CHIRON INTEGRATED HEALTHCARE APPROACH FOR HOME, MOBILE AND CLINICAL ENVIRONMENTS

CHIRON concepts and objectives

The CHIRON Project is aiming at exploiting the enormous contribution ICT can give in making possible a radical change in healthcare through:

  1. An overall, integrated system architecture realizing a “continuum of care” i.e., addressing in an integrated approach health management at home, in the hospital and in a nomadic environment where health is addressed not as the management of episodic events but as a value the single person and the whole community have to build and to preserve;
  2. A “person-centric approach” where the needs of the citizens, the medical professionals and the whole community are at the core of the design and the uniqueness of each user is fully recognized (“personalized healthcare”);
  3. A knowledge-based system integrating past and current data of each patient together with statistical data related to the whole community in a large, distributed repository that is secure, easy to be accessed by the authorized persons, easy to be interpreted and fully understood in spite of the massive and diversified quantity of contextual information.
  4. Proactive computing in which embedded systems anticipate the needs of people, adapt themselves to context and take the required actions thus enriching quality of life and fostering independence.

The reference architecture for person-centric health management proposed by CHIRON will not be related specifically to a given disease but applicable to various clinical conditions and to various domains (clinical settings, nomadic environments, people’s homes).
The middleware resulting from the CHIRON project will be applicable for other health related systems development; specific “transferable” aspects are the reference architecture to support integrated care cycle, the portable and stationary sensors, the measurement devices and actuators, the personal profiling and the personalized approach in healthcare, the new concept of Virtual Data Repository.
In the CHIRON project we intend to completely specify these new solutions, implement them with attention also to issues such as data security, privacy, trust and information aging, and evaluate them in clinical trials.


CHIRON intends to address the needs of all the main stakeholders involved in the healthcare process:

  • the patients and the individual citizens;
  • the medical professionals;
  • the whole community.
The CHIRON main stakeholders and their addressed needs
The patients The medical professionals The Health / Social Service and the overall community The industry / the vendors
Quality of life Anywhere and anytime access to info related to the patient Cost saving (reduced frequency and time of hospitalizations) Interoperability through standardization
Reinsurance in being continuously monitored with regard to their health Support in their critical tasks (diagnosis, therapy planning) from a large quantity of data related to the specific patient Better quality of care Clarity in reimbursement policies
Reduced need of hospitalization Support from outcomes of epidemiologic studies and info related to patients with similar disease (knowledge-based medicine) Extension of “active life” of the citizens Coordination and harmonization strategies at European level
Better quality of care and personalized care (the patient at the center of the healthcare service) Better productivity and better focus on critical cases and tasks Reduced costs for patients and their families Clear legal framework
Increased independency

As highlighted by some reports7 these requirements are sometimes different from each other:

  • citizens generally want fast, safe and effective delivery of health services at reasonable cost; moreover continuous home health monitoring is required to be as unobtrusive as possible to achieve a high acceptance rate;
  • administrations might want safe, efficient and measurable delivery of health services at lowest possible cost;
  • care professionals might seek assistance to deliver safe and effective delivery of health services regardless of the cost.

Also industrial players have sometimes different objectives with regard to standardization, interoperable systems vs proprietary systems.

In line with this approach CHIRON intends to develop:

  • Continuous multi-parametric monitoring of physiological and psycho-emotional state, environmental parameters, patient activity and lifestyle related factors;
  • An evolving Patient’s Profile including all the relevant aspects related to the health of the user including medical history, habits, etc.
  • A personalized risk assessment model for the patient based on the medical history of the patient and kept continuously up-to-date;
  • The provision of first feedbacks to the patients ( a personalized coaching system helping the patient to reduce immediate risk and improve long term recovery prospect through behaviour and lifestyle adaptation and stringent compliance);
  • A simple and powerful system providing early diagnostics and personalized therapy support through the correlation of the monitored data with the Patient’s Risk Assessment model (Alter Ego) and through the integration with the hospital information system;
  • A Virtual Patient Repository (VPR) with exhaustive information related to the health of the patient, physically distributed in various databases and realizing a complete care cycle approach and an effective support the medical professionals.

“Medicine is one of the most knowledge intensive science; the challenges are:
- to incorporate the most recent and evidence-based knowledge into personal health systems” 8 and
- to transform collected information into valuable knowledge and intelligence to support decision making.
Expert systems – devoted to specific diseases – are available or represent the topic addressed by some European Projects.
The main objective of CHIRON – with regard to the expert system topic – will be to provide an architecture and an interfacing layer allowing the transfer of the data gathered from multiple and heterogeneous sources to the currently available and newly developed expert systems, where the information will be analyzed and appropriate feedbacks will be generated.
At the same time we will develop a methodology for the building of a robust expert system that – starting from a wide range of data acquired and preprocessed by the related embedded systems – personalizes their analysis according to the specific case and to the specific patient and defines a reduced set of key parameters / information able in a simple and robust way to assess the clinical situation of the patient and to support the doctor in his decision process.


7 See – as an example – the “ e-health INTEROP Report- Phase 1” issued by CEN/CENELEC/ETSI in February 2009
8From PHS 2020, support action project co-financed by the European Commission – FP7-IST-2007 –“The role of ICT in healthcare” – www.phs2020.com

The attached pdf file highlights the CHIRON objectives differentiated in:
  • Scientific and technological objectives
  • Medical objectives
  • Socio-economic objectives