Clinical Relevance of the First Domomedicine Platform Securing Multidrug Chronotherapy Delivery in Metastatic Cancer Patients at Home: The inCASA European Project.

BACKGROUND: Telehealth solutions can improve the safety of ambulatory chemotherapy, contributing to the maintenance of patients at their home, hence improving their well-being, all the while reducing health care costs. There is, however, need for a practicable multilevel monitoring solution, encompassing relevant outputs involved in the pathophysiology of chemotherapy-induced toxicity. Domomedicine embraces the delivery of complex care and medical procedures at the patient's home based on modern technologies, and thus it offers an integrated approach for increasing the safety of cancer patients on chemotherapy. OBJECTIVE: The objective was to evaluate patient compliance and clinical relevance of a novel integrated multiparametric telemonitoring domomedicine platform in cancer patients receiving multidrug chemotherapy at home. METHODS: Self-measured body weight, self-rated symptoms using the 19-item MD Anderson Symptom Inventory (MDASI), and circadian rest-activity rhythm recording with a wrist accelerometer (actigraph) were transmitted daily by patients to a server via the Internet, using a dedicated platform installed at home. Daily body weight changes, individual MDASI scores, and relative percentage of activity in-bed versus out-of-bed (I

The Green Surgical Block 4.0: Automation of the operating theatre's climate conditions through a real-time patient-flow solution.

The energy consumed by surgery units constitutes a staggering part of the overall healthcare carbon footprint. Partly due to the demanding climate conditions necessitated by operating theatres (OTs), energy is also wasted because of poorly managed heating, ventilation and air-conditioning systems (HVACs) that consume up to 57% of the total energy used in a hospital. With their goal of optimising OTs' performance and reducing patient waiting lists, heads of surgery units worldwide do not dare to risk cancelling scheduled surgery because of problems with the OT environment conditions (ie temperature, humidity, pressure). Current solutions are monolithic, complex and completely disconnected from healthcare logic, failing to take into account the idiosyncrasy of hospitals. This article presents an innovation that uses real-time patient flow data to automate and optimise the OT's climate conditions.

Surgical block 4.0: a digital intervention based on a real-time location patient-flow solution to support the automation of surgical pathways.

As internet of things (IoT) technologies are increasingly adopted by healthcare and hospitals, new opportunities are emerging to transform patient pathways and achieve efficient delivery of care. This implemented project follows the drivers and requirements of industry 4.0, based on surgical process analysis and optimisation using IoT technology, with the goal of creating '4.0 hospitals'. Our study presents the implementation of a novel IoT application, aiming to give support to multidisciplinary surgical teams through the optimisation of patient pathways to facilitate the surgical process. The implemented solution is based on real-time location systems (RTLS) technology, a subgroup within IoT, and it originated through the hospital needing to address the sudden surge of surgical elective care demand. The solution also enhances patient safety, facilitates quality of care by increasing communication and reduces costs. This IoT tool has facilitated the increase of theatre utilisation from 70.02% to 82.5% in 2 years, which has translated into an increase of surgical activity capacity, with an impact on reducing the waiting list.

Introduction to the cognitive hospital.

The third industrial revolution has radically impacted the transformation of hospitals. Through the adoption of key digital technologies, hospitals have become more accessible, flexible, organised, responsive and able to deliver more personalised care. The digitalisation of patient health records, one of the most remarkable achievements to date in healthcare management, has enabled new opportunities, including the idea of hospitals evolving to become artificially intelligent. In parallel, the adoption of electronic and mobile internet technologies in hospitals has introduced new structural concepts, seeing a variety of terms blossom such as 'smart', 'intelligent', 'green' and 'liquid'. Now in the early fourth industrial revolution, driven by AI and internet-of-things technologies, this article unveils a new concept adapted to the upcoming era.