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Do Cardiac Health: Advanced New Generation Ecosystem

Periodic Reporting for period 3 - Do CHANGE (Do Cardiac Health: Advanced New Generation Ecosystem)

Reporting period: 2017-02-01 to 2018-07-31

Do CHANGE is a research & innovation project with European and Taiwanese partners, co-funded by the European Commission and the Taiwanese Government. It will last from early 2015 to early 2018. The primary objective of Do CHANGE is to develop a health ecosystem for integrated disease management of patients with ischemic heart disease and heart failure. The system will give them access to a set of personalized health services in a near real-time fashion. This disruptive system will incorporate the behaviour change method “Do Something Different”, in conjunction with new innovative wearable/portable tools that will give indications of salt and fluid intake, monitor behaviour and clinical parameters in normal living situations. The total ecosystem will provide guidance to the patients themselves, their families, informal carers, and patient's social environments for disease management. Also, clinical diagnosis by various health care professionals (dietician, psychologist, cardiologist, cardiology nurse practitioner, GP, case manager) will be supported, but only after they have been given authorised access to these data by the patients.
Do CHANGE was a research & innovation project with European and Taiwanese partners, co-funded by the European Commission and the Taiwanese Government. The primary objective of Do CHANGE was to develop a health ecosystem which changes lifestyle or behavioral risk factors for coronary heart disease, chronic heart failure and hypertensive patients.
As a behavior change technique, Do Something Different (DSD) has been applied, which focuses on getting people to actually change small behaviors by delivering change prompts through small positive actions called Do's. The aim of all Do's is to override a person’s inbuilt impulse to act habitually; to help them break free from the gravitational pull of habits as they go about their day and to remind them of the micro-behaviors they need if they are to live more healthily.

COOKiT is one of the new hardware concepts. The product consists of: a physical intelligent spatula, a physical charging station, an online back end server and a smartphone application. The spatula measures cooking habits such as the amount of sodium used, the amount of time spent cooking and general cooking patterns. FLUiT helps people adopt healthy drinking habits. It is a sensor band that fits around drinking bottles, mugs and glasses. FLUiT includes two sensors: one quantifies liquid intake and one interprets drinking actions. Algorithms identify drinking habits and provide actionable and contextual Do’s to break them. Horus is an image pattern recognition software application that allows users to identify the ingredient nutrition and composition of the specified food items. The service can capture the composition of an entire meal in one photo and segment different target areas in that photo. Each target area could be identified to different specified food items from the back end server, which is established with food database training models.
A new ICT architecture consisting of distributed systems has been defined, with the high-level interfaces between them being specified and developed. The architecture will support the coordination of identity and privacy preferences between the distributed systems, such that information associated with an individual that is distributed between these systems can be shared in accordance with their preferences. The architecture will also support the sharing of pseudonymised information for individual analysis and “big data” analytics. A data analytics framework has been set-up, which will be incorporated within the Do CHANGE architecture, processing collated data from the pseudonymised database with the aim of optimising the health outcomes of patients.
Two RCT clinical trials (200 interventions, 200 serving as control group) were applied to demonstrate the total proof of concept: with a series of fine-tuned responsive Do’s, based on modern wearables it is possible to substantially and sustainably change the behaviour of patients that are at risk for worsening health if they do not change their habits.

Do CHANGE cost-effectiveness and exploitation studies suggest some novel commercially exploitable aspects not previously considered. They suggests different objectives and outcomes for the different client groups outlined. It also suggests that some of the main barriers to successful exploitation are inherent to the healthcare business sector.
A new sensor has been developed to measure NaCl in a substance, based on chemical impedance. In the applied methodology, the sinusoidal signal is generated by the electronics which have been integrated in the COOKiT device. Regarding complete meal scanning the development of the computer vision with the deep learning methodology of Convolutional Neural Network (CNN) has been developed.
For combining data from different sources and granting acess to these data by the individual, a new technical architecture consisting of distributed systems has been defined, with the high-level interfaces between them being specified and developed. The architecture will support the coordination of identity and privacy preferences between the distributed systems, such that information associated with an individual that is distributed between these systems can be shared in accordance with the preferences of the individual.

The Do CHANGE ecosystem could have considerable impact economically, socially and medically if it can be deployed in part or in full in healthcare. The emphasis on behaviour change, however, is a fundamental element of the ecosystem. There are major human and economic benefits to be had in tackling the behavioural risk factors in disease and the Do CHANGE ecosystem could be used in many other health areas. There seems little doubt that many lives would be saved and healthcare costs reduced by changes in lifestyle of the kind being targeted in Do CHANGE.
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