The global burden of stroke and multiple sclerosis (MS) is immense, both in medical and in economic terms. Acute stroke management is a time-critical emergency requiring specialized treatment. Likewise, long-term professional support helps to reduce the impact in patients with MS and in stroke survivors. Remote monitoring and integrated e-solutions hold the promise to provide timely expert care, from the hyper-acute emergency setting (e.g. pre-hospital stroke care) to the chronic rehabilitation phase (e.g. MS, chronic stroke care).
The objective is to develop, validate and implement an open source and secure ICT platform for interoperable collection and communication of wireless 3G/4G audio-video data, point-of-care device data and patient medical history data, across hospitals, emergency vehicles and patient portals at home. The ICT platform will also enable blinded big data analysis of the medical data to optimize treatment and to facilitate clinical research and health economic studies. The IRIS platform will comply with legislation on privacy and data protection, medical device regulations and liability legislation as well as technological regulations.
Over the past years, we have developed an integrated audio-video and point-of-care medical device for acute stroke care (PreSSUB-Innoviris project). This is an ideal basis for integration in the IRIS platform. New applications for remote consultation of stroke and MS patients in their home will be developed on IRIS: COACH (Counceling, Advice and Consolidation of Health promoting actions).
The IRIS consortium is very well suited to achieve the proposed innovation and will have the following approaches:
Creation of the ICT platform: Based on existing cloud telecommunication systems, we will build the architecture with a focus on open access of devices (i.e., sensors, servers, client applications). The proposed architecture and communication methods will be based on well-accepted protocols and entities defined by standardizations bodies from the Internet (IETF) or telecommunications (IEEE, ITU). If an extension to an existing standard (or a new one) has to be proposed, it will be made publicly available and properly documented in order to support the diffusion of an interoperable ecosystem of medical devices based on our solution. With that respect, it is important to note OPERA is member of the ISO TC 215 group ("standardization of Health ICT, to allow for compatibility and interoperability between independent systems") which will allow to set the developed solution in line with international standards of medical interoperability. Specific attention is on interoperability (between telemedicine solutions, between devices and the platform, between the platform and Hospital Information Systems (HIS), between different data sets), data compression and storage (data mining, visualisation).
Data integration and analysis: The platform will develop and incorporate tools for efficient, scalable and error resilient compression of the multi-modal data streams. The expertise of ETRO in this field will be of crucial importance to the project. A key focus will be on end-user adoption for the consumer and physician portals. By developing the platform architecture using stroke telemedicine solutions in hospital and home environments, we will ensure its acceptance. Applications targeting home monitoring will be developed in close collaboration with patients, while visualisation and data mining modules running on the platform will be developed in partnership with clinicians.
Legal and ethical compliance: Especially for medical data, the legal and ethical compliance is a key driver in the development of an open platform. Prior to and during the development, our legal expertise (LSTS) will provide an overview and in-depth-analysis of applicable legal issues with regard to data protection and privacy, fundamental rights and ethical questions, medical device regulations, liability issues, reimbursement and cross-border healthcare. This research can outline legal recommendations towards Brussels and Belgian policymakers adjusting the legal and regulatory framework for enabling an open platform.
By integrating these 3 elements, we will develop a first prototype architecture which we will test in a clinical environment, involving experienced researchers in stroke and MS telemedicine. This project's final outcome will be an open platform that allows any medical device and audio-video manufacturer to be connected for a variety of medical indications. Currently, no such service and solution exists for telemedicine projects. The project will be valorised by leveraging and catalysing other telemedicine solutions and providers and by delivering a broad range of services through an IRIS spin-off.
The UZ Brussel is perfectly placed to sponsor this project because it aggregates all stakeholders involved in clinical e-health applications: from patients to medical personnel and technicians. Our second sponsor, Belgacom, will be of tremendous value to IRIS for its insights in the technological needs of the platform and experience in multiple ICT valorisation strategies.