areas. The legal aspects will cover the analysis on the subject of data protection and privacy as well as other aspects related to the provision of telemedicine services (accountability, access to care, better monitoring of patients, etc.)

Approach

e-Care adopts a highly interdisciplinary approach with an intensive collaboration between computer scientists, clinicians, data protection law experts, economists and social scientists specialised in health organisation policies and management.

The project takes advantage of a Telemedicine platform owned by UniMi, interconnected with the regional health system and already adopted by several hospitals. A number of pilots will show the potential application of tele-medicine in highly innovative e-health services powered by Artificial Intelligence data analysis algorithms and advanced sensor devices deployed at the patients’ home.

Active Pilots

Some pilots have started in e-CARE benefitting from additional funding coming from the National Recovery and Resilience Plan (PNRR) funded by the European Union – NextGenerationEU. Funded projects currently contributing to the implementation of the e-CARE pilots are MUSA – Multilayered Urban Sustainability Action and SOLITAIRE – Digital interventions for Social isOLation In youThs And theIR familiEs.

Practice

Pilot on Remote AutomatiC ulTrasound scan analysIs for hemophiliC patiEnts

Serenade

Sensor-based explainable detection of cognitive decline

Solitaire

Digital interventions for Social isOLation In youThs And theIR familiEs

Wearable and mobile devices, environmental sensors, medical devices, vocal interfaces
Deep learning algorithms for image and signal analysis, explainable AI, pattern recognition
Data protection techniques
Cloud and edge computing technologies

Impact

e-CARE has the potential for significant impact on the new telemedicine services, also in the directions/areas indicated in Mission 6 of the PNRR (National Plan for Recovery and Resilience):

reduce the current geographical and territorial gaps in health terms thanks to the harmonization of standards of care guaranteed by technology;
guarantee a better “care experience” for citizens and patients;
improve the level of efficiency of the regional health systems through the promotion of home assistance and remote monitoring protocols.

Social impact

One of the opportunities offered by telemedicine is that of greater access equity to health care in remote areas, as well as offering better follow-up of patients with chronic conditions. At the same time, the use of telemedicine carries the risk of excluding patients who for demographic or geographic characteristics do not have access to the required digital technologies. e-CARE will look at these potential drawbacks, limiting and finding solutions to problems resulting from the digital divide.

Economic impact

Remote monitoring and care, data analysis and Artificial Intelligence have the potential for healthcare cost containment in the long run, also in face of the aging of the world population. Telemedicine represents also a driving force for economic recovery. New business opportunities are created for the production and marketing of medical devices, sensors and services for care at home, for startups providing data analysis and artificial intelligence services, as well as for management of telemonitoring systems and centres. Finally, healthcare application will also boost the use of 5G and edge computing services as strategic technologies.

Scientific impact

The proposed multidisciplinary research will lead to scientific results of great interest in the medical, IT, economic, social and legal areas. Planned publications in prestigious publishing houses and possibly patents represent key results for the dissemination of the project outcomes.