The EU-funded SmartCare project helped older people, and those with chronic conditions, to live independently by enabling them to monitor their own health parameters, such as weight, blood pressure and heart function, and transmit the information to carers and doctors who were able to respond rapidly to any problems. The project’s unique approach was that it brought together health- and social-care workers through the use of ICT.
SmartCare: using ICT to enable older people to live independently for longer
- 17 June 2021
‘SmartCare was developed in the northern Italian region of Friuli-Venezia Giulia for improving integrated care for people with chronic conditions. Patients make self-measurements of their health conditions related to blood pressure, oxygen, electrocardiogram and weight. In our region, we had 200 patients involved in the project, around 100 informal carers and 80 social care professionals.’
The project was piloted in Friuli-Venezia Giulia, Italy, and eight other European regions. The aim was to empower older people, particularly those in remote rural areas, to manage their health and chronic conditions via telecare and telemonitoring. By integrating healthcare and social services, the objective was to ensure a better quality of care and more efficient use of health funding.
Telemedicine improved coordination between health-care workers, ensured better quality of care for older people, empowered them to take care of their own health, and improved their digital skills and health literacy.
The pilot phase involved patients, non-profit and non-governmental and care-provider organisations, and professional and informal carers, such as relatives.
Advanced communication systems
Progressive ICT infrastructure and services were critical to the success of the project and the required coordination between the health and social-care sectors.
There were three main ICT elements in the project: the digital system accessed by doctors, nurses, social workers and informal carers; mobile devices for telemonitoring; and the hub that collected the data transmitted by the mobile devices and sent it to the health platform. The mobile devices and hub were located in patients’ homes.
The system also operated three levels of alarm: the first, which could be due to a measurement error, resulted in a call centre contacting the patient to ask for a new measurement. A nurse or a family member visited the patient when the second level was triggered. At the last level, an alert was sent to a hospital emergency unit.
Shorter hospital stays
According to the project’s final report, the project set out to determine if integrated care would improve patients’ quality of life while reducing their need for hospital admissions and contacts with healthcare professionals.
From a total of over 10 000 patients, the evaluation cohort comprised 1 764 people (56.3 % female). Of these, 1 043 received integrated SmartCare (IC) services, and 721 the usual methods of care (UC). Their average age of the cohort was 75.9 years.
Although more patients in the IC group were admitted to hospital, they were less likely to be hospitalised than those in the UC group, and their hospital stays were shorter. According to the report, about 80 % of these admissions were unplanned, and usually in the cardiology department. The project found that IC had little effect on quality of life.
SmartCare resulted in all nine pilot sites devoting more attention to improving home-care services, and making them a priority for treatment of long-term diseases, such as heart failure, chronic obstructive pulmonary disease and diabetes, especially when patients have comorbidities.
The ICT solutions used resulted in better access to and sharing of data, improved communication between patients, carers and health- and social-care workers and helped to develop patient and family-centred care networks.
Demands of an ageing population
Projects like SmartCare are responding to the needs of an ageing population in Europe, longer life expectancy and an increase in chronic diseases such as cancer and dementia. Expenditure on long-term care is rising while changing family structures are leading to a shortage of informal carers, like relatives, to look after the elderly.
This project is in line with EU policy objectives including the Strategic Implementation Plan for the European Innovation Partnership on Active and Healthy Ageing, the Digital Agenda for Europe, eHealth Action Plan and the eHealth European Interoperability Framework.
Total investment and EU funding
Total investment for the SmartCare project is EUR 16 000 000, with the EU’s European Regional Development Fund contributing EUR 8 000 000 through the “Enterprises and Competitiveness” Operational Programme for the 2014-2020 programming period. The investment falls under the priority “Innovation, Research and Technological Development”.