ABSTRACT
The current COVID-19 pandemic has accelerated the use of digital technologies, in all sectors and in particular in healthcare. In this scenario, in fact, telemedicine systems have been adopted to remotely monitor and manage infected patients or patients subjected to quarantine regulations. In Tuscany region, Italy, SatNav E@syCare, a telemonitoring platform resulted from the integration of E@syCare, designed for chronic patients, and satellite technologies, has been experimented, receiving positive feedback both from doctors and patients. Such a system could be used also in long-term care, for monitoring chronic patients, providing characterisation and customisation of medical devices according to the patients’ chronic conditions and implementing an expert system, which generates personalised monitoring and treatment plans, to support physicians at the moment of enrolment. The pandemic experience could then be a lesson learnt promoting the adoption of smart telemedicine platforms for the care of chronic patients. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Telemedicine is becoming increasingly important in recent years, especially in chronic diseases treatment. Thanks to these platforms, it is possible to assist patients remotely, being continuously monitored according to personalized care plans as if they were at the hospital. The characteristics of telemedicine platforms resulted extremely useful when Covid-19 pandemic broke out. Intense monitoring of patients at home, social distancing, and resource rationalization provided great help to medical personnel and healthcare systems. This novel disease, however, has posed new challenges, given by the quicker evolution of a patient's clinical status with respect to chronic diseases. In particular, the updates of the care plan performed remotely by doctors need to be immediately delivered to monitoring kits located at the patient's home, in order to adjust the monitoring plan of the target patient. Since this update is a critical operation, acknowledgment strategies are required to guarantee feedbacks upon delivery. Immediate updates can be achieved via a push notification system. In this paper, we present a push notification system based on HiveMQ Community Edition message broker, that provides end-to-end positive (ACK) and negative (NACK) acknowledgments, strict authentication, and authorization of users and messages, security, data consistency, and privacy. The realized system has been integrated and tested in the E@syCare telemedicine platform certified as a medical device, but it can be easily adopted by any other telemedicine solutions, as long as they can perform web service requests to the authentication server and integrate HiveMQ client library in their software components. © 2022 IEEE.
ABSTRACT
In the framework of the Covid-19 pandemic, digital technology has played a key role in the healthcare sector, becoming essential for improving the quality of care and well-being of individuals and populations. In this scenario, telemedicine platforms have enabled remote monitoring, reducing the contacts between patients and doctors and automating health processes. In this paper, we present the experience of SatNav E@syCare, a telemedicine platform enhanced with new functionalities to respond to the outbreak. In particular, Global Navigation Satellite System technology has been added to the system to geo-tag vital parameters, together with the possibility of digitizing examinations (e.g., lung ultrasound), planning access to the territory, automatically managing patient visits and monitoring patient physical activity. The system has been used by general practitioners and doctors of continuity care in different ways according to the phase of the pandemic and the adopted model of care (patient self-measurements vs home visits). More than 2000 patients of all ages have been monitored with SatNav E@syCare. Among the doctors involved in the project, more than 90% are using the system for at least one hour per day, leading to a reduction of time spent to manage patients. Moreover, the system has simplified their daily work, thanks to the digitization of information and sharing of data with colleagues. In their opinion, in a non-pandemic future, the use of the system will introduce benefits both for patients and healthcare professionals in the monitoring of chronic conditions on the territory. © 2022 IEEE.
ABSTRACT
Telemedicine platforms have been largely used to manage multiple problems during the Covid-19 pandemic. In fact, they have given the possibility of remotely monitoring infected and high-risk patients, reducing hospitalisations. Telemonitoring systems with Global Navigation Satellite System technology allow to geo-localise all patients' measurements and enable the tracking of positions. These data can be used for contact tracing or to support doctors in epidemiological analysis. This paper presents the integration of satellite technologies in an existing telemedicine system (E@syCare), during the current outbreak. In particular, the platform has been enhanced with GPS, to geo-tag all vital parameters collected by the tablet gateway and the smartwatch. Geographical data are processed, after a request through the improved web-based medical interface based on some filters (e.g., vital parameters and their thresholds, considered period of time, and maximum cluster radius), with two sequential clustering algorithms. Agglomerative Clustering is used to find the optimal number of clusters given a maximum radius, and K-Means to effectively generate the predefined number of clusters. Resulting clusters are shown on an interactive epidemiological map in the webbased medical interface. This additional feature gives the possibility to healthcare authorities to correlate the spread of a disease or a virus with specific geographical areas or environmental conditions, to monitor fitness/movement habits of patients (also when the pandemic is over), and to track contact among patients. ©2021 IEEE.