Lombardy Region – Measure to support the development of collaborations for the identification of therapies, and diagnostic, protection and analysis systems to counter the Coronavirus emergency and other viral emergencies of the future (Action I.1.b.1.3 of Axis 1 of POR FESR 2014-2020).
Providing the Regional Health System and all patients with a modular, scalable and customizable digital health solution based on the different needs of the different players and stakeholders in Healthcare. This solution applies to all patients, whether tested positive to COVID-19 or not, but above all in a condition of frailty.
To this end, TCube adapted and validated a three-module Telemedicine system, capable of guaranteeing an integrated treatment for the management of frailty from a multidisciplinary perspective, and of providing diagnostic-therapeutic continuity, safety (both for users and for operators with physical distancing) as well as greater support and involvement of the patient in the treatment process.
The TCube platform integrates tele-monitoring, tele-rehabilitation and tele-support services by developing interoperable and scalable multi-domain and multi-device pathways, able to connect, motivate and support patients and caregivers at an optimal level of efficiency and engagement.
The contribution of Grifo multimedia within the project concerned the development of a game app (exergame) to support the enactment of a protocol for pulmonary rehabilitation based on resistance exercises and strengthening of the muscles connected to respiratory activity.
The game integrates a heart rate monitor to guarantee the correct level of fatigue for each patient. Particular attention is paid to ease of use and the ability of the game to function in conditions of poor connectivity to the Internet. The game is the tool by which the tele-rehabilitation activity programmed in the individual rehabilitation plan is realized. The rehabilitation activity, once set in the telemedicine platform, is communicated to the exergame so that the patient can perform it while playing.
The communication model can be summarized as follows:
- the doctor defines the Individual Rehabilitation Plan (IRP), or the activities that the patient must carry out, indicating the methods and times of execution;
- the set IRP is sent to the game which suggests the prescribed activities to the patient on a daily basis by proposing a specific game activity;
- the patient performs the prescribed activity and provides the game app with feedback, also through an integrated actigraph that collects heart rate data while the patient carries out rehabilitation activities or tracks movement in space;
- all feedback duly recorded and contextualized is passed in the form of game performance to the telemedicine platform and stored for subsequent processing.
TCube represents an important service innovation, since this platform can change the methods of continuity of care for frail subjects, whether or not they are affected by COVID-19, by providing tailored rehabilitation programmes. This innovation will also change the treatment process, thanks to the introduction of value-added activities, since they are tailored to the needs of the patient-citizen and take into account the organizational and economic sustainability of the Healthcare Facilities.
Thus, the reference paradigm will change: not only does innovation consist in introducing a new technology for this new pathological condition, but it also involves a different organizational model of delivery, which optimizes the available resources and ensures a safer environment for healthcare professionals and patients, as well as a model with high territorial accessibility.
Lastly, patients participate in their care path and take advantage of services based on their own care needs. The TCube platform provides continuous feedback with health personnel and the possibility of adjusting needs at any time during the treatment process.
6 months: from May to November 2020