A Novel Virtual Coaching System Based on Personalized Clinical Pathways for Rehabilitation of Older Adults-Requirements and Implementation Plan of the vCare Project.

Sofoklis Kyriazakos,Marc Lange,Vibeke Lynggaard,Elda Judica,Morten Bøttcher,Alvaro Martínez,Patrick Philipp,Irma Sterpi,Massimo Corbo,Lucia Pannese,Juan Carlos Gomez-Esteban,Rocio Del Pino,Massimo Caprino,Inigo Gabilondo,Peppino Tropea,Stefan Busnatu,Kai Gand,Hannes Schlieter,Jordi Rovira

doi:10.3389/fdgth.2020.546562

Abstract

Home-based rehabilitation after an acute episode or following an exacerbation of a chronic disease is often problematic with a clear lack of continuity of care between hospital and home care. Secondary prevention is an essential element of long-term rehabilitation where strategies oriented toward risk reduction, treatment adherence, and optimization of quality of life need to be applied. Frail and sometimes isolated, the patient fails to adhere to the proposed post-discharge clinical pathway due to lack of appropriate clinical, emotional, and informational support. Providing a suitable rehabilitation after an acute episode or a chronic disease is a major issue, as it helps people to live independently and enhance their quality of life. However, as the rehabilitation period usually lasts some months, the continuity of care is often interrupted in the transition from hospital to home. Virtual coaches could help these patients to engage in a personalized rehabilitation program that complies with age-related conditions. These coaches could be a key technology for empowering patients toward increasing their adherence to the care plan and to improve their secondary prevention measures. In this paper, we are presenting a novel virtual coaching system that will address these challenges by combining recent technological advances with clinical pathways, based on joint research and validation activities from researchers from the medical and information and communication technology (ICT) domains.

Highlights

Non-communicable diseases (NCDs) represent the leading public health challenges globally in the 21st century, resulting in ill health, economic burden, life loss, diminished quality of life (QoL), and poor social development in both high-resourced and low-resourced countries
The efficient implementation of the secondary prevention measures through adequate rehabilitation programs represents a primary issue for patients with NCD as they age, helping them to enhance their QoL and to live independently
Rehabilitation after an acute episode or in a chronic disease is a key aspect for patients’ management and is a main contributor to their increase in the QoL associated with improved self-care

Summary

Introduction

Non-communicable diseases (NCDs) represent the leading public health challenges globally in the 21st century, resulting in ill health, economic burden, life loss, diminished quality of life (QoL), and poor social development in both high-resourced and low-resourced countries. Using today’s intelligent monitoring and interaction technologies, virtual coaches (VCs) could support these patients to continue with a personalized rehabilitation at home, adjusted to the age-related conditions. This way, they partly compensate the absence of a human caregiver. By natural language processing interaction, facial recognition, and behavioral monitoring, VCs could motivate patients to engage and perform their recommended physical activity routine, to stick to the medication plan, to avoid unhealthy habits, and to keep their social life active. It supports professional care and provides a reliable tool for motor and behavioral engagement supporting the patient’s long-term recovery from stroke’s impairments

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