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Thematic Priority: IST (Information Society Technologies)
Applied IST Research adressing major societal and economical challenges
Directorate C. – Components and subsystems. Applications eHealth
Our mission
The mission of the unit is to contribute to the Lisbon Strategy in making Europe the most competitive knowledge–based economy by 2010 through RTD in intelligent environments that enable ubiquitous management of citizens’ health status and assist health professionals in coping with major health challenges
Our vision
The vision of the Unit is to significantly contribute to improvement in quality, access and efficacy of health care through:

• · development of an intelligent environment that enables citizens to manage their well-being through access to qualified sources of health information and active participation in illness prevention, 
  · enabling patients to participate, with better knowledge and responsibility, in the processes of care and rehabilitation, through intelligent monitoring systems as well as through relevant and personalised health information,
• providing health professionals with access to timely relevant information at the point of need, new tools for better management of risk and systems to acquire up-to-date biomedical knowledge and facilitating health authorities to manage properly the on going reorganisation of health delivery systems.
  Focus of action

The focus of action of the Unit is:

• to develop smart and wearable biosensor technology (intelligent clothing and textiles) and implants that interact and communicate with other systems and health points of care for the ubiquitous monitoring of health status leading to better management of well being and improved disease prevention and treatment of patients,
• to develop ICT systems supporting health knowledge management, interoperability of health information sources, medical ontologies, clinical guidelines development, and method for decision support and risk analysis evidence based medicine and risk management, 
• to develop and promote knowledge in the areas of medical informatics, bioinformatics and neuroinformatics that enable disease prevention and therapy and tools enabling the individualisation of diagnoses and treatment,
• to develop and contribute to initiatives that help create the ERA in the field of eHealth.

MIR is one of the companies at the technological peak of the world market for portable lung function devices, and is the only company to have developed a portable instrument which integrates the two functions of tele spirometer and tele oxymeter.
There are very few other companies operating in the sector of tele pneumology, and no others which have achieved the high level of the MIR technology, which is protected by international patents.
 
The MIR tele pneumology device is aimed at:

• the GP (General Practitioner) for respiratory screening, and
• the COPD or asthma patient, for home care monitoring

spirotel is made up of:

• spirometer
• oxymeter

With a simple telephone call, the results of the measurements made by the GP are sent to a WEB Server using a very simple-to-use wireless technology, and the data  are then available on the server for the specialist to access via Internet to download the data, to view the results (in graphic or tabular form), to analyse the results and to translate them quickly into information which is of vital importance for the patient.
 
A software running on the WEB Server acquires the data from the instrument. Having received the data, the software then compares the results received with the “normal” or theoretical data of that patient. The trend of the results can then be analysed, and the software can then produce diagnoses and prescriptions as required.
 
The same hardware but configured with a different internal software can be used for home care telemonitoring of the COPD or asthmatic patient. In this configuration, the device can collect not only parameters plus supplementary   information such as symptoms, drug taken and life style. The WEB Server software then supplies an evaluation of the risk according to the profile of the patient. If required, in the case of severe pathology, the system is able to send e–mail, SMS, or MMS messages directly to the GSM of the doctor.

The remote monitoring of the vital parameters of the patient allow the patient to have maximum freedom, mobility and comfort and to improve the care level  for the chronic pathologies whilst at the same time reducing the costs of the health care system. The patients also feel themselves better “connected” both to their doctor and to the health care system.
 
Given that the National Health Service have access to the data held on the Server, the server becomes an important health information database where data can be accessed and viewed and decisions can be made on the base of objective evidence. The distances between the GP doctor, the patient and the specialist can effectively be eliminated. This combination thus allows prevention of the pathology, plus an improvement in the well being and the treatment of the patients.
 
Physically the Server can be located in a single site, or it can be distributed throughout the territory in a series of smaller servers. The Server must be only one, but if required can be made up of several smaller “feeder” units and in this way it is possible to personalise the system and thus allow it to be tailored to meet specific requirements, whilst remaining a single Server and a single system manager.
 
The MIR proposal follows closely the “interactive healthcare management” philosophy, which are emerging as guidelines in Europe and in the rest of the world. The objectives are to improve the quality and the efficiency of the health system and at the same time to reduce the costs of the system. This means:

for the patient

• personalised management of the disease and continuous optimisation of the therapy (follow–up)
• reduction in the cycle time symptoms-diagnosis-therapy
• better understanding of the illness and of the varying degrees of severity of the illness
• better adhesion to the therapy plan
• improvement in the quality of life

for the health service

• reduction in the number of unnecessary hospital recoveries
• “fast-track” treatment for high risk patients
• improvement in quality of treatment given and increase in competitivity of service
• reduction in costs of the production-distribution cycle of the treatment
• creation of a structured database, for epidemiological studies

for the doctor

• increased safety through monitoring and constant control of the patient
• possibility to modify the therapy very quickly in the case of a change in the patient’s condition, or even in critical cases the possibility to call a patient quickly for a doctor visit or even for hospital admission.

for the hospital/patient

• “protected early discharge” of the patient, enabled by the monitoring of some vital parameters at home
• reduction of the recurring condition, thanks to the constant follow–up
  
• consequent reduction in the costs for readmissions caused by the recurring conditions
  
• reduction of the risks of secondary infections or conditions, which can often be contacted during a hospital stay

Even if an accurate estimation of the actual cost reduction is almost impossible to make, it can be foreseen that the implementation of a tele pneumology service can go a long way towards achieving the health system objectives for chronic respiratory diseases, which can be summarised as follows:

• reduction in the rate of hospitalisations
• reduction in the number of repeated recoveries, in one year
• reduction in the number of repeat recoveries, within 30 days of patient discharge
• reduction in the number of “in patient” days
• increase in the number of patients using the “protected early discharge” system