The SMARTHEALTH Project focuses on the development and validation of a platform for remote monitoring and clinical follow-up of patients' health. This platform will be integrated in both hospitals and health centers and will allow a close and efficient monitoring of the evolution of a large number of patients. The SMARTHEALTH platform will be used both by health professionals and by patients themselves regularly in their day-to-day lives and it is expected that its use may have a high social, health and economic impact at a national and international level.
Today, healthcare is undergoing a time of intense transformation. Advances in Information and Communication Technologies (ICTs), the aging of the population, and the need to ensure the quality of care and the sustainability of health systems in times of budget constraints, are forcing health organizations to develop new models of care. Different organizations, such as the European Commission, are strongly committed to m-Health, ie, the implementation of mobile health systems as a tool to overcome the current challenges of health systems. At the same time, the European Commission considers that m-Health can also contribute greatly to the development of patient-centered healthcare, prevention and the improvement of the quality of life of patients.
At the scientific level, there is incipient scientific evidence that identifies the benefits associated with remote care distributed through different m-Health systems. Specifically, it is observed that through the use of this type of system, relevant decreases are achieved in the number of hospitalizations and visits to the emergency room, while prolonging the life expectancy of patients. Within this general context, healthcare professionals who carry out patient follow-up tasks continue to face a number of relevant deficiencies every day that limit the effectiveness of their work. First, the tools available to healthcare professionals to encode key aspects such as diagnoses, procedures, and tests performed on patients are rudimentary, which means that encoding is slow, cumbersome, time-consuming and effortless and subject to a significant error rate in many cases. On the other hand, this poor coding limits the subsequent exploitation of the Clinical History data, and therefore the benefit that could be derived from them to patients. In addition, the current Spanish regulations have recently been changed and require that it be changed from coding from ICD-9 to ICD-10 as of January 2016. ICD-10 includes more than 50,000 terms and relationships, which greatly hinders its use. .
Second, most electronic medical records in use today do not incorporate a model of the care process performed by each patient that is processable by computer. Therefore, the automatic exploitation of the information contained in the medical record is very limited, both at the clinical level and at the management level. In this sense, it is necessary to develop semantic models, which, based on standards such as ICD-10, SNOMED-CT and others, allow a complete exploitation of the electronic medical record in an automated way. Finally, tools are needed that allow a broad set of telemonitored patients to be followed up in an agile and pleasant way for healthcare professionals. These tools should perform a first filter of the health status of patients, detect alarms and help to manage health care more efficiently. To do this, these tools must be integrated into the hospital's own information system and must be easy for healthcare personnel to use.
The SMARTHEALTH project, integrated by Asunción Klinika, the Vicomtech IK4 technology center and the Indian company Plenar Technologies and the SMARTHEALTH Platform, will be built on two pre-existing commercial products:
The Hospital Information Management System (HIS) and the Electronic Health Record (EHR), HYGEHOS, developed by INVIZA SA, the company that owns Asunción Klinika and is currently in use in around twenty hospitals, clinics and centers sanitary at the national level.
The DOCTODOOR® Remote Patient Monitoring System (SSRP), developed by the company PLENAR TECHNOLOGIES (India), is in use in hospitals and clinics in India, the United Kingdom and the United States.
The SMARTHEALTH project is subsidized by the Center for Industrial Technological Development, as an International Research and Development Project, under the heading CDTI ISI-20150002. SMARTHEALTH. LARGE POPULATION HEALTH MONITORING AND CLINICAL ASSESSMENT PLATFORM ”.
The general objective of the SMARTHEALTH platform is to improve the quality of life and the quality of care provided to populations with a high number of chronic patients, while assisting the health professionals in charge of such supervision in an efficient and sustainable way.
Specifically, the platform will be tested in patients who have undergone total knee replacement surgery, who will be monitored for 30 days after surgery. Through this test, in which a control group will also participate, which will undergo the usual procedures, it will be sought to verify:
If electronic monitoring results in a substantial improvement in the patient's outcome
If the platform is usable and accessible at the patient user and clinical user level
If the patient adequately adheres to the program prescribed by the clinician for remote monitoring