1.1 Introduction to the pilot
The Puglia Pilot is the Italian research pilot site of the Gatekeeper project. Regione Puglia (AReSS Puglia e InnovaPuglia, linked third parties), Fondazione Casa Sollievo della Sofferenza, Fondazione Politecnico di Milano and MultiMed Engineers are the partners involved in the pilot .
The Pilot’s activities intend to improve the quality of life of people ageing in Italy, and to maintain their high spirit and mobility for as long as possible. The three research lines will also spread healthy habits literacy among the Puglia population and enhance the chance for an earlier diagnosis, as well as risk detection and intervention.
1.2.2 Target population
The target population consists of about 10,000 patients and citizens: 1,100 patients 65+ and 9,000 citizens 55+.
1.2.3 Technologies to be used
- Activage: App to collect personal wellness data through the Samsung Health app and securely store them in the Gatekeeper platform.
- Intervention planner: App for the management of coaching resources and for planning their delivery through personalised messages to promote active and healthy ageing.
- DMCoach: App aimed at coaching diabetic patients towards the adoption of healthy lifestyles.
- Data visualisation Dashboard Authoring Tool: Authoring tool for building and managing adaptive multimodal User Interface targeting healthcare professionals for remotely monitor elderly patients.
- Smartphone A41: Smartphone with Octa-core processor, 4GB RAM, 64GB storage.
- Smartwatch Active 2: Smartwatch with GPS, accelerometer, barometer, gyroscope, heart rate sensor, light sensor.
- Combined digital glucometer and blood pressure monitor BP800: Monitoring system, network connected with a Vodafone SIM card.
- Digital bioelectric impedance scale BC800: Scale, reporting weight and percentage of muscle, water and fat, network connected with a Vodafone SIM card.
- Multiparametric PPG device: Wrist device based on a PPG optical sensor for the continuous monitoring of multiple vital signs.
- Digital pulse oximeter: Digital device for measuring blood oxygen level.
- Digital glucometer: Digital device for measuring blood glucose level.
- Digital blood pressure monitor: Digital device for measuring blood pressure level.
- Cloud computing: Service for hosting the Gatekeeper platform and for the secure storage of Gatekeeper health data.
- AI predictive model for T2D: Model for the prediction of Type 2 Diabetes control.
1.2.4 Expected impact
The study will be completed after a 12-month period in all of the 3 Research lines. After the end of the experiment, the data collected during the observational period, from a target population of about 10,000 people, will be linked with data extracted from the regional administrative healthcare databases. This will be done in order to conduct a cost-utility assessment (primary end-point) and to assess other secondary endpoints regarding the feasibility and acceptability of a large-scale use of technical devices with older adults. If the assessment is positive, the use of the tested solutions as a permanent service at regional level will be considered.
1.3 Ongoing activities
The Puglia Pilot will launch three main experimentations over the next 24 months:
- The first one has already started in the Casa Sollievo della Sofferenza, the Apulian hospital. The study involves 100 patients with Type 2 Diabetes Mellitus. It aims to use wearable technologies to monitor participants’ glycaemic level and other fundamental parameters such as sleep and movement factors. The expected result will be an innovative statistical model for the predictive control of type 2 diabetes mellitus based both on the use of "conventional" clinical parameters as well as on the use of "non-conventional" data from wearable devices.
- The second study will involve 1,000 patients with multimorbidities in the Apulian Local Health Authorities of Lecce, Taranto and Barletta-Andria-Trani. The continuous monitoring of health parameters related to Chronic Obstructive Pulmonary Disease, Type 2 diabetes mellitus, heart failure, hypertension and support for the patient's self-management and empowerment with respect to pathologies. Not secondary in this research will be the expected improvement in the decision-making process of the Care Puglia 3.0 model through data collection.
- The third planned study will enroll 9,000 citizens. They will take part in a research based on wearable technologies and apps, to build a trusted ecosystem that will mix monitoring of health and personal parameters with the provision of information and content on wellbeing. The challenge in this case is to find out if precious advice delivered as e-coaching and health literacy can improve the way of life of the target population.
1.4 Pilot site team
Pilota Puglia Team:
- AReSS Puglia
- Fondazione Casa Sollievo della Sofferenza
- MultiMed Engineers
- Fondazione Politecnico di Milano