Monitoring the physical exercises prescribed by the physiotherapist, communicating via chat with the medical team, remembering medication and scheduled medical visits and giving tailored recommendations on health and wellbeing anchored in artificial intelligence: these are just some of the features of a new personalised digital health app developed by the Eurecat technology centre in conjunction with the Althaia Foundation as part of the BAGESS Territorial Specialisation and Competitiveness Project (PECT) coordinated by Manresa Town Council.

The app is called Crono 360 and its rollout has begun as a pilot test with chronic patients with mental health problems and also with people undergoing cardiac rehabilitation at the Althaia Foundation Hospital in Manresa.

The tool’s purpose is to enhance continuous care and quality of life for people with dependency and/or chronic illnesses bearing in mind the demographic position and ageing rate in el Bages.

“The patient can straightforwardly see in the app the treatment and activities recommended by the clinical team and what they have to do,” says David Marí, director of Eurecat’s Digital Health Unit. “The system can also monitor and factor in follow-up variables based on information gathered by portable electronic device systems.”

The new Crono 360 digital app is the outcome of coordinated joint efforts between Eurecat staff who developed the technology and Althaia practitioners in a range of departments who mapped out the contents and recommendations coupled with the procedure and integration with the hospital’s systems. The design stage has additionally been informed by patients’ feedback and needs surveyed in focus groups.

Although two specific chronic diseases have been chosen for the first use cases, the tool has been designed to be modular and adaptable so that in the future it can be brought into play for other chronic illnesses.

A digital solution to empower patients in looking after their health

This new personalised medicine solution harnesses the technologies of the BECOME recommender system and the xCare platform developed by Eurecat.

The BECOME advanced recommender system “helps to empower people to look after their health due to twofold personalisation of both the content provided and also its interaction with the user with various tailored strategies and times to display the information,” says Sílvia Orte, head of Comprehensive Care research in Eurecat’s Digital Health Unit.

“It’s like having a personal trainer who is always on hand and ready to help out by giving bespoke advice while gathering fresh information.”

“This artificial intelligence-powered recommender app also taps the technology of the xCare digital health software services platform developed by Eurecat,” adds Felip Miralles, director of Health Technologies at Eurecat. “This includes assorted self-management tools for clinical processes specifically tailored to each patient and which already has a repository of over a thousand recommendations.”

Pilot test with practitioners and patients to validate the app

A total of 33 patients are currently taking part in the first stage of the pilot test designed to assess the app’s usability for practitioners and patients alike to see whether the interaction is user-friendly, convenient and intuitive. Its users’ satisfaction will also be evaluated.

“Once this pilot test has been completed, the idea is to continue with the research to evaluate more clinical aspects such as greater adherence to visits or treatment, reduced usage of resources and patients’ enhanced emotional or health status,” notes Gemma Cuberas, head of Althaia’s Research and Innovation Unit.

This tool will add to the paradigm shift in patient care, helping to drive the transformation of the health system towards more comprehensive care. “Remote care should not replace in-person service but rather should enhance follow-up and buttress the close relationship between patient and practitioner via new technologies,” says Cubreras.

Follow-up of patients with mental health problems and heart diseases

The tool’s features have been tailored to each use case. In terms of mental health, the new app reminds patients of the medication they need to take and the medical visits they have scheduled while also helping them to keep up healthy lifestyle habits by guiding them in aspects concerning sleep, physical exercise and diet. It also includes an alarm system which notifies practitioners about risk situations for patients together with a chatbot tapping artificial intelligence to deliver personalised responses to users.

The monitoring approach also builds in the specialist practitioners tracking the disease and their counterparts in primary care to deliver global care for the patient. Hence Crono 360 furnishes practitioners with a web-based app to evaluate, prescribe and follow up symptoms and treatment as part of the hospital’s clinical information system.

In the case of heart disease, the tool makes it possible to track the cardiac rehabilitation programme. Patients have to hand their daily physical exercise plan, questionnaires to check their state of health, educational packages to add to their knowledge in managing the disease and a calendar showing scheduled medical visits together with a chat to stay in touch with their medical team.

Moreover, the connection with an electronic bracelet means the app can also record heart rate and other variables while patients are doing physical exercise and so alarms can be triggered if any anomalies are detected during monitoring.

BAGESS PECT

Crono 360 has been developed as part of the BAGESS Territorial Specialisation and Competitiveness Project (PECT), which is the first step towards the rollout of the Bages Shared Agenda strategy on chronic diseases and dependency which is designed to turn the county into a pioneer in Catalonia in integrating key health and social strand.

Under the overall framework of this project, the solution comes in addition to developments being made by the other partners to meet needs in ageing, dependency and chronic diseases with specific pilot schemes in el Bages.

The BAGESS PECT project is co-financed by the Government of Catalonia and led by Manresa Town Council. Its partners are Eurecat, Althaia, the Ampans Foundation, the Bages University Foundation, the Jordi Gol University Institute for Primary Care Research and Sant Andreu Salut which are all undertaking actions as part of it.