LE NUOVE TECNOLOGIE AL SERVIZIO DELL ANZIANO Dai big data sanitari alla salute personalizzata: il progetto OPLON in Emilia Romagna

Transcript

1 LE NUOVE TECNOLOGIE AL SERVIZIO DELL ANZIANO Dai big data sanitari alla salute personalizzata: il progetto OPLON in Emilia Romagna Laura Calzà CIRI-SDV, University of Bologna

2 Nel 2012 la Commissione Europea ha lanciato il Partenariato europeo per l innovazione sull invecchiamento attivo e in buona salute (EIP-AHA), con l'obiettivo di accrescere di due anni la speranza di vita in buona salute dei cittadini europei entro il 2020 Agenzia sanitaria e sociale regionale

3 H2020, PHC-06 Evaluating existing screenings

4 I committments della Regione Emilia-Romagna Aderenza alle prescrizioni di farmaci a livello regionale (Action A1) Luca Sangiorgi, Istituto Ortopedico Rizzoli Prevenire le cadute e le fratture nell anziano (Action A2) Lorenzo Chiari, Università degli studi di Bologna Affrontare la fragilità dell anziano e gli aspetti cognitivi (Action A3) Laura Calzà, Università degli studi di Bologna Modelli collaborativi a supporto delle cure integrate (Action B3) Giorgio Vezzani, Azienda ospedaliera - IRCCS Arcispedale S. Maria Nuova Reggio Emilia Collaborare per una vita autonoma dell anziano (Action C2) Teresa Gallelli, CUP 2000

5 Frailty: a multidimensional condition In a common medical sense, the frail elderly have an advanced age, chronic pathologies, clinical instability and a certain degree of disability. The condition of "pre-frailty" is present when only a few frailty factors are observed. In Italy, there are one million frail patients whose number will double in next 20 years (ISTAT 2006) Lang et al., 2010

6 The Identification of Frailty: A Systematic Literature Review determinants and pathways robust/ resilient partial components/ manifestation clinical observable syndrome adverce* outcomes pre-frail frail *disability, morbility, hospedalization, Istitutionalization, mortality primary prevention secondary prevention tertiary prevention Hypertension, smoking, cholesterol, vaccinations, exercise, nutrition Chronic diseases management, geriatric assesment, fall prevention, exercise, nutrition Rehabilitation, medical and geriatric management, maintan function/quality of life Journal of the American Geriatrics Society, Volume 59, Issue 11, pages , 21 SEP

7 Social domain: Physical domain: socio-economic context of the elderly Strength (handgrip), Walking speed, weight loss, Easily exhausted, physical activity. Ex: Short Physical Performance Battery, SPPB Cognitive domain Ex: Cognitive status evaluated with the Short Portable Mental Status Questionnaire (SPMSQ) Non-neurological diseases Neurological diseases Chronic diseases Psychiatric diseases Social isolation Inappropriate drug treatments Malnutrition POCD etc Holtzman et al, 2012

8 OPportunities for active and healthy LONgevinity The aim of the OPLON project is to propose actions and methods to prevent fragility and decline and to promote the health of the elderly, designing and developing early diagnosis instruments and care&cure networks. The solutions will be aimed mainly at elderly people in the risk zone, who start to experience limitations to the pursuit of daily activities and risk developing fragility (becoming pre-frail), which is a serious risk factor in terms of health. Project leader: Fulvio Marchetti, Santer-Reply

9 MIUR Smart cities and social innovation Art 1:. The Ministry of Education, University and Research (MIUR henceforth), in line with the European guidelines of "Horizon 2020," the guidelines the European Digital Agenda, the National Plan for E-Government, actions underway in the framework of the Digital Agenda Italian, attributes to interventions in the field of Smart Cities and Communities the value of a strategic priority for the entire national research policy and innovation. Line of intervention: ageing of the society 10.5M * * * * * * Partners: - 4 large companies - 4 SME - 5 research institutions Formal commitment from: - Ministry of Health - regional governments and health agencies (4), - healthcare local institution (4) - municipalities of major impacted towns (3) - associatations (GPs, municipalities & healthcare institutions) 9

10 Existing Database (anagraphic, health records, etc, issues): Example: Bologna municipality ( subjects) Research (350pz): Modelling Brief cognitive screening Physical activity Health status Services for: multidimensional frailty early recognition E-healt in specific co-morbilities Education and health promotion

11 SOLE (Sanità On LinE) è la rete che collega i Medici e Pediatri di famiglia con le strutture sanitarie ed ospedaliere della RER: prescrizione elettronica di visite ed esami specialistici variazioni anagrafiche e delle esenzioni ricovero e dimissione referto di pronto soccorso Vaccinazioni Raggiunge 100% dei MMG e strutture ospedaliere; consenso per parte delle informazioni FSE (Fascicolo Sanitario Elettronico) è una raccolta di dati e informazioni sanitarie che costituiscono la storia clinica e di salute di una persona: Al momento consultabile solo dal cittadino mediante credenziali In prospettiva: professionisti del Servizio sanitario regionale autorizzati dall utente (accessi tracciati)

12 Physical domain - wearable and environmental sensors Cognitive domain - Cantab suite (Executive function, Episodic memory, Working memory, Reaction time) Length: 20 minutes Administration: Standardized Scoring: Automatic Research: Computerized and paperless - Language: identification of objective measures in subjects speeches for the early identification of cognitive frailty, through Natural Language Processing somputerized analysis (phonetic / prosodic, lexical, morphological and syntactic levels)

13 Physical domain - wearable and environmental sensors Cognitive domain - Cantab suite (Executive function, Episodic memory, Working memory, Reaction time) Length: 20 minutes Administration: Standardized Scoring: Automatic Research: Computerized and paperless - Language: identification of objective measures in subjects speeches for the early identification of cognitive frailty, through Natural Language Processing somputerized analysis (phonetic / prosodic, lexical, morphological and syntactic levels) 13

14 OR1: Definition of the model for the prediction of the onset risk of chronic diseases and frailty, and study of modes of implementation for the algorithm OR4: Testing (PoC) OR3: Development of a technological platform aimed at supporting the models of prevention, care and monitoring of frailty OR2: Definition of a "care & cure" model for integrated healthcare and the monitoring of the frail population

15 Deliverables: Piatafforma ICT interoperabile Profilo di rischio personalizzato best practice di prevenzione secondaria (es anestesia/chirurgia e rischio cognitivo) La sfida per le nuove tecnologie: validazione costi