CardIA is part of 1000001 Labs’ efforts in health informatics, personal computational medicine and standardization of medical records. Administrations, hospitals, primary-care centers, pharmacy offices and social health centers routinely consult and update patients’ electronic medical records, which are stored and transmitted in standard formats, facilitating interoperability. Thanks to efforts in this area, new tools are gradually being implemented, such as: the electronic prescription of medicines; digital health channels for citizens, that allow them to access their medical records and analytical results, and to carry out basic transactions, like the request of visits; and tele-medicine applications, which connect more remote or isolated patients and health centers with the highly specialized resources of the city. And there is still room for growth, because current heterogeneity of health systems hinders the interoperability of data and processes.

Monitoring and prognosis system based on the ICF for people with traumatic brain injury
Subirats, L., López-Blazquez, R., Ceccaroni, L., Guifre, M. et al.
International Journal of Environmental Research and Public Health, 12 (8), 9832-9847, 2015
ISSN: 1660-4601. Impact index: 2.04

The new health care has been described as 4P: personalized, preventive, predictive and participatory. It requires a transformation from analog to digital, from face-to-face to virtual; an improvement of the user experience; and the gradual introduction of algorithms in the health system, in the cases in which they are superior to human professionals.

1000001 Labs’ staff worked for the hospital and healthcare sector and have been leading and participating in important collaborative projects of applied research and innovation at European level. Our interests, efforts and lines of research are aligned with the challenges and objectives proposed in the Research Framework Program of the European Commission, Horizon 2020. The challenges that have been proposed in the programs of health, quality of life and inclusion have led to projects about personal health systems, models for the prevention of chronic diseases, virtual human physiology, smart home, health-care technologies to improve the capacities of people with functional diversity. Considering these challenges and taking into account our orientation to artificial intelligence, we have specialized in personalized computational medicine, and formal representation and standardization of medical records.

Automatic assessment of socioeconomic impact in cardiac rehabilitation
Calvo, M., Subirats, L., Ceccaroni, L., Maroto J. M. et al.
International Journal of Environmental Research and Public Health 10 (11), 5266-5283, 2013
ISSN: 1660-4601. Impact index: 2.06

Solutions have been developed that allow clinicians and therapists to plan, prescribe, monitor and customize comprehensive therapies and actions to patients, especially chronic patients who carry out therapies on a continuous basis. The evolution of the patient’s health is monitored by the use of scales and sensors that allow data to be collected continuously. These data, processed and presented to the therapist together with additional clinical evidence, allow adjusting and personalizing the treatment to each specific patient. Applying these concepts to diverse medical disciplines, specific applications have been developed:

  1. for prescribing physical rehabilitation to patients who have suffered a stroke and can improve their mobility and balance through virtual reality and an instrumented t-shirt;
  2. for prescribing physical rehabilitation to chronic cardio-respiratory patients;
  3. for monitoring and predict the health status of people with traumatic brain injury;
  4. for automatically assessing the socioeconomic impact in cardiac rehabilitation.

The aim is, on the one hand, to provide tools and knowledge for emancipation and rehabilitation of the chronic patient, such as:

  • expert knowledge;
  • information on the progress of patient condition;
  • a new channel of communication between patients and their therapist; and
  • an algorithm to personalize treatment related to rehabilitation;

on the other hand, to provide health professionals with tools and knowledge based on previous cases and clinical evidence for the prescription of treatments, such as information and recommendations for progressive personalization and adaptation of rehabilitation actions.

A simulation and integration environment for heterogeneous physiology-models.
Huertas Migueláñez, M. M. and Ceccaroni L.
Proceedings of the 15th IEEE International Conference on e-Health Networking, Application & Services (IEEE Healthcom 2013) (Lisbon, Portugal), 2013

Personalized computational medicine complements these solutions through the modeling and representation of medical knowledge, in order to build simulation and decision support tools, especially for medical personnel, but also for patients and their families. The applications of the simulation tools cover medical research aspects for deepening the knowledge of the genetic, physiological and environmental aspects of diseases. The applications of the decision-support tools have a greater incidence in the medical practice, helping in:

  • the early diagnosis of a pathology;
  • the prognosis of the evolution of a specific patient’s health;
  • the evaluation of risks;
  • the analysis of co-morbidities;
  • the management of therapies;
  • the prescription of drugs and interventions in the specific diseases under study; and
  • the prevention of diseases and the promotion of healthy living habits when addressing patients.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients
Velickovski, F., Ceccaroni, L., Roca, J., Burgos, F., Galdiz, J. B. et al.
Journal of Translational Medicine, 12(S2), S9.1- S9.10, 2014
ISSN: 1479-5876. Impact index: 3.99

Through projects such as Synergy-COPD (whose principal investigator and coordinator was Luigi Ceccaroni), support was provided in:

  • the detection and screening of potential under-diagnosed cases of chronic obstructive pulmonary disease (COPD) in pharmacies;
  • the assessment, comparative analysis and prediction of the evolution of the health status and quality of life in relation with the prescription of rehabilitation and interventions in daily life to patients with disabilities of neurological origin.

Circles of Health: Towards an advanced social network about disabilities of neurological origin
Subirats, L., Ceccaroni, L., Lopez-Blazquez, R. et al.
Journal of Biomedical Informatics, 46 (6), 1006-1029, 2013
ISSN: 1532-0464. Impact index: 2.13

The aim is to improve rehabilitation therapies and healthcare over time, based on:

  • periodic monitoring of changes in interventions;
  • evaluation of results of these changes; and
  • prediction of the future state of the patient.

Knowledge representation for prognosis of health status in rehabilitation
Subirats, L., Ceccaroni, L. et al.
Future Internet 4 (3), 762-775, 2012
ISSN: 1999-5903

Other projects are aimed to people with functional diversity who benefit from home automation, social-network adaptation and rehabilitation services through such sophisticated user interfaces as brain-computer interfaces (BCI). The objective is to improve the quality of life of people with special needs, extending at the same time their personal autonomy and reducing their dependence. And advanced, personalized, adapted interfaces are key to this aim.

Context-Awareness as an Enhancement of Brain-Computer Interfaces.
Navarro, A. A., Ceccaroni, L., Torrellas, S., Velickovski, F. et al.
Lecture Notes in Computer Science 6693/2011, 216-223, 2011
ISSN: 0302-9743

Efforts have been also dedicated to the formal representation of medical records, which, because they’re mainly confined to paper, can’t be easily transferred from one physician or hospital to another. And because they’re not subject to any standards (or even legibility requirements), they’re nearly impossible to compare and combine. Improving the system is possible, but it needs the cooperation of a number of interest groups that have no interest in working together. Legislation has been passed in several countries and was supposed to fix this lack of interoperability, but massive lobbying is delaying its application. Electronic records could solve the problem, but, because the software vendors selling electronic record-keeping systems are competing, their systems are proprietary and incompatible. Oddly, that’s acceptable to many physicians. Another name for an all-knowing, all-compatible electronic system is ontology (basically, a relational database), and physicians don’t want people mining their databases — not because of patient-privacy concerns, but because the information could be used for doctor-on-doctor performance stats. Plus, doctors already dislike filling out charts; and in general it is safe to assume that they don’t want to learn data entry using complex standards. Therefore, our efforts on formal, transparent knowledge representation need to be accompanied by interfaces and software that will appeal to physicians and patients alike.

Interoperable knowledge representation in clinical decision support systems for rehabilitation
Ceccaroni, L. and Subirats, L.
Applied and Computational Mathematics 11 (2), 303-316, 2012
ISSN: 1683-3511