Integrated information system for the management of continuity of care through home care and organization of health and social interventions in fragile patients.
Starting date of the project 08/21/2013 – Ending date of the project 20/08/2014
The project is part of the Announcement Apulian ICT Living Labs of the Puglia Region
Reference domain: “Health, Wellness and Socio-Cultural Dynamics”
One of the qualifying points of a mature system of welfare is the proper and efficient evaluation of the degree of self-sufficiency and health status of the citizens, especially of those most vulnerable, who need social and social care assistance. Although it is evident the centrality of the hospital in the early stages of the disease for diagnostic and therapeutic aspects, the hospital is not able to offer in the later stages, appropriate responses to the needs of patients who are entrusted to local health facilities and family care. The majority of patients, while presenting situations of fragility or functional decline, also linked to chronicity caused by rare diseases, however, are equipped with capabilities such as to maintain a good level of autonomy if accompanied by appropriate remote assistance and monitoring systems that can monitor on their health status, detect critical events such as a fall or loss of balance, be of help in performing daily activities, facilitate communication with family members and health care workers and operate a coordinating the various activities of therapy or rehabilitation.
This project aims to produce an integrated system capable of performing a periodic record, at the address of the assisted, all those useful parameters to monitor over time the state of health in a multidimensional approach, using a mobile device. The data collected will be transferred using appropriate secure protocols, at a central server in a database that can be interrogated by authorized parties. The system will allow you to represent summary and detail data of individual patients highlighting the significant changes and signaling, through appropriate algorithms, the need for an intervention. It will also allow to record the performance of the various operators in a social care medical record, available to each operator with respect to its competence by allowing a multi-level communication.