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POLY-stakeholders for integrated CARE for chronic patients in acute phases

Periodic Reporting for period 2 - POLYCARE (POLY-stakeholders for integrated CARE for chronic patients in acute phases)

Reporting period: 2017-07-01 to 2018-12-31

POLYCARE project aims to develop and test an integrated care model, patient-centred, supported by the use of advanced ICT systems and services that allows the monitoring and care of older chronic patients in acute phases at home. In doing so, two main objectives may be achieved: better conditions of life and care for these patients and the improvement of the sustainability of the health and social care systems.

The POLYCARE secondary identified objectives are:

1.- Provide to chronic patients an integrated care system to achieve a real and high quality home hospitalization
2.- Empower the self-health management of these patients using customisable apps.
3.- Get a non-intrusive monitoring system getting continuously info about its vital signals.
4.- Increase the collaboration between patients and the medical and social caregivers.
5.- Reduce technical barriers training the professionals to use the new ICT solutions.
6.- Ensure data protection and privacy issues.
7.- Get more and more accurate data and develop a decision support tool to better understand and get recommendations to the patients.
8.- Provide a better medication prescription.
9.- Definition of a new methodology for home hospitalization (patients - clinical - social caregivers)
10.- Reduce the stay of chronic patients in hospitals and consequently the related costs

POLYCARE team is working around these objectives to enable the reduction of bed days for emergency admissions & Significant reduction of medical expenses.
In terms of project management (WP1) it was established all the management procedures, the quality plan and all the organizational meetings to hold during the project life duration. It was also created all dissemination and social media channels. The architecture design and assessment of the POLYCARE requirements. (WP2) was established during this period too, including a review of the state of the art on those aspects and components that are being developed in POLYCARE. There are 3 main technical areas (WPs 3, 4 and 5) that are in charge of developing the ICT POLYCARE components. It was started the definition of the methodologies as part of the WP6 activity.

The work focused on trying to match the points of view of the clinical and technical parts in order to set the basis for defining the functionalities of these applications. In WP4 the work focused on developing the DSS, the CE and the technical architecture. Also the work on the SSP (WP5) experienced several advances and the several tasks were oriented to integrate the system architecture requirements. It also started the work on the pilots. The pilot sites started the specific definition of the three PoCs and also to identify the preliminary trial and integration planning as part of WP8 activity. Finally, some actions were taken in terms of exploitation and innovation management. The most relevant results obtained during this period included: (1)Successful submission of the expected deliverables, (2)The technical design of the application for patients was finalized, (3) The technical design of the DSS and CE was finalized, (4)The integration of the system requirements within the SSP platform was achieved, (5)The definition and planning of the PoC trials was finalized.

M12 - M18
Based on the technical designs agreed during previous semester, all pending development tasks of the different technology components were started. WP7 activities to plan and execute the integration plan have been driven and in WP8 the infrastructure set up of each pilot, trainings and preparation to start the pilots have also been carried out. On the clinical side WP6 task were finalized. WP9 potential business models and exploitation were proposed and will be refined during the second phase of the project. Most relevant results included: (1) development of the technical components – improvements and extensions will be required- , (2) set up preparation of the pilots and (3) development of the methodologies at each of the pilot sites.

M19 – M24
Echosanté partner dropped its participation in POLYCARE due to a bankruptcy process. From the management it was taken all the steps for the exit of this partner and the search and inclusion of a new partner to substitute Echosanté. SANTELYS was our candidate. The POLYCARE platform experienced delay in the finalization of most relevant features and integrations resulting in a delay while starting the pilots. WP3, WP4, WP5 and WP7 increased the man power devoted to finalized the technology, meanwhile clinical partners finalized their set ups and contributed to the testing and validation of the technology.

SANTELYS was confirmed as newcomer partner in POLYCARE and all partners contributed to get them on-board. Clinical partners will all aspects related to the integrated care methodology and technical partners run a compilation of new requirements for this new pilot. In addition technical work continued to bring technology to a more stable status. Also new functionalities were requested to start the pilots. The most important outcome of this period was a stable version of the POLYCARE platform ready to start the pilots.

The final semester has been mainly devoted to run the pilots at the 3 sites and provide with the final version of the technical components. In addition, it has been carried out the local and global evaluations and derived the results and key findings from the project which are the major results of this period and the project. All the steps to close the project have been also taken during this last period
POLYCARE project presents several innovation areas in which POLCYARE aims to go beyond the state of the art, related to the different areas and components that are being developed:

1.- POLYCARE innovation at the Decision Support System will be focused on applying rules START/STOP in order to detect and prevent medication prescription errors and we will research on a suitable level of alerts. POLYCARE will foster advances in the state-of-the-art by incorporating existing know-how in the area of anomaly detections and predictions to this concrete target user group of patients affected by chronic diseases. Additionally, the project will focus on the improvement of the relationships between patient and health professional through our DSS, which will target customised presentation of information tailored to the needs of the users and will try to provide early alerts on critical situations.
2.- POLYCARE innovation at wearables will be focused on integrating and evolving devices low-cost, very simple for patients and to take as much as possible vital signals using only one device.
3.- In terms of gamification, POLYCARE innovationaims to apply gaming concepts for design applications for mobile and smart TV in order to engage patients for their own health management.
4.- POLYCARE innovation at social care services is focused on providing mobile apps in order to access to the collaborative environment and the Decision Support System in order to get procedures and real time information necessary to get or communicate.
5.- POLYCARE innovation at social care services is focused on providing mobile apps in order to access to the collaborative environment and the Decision Support System in order to get procedures and real time information necessary to get or communicate.