WEARABLE SYSTEM FOR HOME TELE-REHABILITATION
In physical and rehabilitative medicine, health workers carry out subjective assessments of the patient's psycho-physical state, who sometimes remains passive during the rehabilitation process during the administration of therapy; furthermore, the follow-up is entrusted exclusively to the continuity of the patient and his ability / possibility to guarantee adherence to the therapeutic prescription received, without a real control by the attending physician or by the specialist center that follows him. This approach negatively affects several aspects such as the quality of life of the patient, the social cost (in terms of direct and indirect costs), quality of the health service, repeatability of treatments and objective evidence of the clinical outcome.
It is therefore necessary to identify and test innovative methods that can increase the patient's quality of life and independence, reduce health care costs and, at the same time, allow the transition from the old hospital-centered healthcare model to new models of services, in which less specialized activities are delegated to lower intensity territorial structures.
The TeleRehab project provides an integrated telerehabilitation platform for the wrist and hand that is able to set up and monitor rehabilitation practices and at the same time model and manage the entire health process that underlies them.
ACTIVITIES AND RESULTS OBTAINED
The first phases of the project involved, together with the project partners, the study of current remote rehabilitation technologies and related functions of greater use, the analysis of user needs and the definition of the technical design of the system.
The proposed technological solution focuses on the study and implementation of a tool capable of governing the entire process of access to rehabilitation procedures.
In this scenario, it was essential to study and analyze the clinical-health activities envisaged in the project to define users and roles involved as well as to trace all the inputs and outputs produced in each procedure, in order to formalize the analysis in a definition of the process model. to automate.
During the definition of the clinical-experimental protocol, the clinical protocol for the validation of the telerehabilitation system was developed and, moreover, the application scenarios were analyzed, in which the operational methods of the experimentation are established: in fact, considering the versatility and the value that the TeleRehab system has in different contexts, we have experimented the system with different basic configurations.
The Info Solution SPA and 2038 Innovation Company SRL companies respectively dealt with the sensory apparatus and the Workflow Manager (transversal ICT platform for managing the rehabilitation process). These were joined by the Polytechnic of Bari and the University of Salento. The Citadel of Charity had the role of experimenter of the solutions, which unfortunately had some restrictions due to the COVID 19 pandemic. Finally, the Dhitech technology district (LDR) supported the team in identifying the best market prospects, in dissemination of the results and the model and ESCOOP adhered to all phases of the project, from the analysis of the needs to the market evaluations, with a specific focus on the activity of analysis, design and experimentation.
The Telerehab platform is functionally composed of two independent modules that cooperate to achieve the objectives mentioned above:
- Tele-rehabilitation sensory module (Info Solution)
It consists of a wearable bracelet, capable of detecting the activation potentials of the muscles, by a protractor, which detects the relative position of the forearm and hand, and by a software for receiving, analyzing and viewing data.
- Management module of the rehabilitation process (2038 Innovation Company)
Engineering and automation of clinical-health procedures through a BPE (Business Process Engine), which manages the clinical-health data produced within an archive. The provision of a possible interface and interoperability layer capable of guaranteeing the management (reading and writing) of the data for any third-party application is envisaged. The platform is modular and reconfigurable to be able to represent in sufficient detail the different application cases that are created. Finally, different levels of access to data are defined according to the professionalism and responsibility of the users.
The previous functional modules have been integrated by adhering to the main international communication standards and defining the methods of interaction with third-party software and communication systems.
The versatility of TeleRehab allows adaptation to different work settings. More specifically, three different scenarios were considered in the project:
1. Setting in a protected structure (rehabilitation), in which the patient is supported by various health professionals (doctors, nurses, physiotherapists), follows all the procedures envisaged for clinical trials in terms of safety, responsibility, adverse events and risk management.
2. Home setting (rehabilitation) in which the patient, during the rehabilitation phase, receives remote support / monitoring from a trained operator.
3. Functional assessment setting (assessment) where the functionality of the TeleRehab system is tested regarding the instrumental assessment of the functional state of the hand through the comparison between the indices detected by the system sensor and the traditional rating scale.
This last phase, carried out in the experimentation phase, allows to obtain technical feedback on the prototype system and defines the innovative and scientific content achieved.
The TeleRehab rehabilitation system allows the provision of the service remotely with the clinical supervision of a healthcare provider, radically changing the current delivery method that typically occurs in the presence of 1-to-1 patient and therapist in dedicated facilities. TeleRehab allows to structure and manage a new therapeutic process, exploiting ICT technologies and making information, documents and data, which traditionally reside physically in paper documents, almost ubiquitously available. This additional functionality instead sees as a final user mainly medical and paramedical staff, not only related to a single structure, but in general to all clinical operators involved in the process of rehabilitation of the patient at any stage. This feature enables the provision of the service on the "territory", intended as a set of territorial health services (pharmacies, clinics, multipurpose centers, etc.) different from the hospital center, including the user's home itself.
ACTIVITIES OF 2038 WITHIN THE TELEREHAB PROJECT
As part of the TeleRehab project, the 2038 Innovation Company SRL is committed to defining the project specifications in terms of system functionality and user expectations, as well as in the architectural definition of the entire ICT platform through configuration and implementation. of a Workflow Manager. It has created an ecosystem based on processes, consisting of: a Business Process Engine (BPE), a web platform and a mobile application connected to a wearable sensor system. In particular, the mobile application implements a system capable of receiving the measurements made on patients that are sorted to the ICT platform, which stores, organizes and makes these data available to patients and doctors.
The rehabilitation processes are performed in the ICT platform and more precisely by the Workflow Manager which, thanks to the use of an appropriately integrated engine with ad-hoc functionality, allows performing step-by-step sanitary rehabilitation processes, exploiting the potential provided by the systems of Busines Process Management (BPM) in the optimization of industrial and business processes, both in the execution and coordination phase and in the results and log consultation phase.
Furthermore, the information necessary for the doctor to perform an assessment of the quality of the exercise performed by the patients can be viewed and processed using frontend applications, such as the dashboarding application (created according to UX's best practices in the clinical-healthcare context) of which the platform is natively equipped.
Project co-financed under the POR Puglia FESR-FSE 2014-2020, Priority Axis 1 - Research, development technology, innovation, Action 1.4.b - INNOLABS Call - Support for the creation of targeted innovative solutions specific social issues - We invest in your future.
Project code: NEM1I83-1 – CUP B33D17002960007
Partner: Info Solution S.p.A., 2038 Innovation Company S.R.L., Cittadella della Carità Taranto, Università del Salento, Politecnico di Bari.
2038 INNOVATION COMPANY SRL
VIA ARCANGELO LEANTI, 16 - 90141 - PALERMO
REA: PA - 31426