Collaborating for Digital Health and Care in Europe

The main event  took place in Brussels on August 29 in the Scotland House. Both physical participation and remote participation were possible.

A workshop with the project Lifebots exchange followed the final event on August 30 in the morning. This event was also open to all interested people following preliminary registration. It explored more specifically the question of interaction between humans and robots, whether digital or physical.

The event was not conceived as a promotional one. Rather the intention was to provide a dynamic opportunity for people, organisations, companies and projects to shape the further integration of all the actors of the @Home paradigm. All attendees, both present on site or connected virtually, thus had the opportunity to interact with the speakers and the audience.

Sessions

DAY 1 | Monday 29 August

George Crooks, Chief Executive (Digital Health & Care Innovation Centre, Scotland)

This introductory speech reflected on the rapid emergence of the @home paradigm and more generally of hybrid models of care (and the many structural and specific reasons which explain this evolution). It also analysed the relative failure of solutions which focus on telerehabilitation “only” (without a patient-oriented approach which takes into consideration all factors which influence adherence). 

Hannes Schlieter, Head of Digital Health Research group (TUD, Germany)

This session outlined how vCare’s ambitious proposition was built initially, how it evolved along the project lifetime and what were the expected results. It also explained how the system had been built in such a way that it can accommodate use cases other than those which were tested in the project.   

Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is done by encouraging personal strategies to prevent reinjury or recurrence and implementing programs to return people to their original health status and functioning, so as to prevent long-term problems. 

The Virtual Coach developed by vCare not only supplements the usual rehabilitation processes but also adopts strategies to empower the patient and his/her caregiver.  

The tailored rehabilitation clinical pathway activated by the clinician evolves constantly in response to the patient choices and rehabilitation goals that he/she can reach. This session built on the concrete clinical experience of four medical sites in four different countries and addressed neurological and cardiological diseases.   

[3] The vCare stories and promise

Moderated by Rachelle Kaye, vCare Advisory Board & Senior International Consultant (Assuta Medical Centers, Israel)

 In this session a deep dive took place into each of the use cases piloted by the project: stroke, heart failure/ischemic heart disease and Parkinson.  

• Overview of the validation methodology: Massimo Caprino, Head of Research & Innovation, (Casa di Cura privata del Policlinico, Milano, Italy)

• USE CASE 1- Stroke: Riccardo Re, Physiotherapist (Casa di Cura privata del Policlinico, Milano, Italy)

External expert:

Jessica Barlinn, Head of the Saxon Stroke Network and leader of the stroke group (University Hospital Dresden, Germany) 

• USE CASE 2 - Heart Failure: Andreea Lacraru, Cardiologist (Universitatea de Medicina si Farmacie "Carol Davila", Bucharest, Romania)

External experts:

Martijn Scherrenberg, cardiologist, PhD candidate Digital Health in Cardiology (Jessa Hospital, Hasselt, Belgium)

• USE CASE 3 - Parkinson: Rocio Del Pino, Ph.D Clinical Neuropsychologist (Biocruces Bizkaia Health Research Institute, Bilbao, Spain)

External experts:

Dr. Alvaro Sanchez Ferro, MD (Neurology), Co-founder & CMO (Leuko, Madrid, Spain)

Mayva Marin (Parkinson's Patient Association, Madrid, Spain)

Each pathology has its specificity, and the coach and all the enabling environment which empowers it needs to be fit to purpose. For each use case, we explained how we designed the environment, and the rationale for the selection of the activities supervised by the coach.

We also explained who are the patients who can benefit most from the virtual coach experience and what have been the concrete results observed during the pilots. We discussed what kind of consequences the use of a virtual coach has on the concrete work of the care team and what it implies in term of workload and roles. 

The patient voice was also heard: real patients enrolled in the pilots provided direct testimony of their vCare experience.  

During a moderated discussion, several external experts who represent all the clinical domains covered, were invited to comment on the solution proposed, the results achieved, and the conditions and challenges for a wide deployment of the solution. 

[4] Connecting vCare with the wider ecosystem

Moderated by  Jean-Christophe Mestres, Advisory Board (IBM Client Engineering, France)

Many projects have a specific focus and are still very often built in silos, targeting a specific disease or a specific aspect or care process in the disease. This is of course acceptable from an innovation point of view. However, from the patient and health system points of view this is not ideal and not very cost-efficient. In this session, we saw how vCare could integrate itself in other platforms which deal with multiple use cases, and we identified common building blocks and challenges. We focused in more detail on acceptability and usability issues.  

 We selected a number of projects which share with vCare either an indication, a use case or a technology (such as the virtual coach). Together with those projects, we discussed how the several barriers between @home implementations can be progressively reduced both from a clinical and a technological perspective. 

• Overview of the vCare architecture and its scalability: Alvaro Martinez (Innovation Engineer, MYSPHERA, Spain) and Emmanuel Sandner (Research Engineer at AIT Austrian Institute of Technology GmbH, Austria)

• Key lessons learnt by vCare: Massimo Caprino, Head of Research & Innovation, Casa di Cura privata del Policlinico, Milano, Italy 

• Presentations by four invited projects:
  

- e-VITA: Sarah Janböcke, (Assistant Visiting Professor at Tohoku University, Sendai, Japan & General Manager of SARAH Janböcke, Essen, Germany)

The aim of the e-VITA Virtual Coach for Smart Aging is to combine sociological, medical, and technological excellence to produce  a virtual coaching system (that can provide personalised recommendations and everyday help improve older adults’ life quality in Europe and Japan, while also delivering opportunities to SMEs and NGOs to derive knowledge,  services, and products from this joint research force).  

 - SHAPES: Mariajose Santofimia, (Professor at University of Castilla-La Mancha, Spain)

The pilot 6 of the Shapes project targets older adults that either need to recover from a certain accident or health issue (e.g., stroke, fall, surgery, rheumatoid arthritis, osteoarthritis, orofacial disorder). It aims at safely conducting physical activity and physical rehabilitation routines  and at boosting motivation through the use of digital tools, robots, a 3D Depth Camera and a Wearable Motion Monitoring Device.

- PASSION-HF: Amin Hesam, (Cardiologist, Maastricht UMC, the Netherlands)

Patient-HF is an integrated eHealth product enabling self-care of chronic HF including self-prescription of medication. It includes novel features such as a decision support engine, interactive physician avatar interface, serious gaming tools and a self-learning feedback system.  

- PROCARE4LIFE: Cláudia Louro, (Cardiologist, Maastricht UMC, the Netherlands)

The project proposes an interactive, personalised model, developed to meet users’ needs, to adopt healthy habits, maintain a daily routine and follow advice from care teams. The target group is formed by people over 65, mainly with a diagnosis of a Parkinson’s disorder or Parkinsonism, and their care teams. 

- BETTER AT HOME: Prof. Dr. Arno Elmer LL.M, (Managing director and Founder of Innovation Health Partners GmbH, Germany)

The project proposes an interactive, personalised model, developed to meet users’ needs, to adopt healthy habits, maintain a daily routine and follow advice from care teams. The target group is formed by people over 65, mainly with a diagnosis of a Parkinson’s disorder or Parkinsonism, and their care teams. 

• Moderated panel discussion with all projects’ representatives

[5] Taking vCare one step further on the road

Moderated by Thom Hoedemakers, Passion HF, Business consultant and SME strategist, the Netherlands

The objective of vCare was to develop a system prototype demonstrated in an operational environment.  

 This session offered an overview of the different possible exploitation paths for the vCare system and its main components. It provided the audience with a more detailed overview of how the different vCare components were selected, developed and integrated. It explained what the main problems encountered have been, how they have been solved during the project lifetime, and what will need further improvement in order for vCare to reach a higher maturity level and to be able to support a large-scale randomised controlled trial (RCT). An agreement has been reached within the consortium to guarantee the maintenance of the vCare system after the end of the project. Lastly, we disclosed the results of our socio-economic impact analysis. 

• vCare Exploitation paths: Luc Nicolas, vCare Exploitation Lead (EHTEL, Belgium) and Sofoklis Kyriazakos, Innovation manager (CEO, Innovation Sprint Sprl, Belgium)

• Cost-efficiency evaluation of the vCare solution: Rocio Del Pino, Clinical Neuropsychologist (Biocruces Bizkaia Health Research Institute, Bilbao, Spain)

We invited a number of solutions that are already on the rehabilitation market to join us for a lively discussion in order to unveil the key success factors for an innovation to find its own market. Together with these products/services, we looked at the short- and medium-term prospects, and considered the consequences of the evolution of the legal framework and the possible business cases. 

• The vCare market: Focus on four existing solutions:

Products on market:

- Rehab Guru: is a tried and tested patient management platform, including exercise prescription, remote monitoring of health, telehealth and clinic management software. Founded by clinicians, for clinicians, the platform is now the product of choice for the UK Ministry of Defence, numerous NHS Trusts, PMIs, and many private clinics across the globe: David Barrow, Director and co-owner, physiotherapist.

- Axomove: is an application designed by health professionals to improve the rehabilitation and prevention of physical health pathologies and diseases. The care team creates tailor-made exercise programmes for each patient supported by videos, educational material and teleconsultation. A dashboard provides daily feed-back: Boris Leveque, Co-Founder & Chief Commercial Officer, ex professional sport man.

Products on the road to market:

- Captain Coach provides a radically new user interface for empowering and motivating people in need of guidance and care. It supports setting goals, getting feedback along the process until the goal achievement. Goals are referred to four domains (physical, cognitive, social and nutritional) that enhance wellbeing in everyday life: Evdokimos Konstantinidis, Leader of ASOSS Research Group at Medical Physics and Digital Innovation Lab, Greece.

- Incasa is a Smart Home platform created so that any home can be transformed into an intelligent environment. In addition to helping today’s elderly people, it can evolve with their needs into the future. The Home Center has its own intelligence, based on the Home Care ERAS (Emergency, Risk, Activity, Status) protocol. It assesses situations in which it must provide help, inform family members or caregivers, or communicate with assistance services: Alejandro Cavaliere, founder at InCasa Smart Senior Living, Spain.

• Panel discussion with products owners and the audience.

With the participation of Cláudia Louro (Kinetikos, Portugal) and  Lucia Pannese (Imaginary, Italy).

This exchange was anticipated to form the starting point for new possible collaborations with external industry partners and clinical sites.