Technological and management innovation for the defense of fragility and continuity of care for the elderly
The ageing of the population, also due to the effective treatment of acute pathologies with high mortality, has led to an increase in the demand for care for elderly subjects of high complexity that often present the coexistence of pathologies such as heart failure, kidney failure and diabetes in a context of overall fragility. These patients are exposed to a high risk of frequent hospitalizations due to the re-activation of chronic diseases. Current guidelines recommend the use of remote home monitoring as a key support to reduce the social and economic costs of these patients and to improve their quality of life.
The goal achieved by the INTEGRA project was the creation of an IT platform that allows the immediate sharing of current clinical data online (blood pressure, electrocardiogram, respiratory activity, body weight, etc.) among all operators involved in the management of the frail and multi-pathological elderly patient, with the aim of responding to the patient’s health demand.
In particular within the project have been developed:
- A home and mobile internet communication base for the reception via bluetooth of signals originally from sensors recording vital parameters (blood pressure, O2 saturgy, ECG, body weight, etc.);
- The signal management and analysis protocols;
- An electronic medical record with related protocols for exporting atomic data from the digital platform
The Partner H&S has dedicated itself to the collection of the measures coming from the devices at the service of the patient, to the creation of the data center and the web platform for the remote management of data; the DSP Partner has dealt with the development of the computer system for the collection of data coming from the platform created by H&S and their articulation within the computerized medical records dedicated to the patient.
The Fondazione MultiMedica Onlus had the task of creating the ideal clinical path for the complex patient according to the guidelines dictated by the Lombardy Region. The management platform realized has been validated in two paradigmatic contexts in the management of chronicity: a structure with high clinical specialization (Fondazione MultiMedica Onlus) and an associated study of General Practitioners.
Remote monitoring and shared computerized medical records have contributed to ensure a good level of quality of life of the fragile subject thanks to the possibility of a systematic control of the patient’s clinical status and the possibility of managing treatments at home in a shared way among all the operators involved.
The product INTEGRA can contribute to the reduction of the frequency of hospitalization and the length of stay of patients according to the management models dictated by the Lombardy Region. INTEGRA also represents a product that can be exported to other national and international realities.