A diagnostic toolkit monitoring IoT devices at home, integrated into the Gatekeeper Platform

The iwelli4ageing project is aiming to extend the iWelli diagnostic toolkit with capabilities to easily monitor data coming from IoT devices within the home environment, utilizing the Gatekeeper Platform

Despite the growing number of people with multiple chronic conditions, the majority of treatment guidelines focus on single diseases and rarely address how to optimally integrate care for people with multimorbidity. This highlights the need for more evidence that helps understanding and dealing with multimorbidity patterns.

Furthermore, the healthcare industry is generating a growing amount of heterogeneous data, including electronic health records (EHRs) and personal health records (PHRs). We have designed the iWelli diagnostic toolkit to support doctors in utilizing these cloud-based health records and in accessing information-rich data from older patients with multimorbidity while at home.

The toolkit

The iWelli diagnostic toolkit has been designed to detect early signs of chronic cardiac diseases by collecting and analyzing heterogeneous datasets.

The toolkit consists of:

  • A cloud-based FHIR Electronic Health Record (med.iwelli.com) that enables doctors to store heterogeneous data. For example, vital signs from their patients, documents, images (like MRI), photos of medical exams, document file types (such as pdf), textual content (like the medical history of the patient), financial records, audio files and many others). The med.iwelli.com Electronic Health Record provides relevant insights into patients’ health data and empowers physicians and healthcare providers to make decisions for dynamic treatment pathways. It creates a database of the medical history of multimorbidity patients with cardiac diseases and identifies unusual changes, trends and supporting changes in treatment pathways.

The med.iwelli.com: An FHIR (“Fast Healthcare Interoperability Resources”) Electronic Health Record

  • A cloud-based FHIR Personal Health Record that allows patients to upload their health data.

The mydata.iwelli.com: An FHIR (“Fast Healthcare Interoperability Resources”) Personal Health Record

  • Three mobile Android applications:
    • One for the doctors to record and store their patients’ health data in the Electronic Health Record from anywhere.


The iWelli Clinic Doctor app

  • One for patients that wish to record and to store their data into their Personal Health Records


The iWelli Clinic Plus app

  • One for patients that wish to simply record and send the data to their doctors

The iWelli Clinic app

  • A credit-card-like ECG device, able to do an electrocardiogram anytime, anywhere, and analyse it instantly, looking for Arrhythmia and Ischemia.

A credit-card-like ECG device connected to the iWelli Clinic app. The mobile application can use artificial intelligence to analyse ECG data.

The iWelli mobile apps

The iWelli Clinic app mobile application is designed to be intuitive, allowing also people with no medical training to accurately use it and collect vital signs, textual data, images and symptoms.

The mobile applications allow users to:

  • record their symptoms related to a heart disease,
  • monitor vital signs (blood pressure, heart rate, blood oxygen, respiratory rate, weight, temperature or any other vital sign that can be recorded at home), add free text notes, analyse the collected data and record the medical history,
  • upload medical exams, select recorded data and send it with just click to the pre-selected doctor and ask an online consultation,
  • store the measurements both locally on the mobile phone and in a secure online space dedicated to hold medical history records,
  • have a video-call communication with doctors and caregivers at the touch of a button.

We have set up a simple process where the physician who wants to monitor their patient remotely, will need to provide the cardio device and install the mobile app (Android/IoS) on a smartphone or tablet. The applications are provided in Greek and English and with a user-friendly design, that requires only a minimal training for the patient.

The iWelli diagnostic toolkit adopts a design approach where patients can also navigate without pressing buttons, using their voice to record their health data

In addition, there are instructions with video on the internet.. The use of the device is done by connecting it via Bluetooth to a smartphone/tablet and recording the ECG for 30 sec. Once the recording is completed, the patient selects their symptoms in a simple form and sends the ECG to the default email(s) to the database of the doctor/doctors . Optionally, the data is checked and a response is given to the treating physician (if desired).

The iwelli4ageing project

Within the Gatekeeper project, we designed the iwelli4ageing project to equip the iWelli diagnostic toolkit with capabilities to easily monitor data coming from IoT devices within the home environment, utilizing the Gatekeeper platform. The iwelli4ageing project also

  • simplifies the implementation of IoT services for our clients utilizing the Gatekeeper platform. We believe that applying cloud-based IoT platforms like Gatekeeper, can improve the quality of healthcare delivery for multimorbidity patients with cardiac diseases, by providing doctors with access to information-rich data that can help them assign dynamic medical plans to their patients.
  • sets up a more complex ecosystem of services in the med.iwelli.com platform to diagnose early signs of cardiac problems with new AI algorithms, help patients and doctors manage diseases more efficiently, and validate the new services in real-life use cases with doctors and multimorbidity patients with cardiac diseases.
  • equips the EHR platform with an Infobutton application to support evidence-based recommendations for treatment plans. The clinical knowledge shared as PDFs or from Medical Journals will be integrated within the EHRs as an executable service through the Infobutton. Our aim is to set up an open-source plugin (Infobutton tool) that augments electronic records (EHRs, PHRs) with intelligent search engine capabilities able to index and look through specific domain knowledge to guide the optimal treatment and support of multimorbidity patientsWithin the framework of the project, we will develop a digital repository of evidence-based interventions and information for the selected medications. 

The iwelli4ageing project within the framework of the Gatekeeper project achieved the following outcomes:

  • Integrated the iWelli Clinic applications and the EHR (med.iwelli.com) and PHR (mydata.iwelli.com) platforms with the Gatekeeper platform to support IoT home care applications.
  • Implemented real life use cases that concern cardiac diagnosis and treatment of patients with cardiac problems like arrhythmia.
  • Equipped the med.iwelli.com EHR platform with an Infobutton application to support evidence-based recommendations for treatment plans.
  • Implemented validation trials with doctors and multimorbidity patients with cardiac problems that tested the new services.

The technical setup of the system was helped by 5 physicians and many patients with chronic cardiac diseases and their carers. The updated services and applications were installed and successfully ran 24/7 with the Gatekeeper platform, where all the recorded data have been stored.

The validation trials evaluated the following, among others:

  • Compatibility between the iwelii4ageing project services and physician’s tasks: The majority of the respondents agreed with the usefulness of the systems’ abilities to support decision-making and to provide help for preventing medical errors. The physicians expressed positive opinions and experiences about the characteristics of the iwelli4ageing user interface and the intuitiveness of the mobile apps and the EHR platform.
  • Ability of the iwelii4ageing project services for information exchange, communication and collaboration in clinical work: Most of the physicians were satisfied with the presentation of monitoring results of the recorded data. The majority of the respondents were satisfied with the support for collaboration and information exchange of the iwelii4ageing project services.
  • Interoperability and reliability: The majority of the respondents agreed with the statement “the iwelii4ageing project services are reliable and stable”.

iwelli4ageing Project partners

The Ehealth and Knowledge Management unit of the National Centre for Scientific Research «Demokritos» (NCSRD) has successfully participated in and coordinated several European e-health projects. The unit is managing the Aha4Attica Reference site to promote digital health in the territory of Attica. The Ehealth unit is exploiting advanced low-cost and open-source technologies for collecting and analysing heterogeneous data. The unit is using artificial intelligence and knowledge management techniques to develop intelligent decision support systems and it is designing smart assistive living environments