Innovative e-health services

TIM is actively involved, either alone or in partnership with external partners, in devising and developing healthcare services at national, regional and local level. Designed to improve the Italian health service and the quality and effectiveness of healthcare, the services allow doctors, nurses and patients to carry out many activities remotely.

The main electronic healthcare service applications available or being developed include:

• value products and services for general practice, aimed at enabling new primary care models and proactive medical services (e.g. screening campaigns managed by general practitioners);
• legal archiving of digital diagnostic images on the network, with a guarantee of the authenticity and integrity of documents;
• management of both healthcare, administrative and logistical processes and a patient’s healthcare information throughout the period of hospitalisation;
• the management and coordination of operational facilities dedicated to emergencies (118) and continuity of assistance;
• healthcare monitoring (Nuvola IT Home Doctor).

All the solutions comply with the data privacy and transaction security requirements of healthcare processes.

Nuvola IT Home Doctor

This allows patients suffering from chronic illnesses, or in post-hospital care, to monitor their physiological parameters (body weight, blood pressure, heart rate, blood oxygen levels, glycaemia, lung capacity, electrocardiogram, physical activities etc.) directly from their own homes or in properly equipped facilities (medical centres, medical practices etc.). The system consists of a technological platform and software configured on the patient’s mobile phone (or alternatively a PC or tablet) and on the healthcare personnel’s PC. Based on the plans established by the doctor, patients receive reminders on their mobile phones regarding the measurements to be taken, they take these measurements using portable electro-medical devices equipped with a Bluetooth interface and, using their mobile phone, they send the measurement automatically to the online platform.
The benefits of the service are that it improves the patient’s quality of life while optimising costs for the healthcare organisation.

Fisio@Home

This is an experimental motor telerehabilitation service which allows medical personnel remotely to monitor the conditions of patients with orthopaedic. The prototype, tested at the Health Authority of Viareggio, has been developed for the rehabilitation of knees, and the application can be used for other conditions. The system allows doctors to evaluate compliance with the established programme and the correctness of the exercises performed.
Movement data is collected by sensors worn by the patient, which measure acceleration, angular speed and magnetic field along the reference axes. The data is sent by Bluetooth to a tablet, where an application processes it in real time in order to extract information that can be used to define the movements and store them. The sensors, created by Scuola Superiore Sant’Anna, have already been engineered and are ready for large-scale deployment.

Cassiel 2.0

The service provides remote assistance is provided to elderly people, monitoring them and receiving alarm signals in cases of emergency. The sensors located in dwellings process the data collected, to perform behavioural analyses with a view to improving quality of life. The complete solution includes a reminder service, called RicordaMI, to monitor therapies and ensure their completion. Through the involvement of three Federfarma Pisa pharmacies in supplying the requirements and dosages set for each patient, and Farmadati for the supply of the medicines database, the system was successfully tested in the province of Pisa, collecting valuable data to improve the solution. Thanks to the adoption of a simple tablet app, the system also is usable by people with mild cognitive impairments. The service also allows the health of the cardiovascular system to be monitored, which is very likely to be less healthy in elderly patients, using non-invasive methods (pressure, weight and physical activity), based on statistical models accepted by the scientific community (Framingham risk score). Formal and informal caregivers can check the state of health of their loved ones on a specific website.

Tele-monitoraggio malattia di Parkinson

As part of the development of a tele-monitoring system for patients affected by Parkinson’s disease, TIM has filed two patent applications relating to the upper and lower limbs. Based on the data collected during the trials, machine learning techniques were applied to developing a UPDRS2 automatic assessment algorithm to emulate the assessment provided by the neurologist according to this standardised scale.
WebSensor is a prototype for remote monitoring of progress in Parkinson’s disease developed with the support of neurologists. A set of sensors worn on the body monitors the exercises performed by the patient and sends the data to a platform that processes them and supplies parameters that can be used to assess the status of the disease. The hand sensors, which are often uncomfortable to wear, were replaced by an appropriate stereoscopic (LeapMotion) camera that frames the hand and automatically extracts the exact position of the fingers in space. In collaboration with the non-profit organization Neurocare from Cascina (Pisa) data was obtained from over 15 Parkinson’s sufferers and the same number of healthy elderly people (controls); this data made it possible to validate the use of the Leap Motion sensor to identify and measure the degree of advancement of the disease.

PAPI

It is a prototype tested on 30 people aged over 65, suffering from slight cognitive function deficits, for their remote rehabilitation. The system provides a kit of interactive games for Android tablets, designed with neuropsychologists to stimulate the patient’s various cognitive functions. The games, tested in collaboration with NeuroCare from Cascina (Pisa), and TrentoRise’s living lab in Trento, communicate with a remote server to send data relating to the patient’s performance and to download their settings. The experiments have allowed both the games to be improved, making them more interesting for users and integrating them with other games created by third parties (that involve the rest of the family), in a kind of game show that encourages their use (GameBus project).