“Liquid Hospital ”: A new technological concept to improve patient monitoring in out-of-hospital settings
25 November 2024.
Author(s): José David Garrido Jaén, Giuseppe Caprara, Úrsula Martínez Iranzo, Cristina Herrera Ligero
Instituto de Biomecánica (IBV)
The healthcare sector is undergoing a profound transformation due to factors such as an ageing population and the advent of new technologies. This has given rise to projects such as the Instituto de Biomecánica (IBV)’s “Liquid Hospital”, which seeks to provide patient-centred healthcare through the use of non-intrusive technologies that facilitate remote monitoring and follow-up. This approach makes it possible to personalise and optimise care, improve patients’ quality of life, reduce unnecessary travel and increase the availability of health and social services. The project also promotes the adoption of precision medicine by facilitating preventive interventions through real-time data analysis. However, the implementation of the Liquid Hospital concept faces technological, regulatory and operational challenges, including, first and foremost, the important role of connectivity, system interoperability, and the need to train healthcare professionals to ensure its success. Public-private collaboration and initiatives to promote public procurement of innovation play a key role in accelerating the development and adoption of these innovative solutions.
INTRODUCTION
It is clear that society and all its constituent parts are in a state of constant flux. Nevertheless, it is safe to say, without fear of error, that the pace of change has increased dramatically in recent years. Although we can think of all manner of reasons why these changes are taking place, there is little doubt that demographic change and the advent of new technologies are proving to be crucial.
One of the areas where this transformation is most evident is in the field of health and healthcare, which has become one of the areas of society on which innovation, the digital transformation and research are having an enormous impact.
There are many and varied reasons for the dynamic development of the health sector (Figure 1). One notable factor is the ageing of the population and the growing incidence of chronic diseases. Pathologies such as diabetes, high blood pressure, cardiovascular diseases and musculoskeletal disorders require a more flexible, continuous and accessible approach to healthcare for all citizens, regardless of where they live or the resources available to them.
Another aspect underpinning this paradigm shift is technological democratisation. Recent years have brought widespread access to mobile devices, high-speed internet and everyday devices that can connect to the web and collect data of interest to the user. In one form or another, technology offers countless opportunities to break down barriers when it comes to accessing services, resources and content that until recently were only physically accessible.
Something else that should be considered, perhaps as a consequence of the above, is the exponential increase in the knowledge and information that patients have in relation to our health and quality of life. The culture of self-care and individual empowerment as a defining feature of our lives allows us to take an active role in monitoring our own health, which makes us quite exigent when it comes to demanding better services, better care and greater involvement throughout the care process.
Last but by no means least, the impact of the COVID-19 pandemic, which showed just how vulnerable even the most advanced healthcare systems are, is still fresh in our collective memory. Hence the need to define new delocalised and digitalised models that can keep the system running even in situations of stress or limited resources, as was the case during the lockdown.
More than five years ago, in an effort to respond to the new reality of the social and healthcare sector, the IBV launched a line of research that includes an outstanding project called ‘Liquid Hospital’. The aim of this project is to promote the development of new technological solutions that make it possible to monitor and assess a person’s state of health and to implement personalised interventions in the patients’ everyday contexts.
Figure 1: Six strategic trends that will shape the future of the social and healthcare sector and justify the Liquid Hospital project
SCOPE OF THE PROYECT
One of the main driving forces behind the project is the need to create a new patient-centred healthcare model that will make it possible to provide care that is better adapted to their individual needs and situation, improving their quality of life and avoiding unnecessary travel, which is often responsible for the high environmental impact of hospitals.
On the other hand, from the outset, “Liquid Hospital” has had a clear technological vocation to increase and enhance the capabilities of today’s telemedicine technologies by developing and implementing non-intrusive and non-contact procedures designed to measure vital and physiological signs, movement and behavioural patterns. The real-time generation and analysis of these data will enable the early identification of risks and the determination of prognostic indicators, thereby facilitating the development of more accurate and effective interventions by social and healthcare workers.
Finally, it should be stressed that the above objectives will actively contribute to the development of the so-called precision medicine, given that the use of the new digital tools defined in the project will make it possible to adapt interventions to the habits and conditions of each patient, optimising the management of chronic diseases and adherence to treatment.
The following schematic illustrates some examples of the technologies and contributions achieved so far in the project.
Figure 2: Technologies developed by the IBV within the framework of the project, in the context of remote telemedicine and social and health care
RESULTS
The HLIQUIDO project has focused on three results that should be completed by March 2025:
The innovative HLIQUIDO platform (Figure 3), is available at https://hliquido.ibv.org/. We have developed a digital platform with interfaces adapted to both clinicians and end users, allowing the seamless and precise integration of peripheral recording devices. Thanks to this platform, the health data management process is more accessible, more secure and better adapted to the needs of each user’s profile – a major breakthrough in ambulatory care.
Advanced data collection algorithms: One of the project’s key innovations is a signal processing algorithm that uses conventional cameras to monitor a patient’s respiratory rate in a non-invasive way. We have also created a database of patients with low levels of oxygen saturation (SpO2) and fluctuating blood pressure, expanding the range of monitoring parameters available. This technology opens the door to full, real-time monitoring, which is vital if we are to improve health monitoring in chronic and high-risk conditions.
A model for interpreting clinical parameters: The project has also developed a unique model for estimating stress levels, combining physiological variables captured by a camera with data taken from validated questionnaires. This innovative integration allows for a more complete and holistic assessment of the patient’s emotional and physical well-being, thus optimising the personalisation of the care given, and anticipating possible complications.
The results obtained from this project will allow companies in the Autonomous Community of Valencia to improve their competitiveness in the national and international market and have a significant impact on the value chain, especially those in the HEALTH / HEALTHCARE and TECHNOLOGY sectors (medium-high and high technology).
Figure 3. Online platform for remote clinical monitoring
EXPETED IMPACT OF THE PROJECT
As a technology and research centre with considerable experience in the health and healthcare sector, the IBV wishes to transfer the results of its activities to key stakeholders in the sector. One of the main objectives of the “Liquid Hospital” project is to have a direct impact on patients, social and health care organisations and companies (Figure 4).
First and foremost, patients will have improved access to social and health care services without having to travel to a specialist centre, something particularly beneficial for people with reduced mobility, the elderly or those living in rural areas at risk of depopulation. The advances made by the project will enable patients to gain autonomy when it comes to monitoring their own health, improve the effectiveness of their treatment and increase their satisfaction with the healthcare services.
Healthcare services, on the other hand, will benefit from optimised operational processes. The decentralisation of social and healthcare services will reduce the system overload, freeing up more resources for patients suffering from more serious conditions or with delicate short-term health problems. This optimisation also implies a reduction in the cost of providing care, as remote monitoring and continuous assessment of the patient’s condition, together with 24/7 access to updated information, will ensure that interventions are only carried out when really necessary.
Finally, companies in the sector, especially those involved in innovation, will also benefit from the results of the project, particularly in terms of the creation of new business opportunities. The creation of comprehensive and interconnected telemedicine solutions will make it possible to escalate services for which there is an unprecedented growth in demand. In addition, the exploitation of hitherto unavailable information and in-depth knowledge of patients’ needs will provide a fertile ground for the development of new services and personalised solutions.
Figure 4. Main stakeholders benefiting from the Liquid Hospital project
To illustrate the positive impact on the various stakeholders in the sector, it is sufficient to analyse the development of the “Liquid Hospital” concept in the context of the current collaboration between the public and private sectors, largely through public procurement of innovation. In these processes, IT providers and health services join forces to create synergies aimed at developing integrated solutions and at defining strategies for their mass adoption. In fact, the IBV, as an agent whose role is to drive innovation among the business sector, has been very active in collaborating with the industrial sector in public procurement of innovation projects focused on the same idea. Examples of this can be found in several European projects such as Pre-Commercial Purchase (PCP) ROSIA https://rosia-pcp.eu/, TIQUE https://www.tiquepcp.eu/ or Procure4Health https://procure4health.eu/, where innovative solutions are being validated in real-life remote care environments, accelerating the development cycle and the level of maturity of the innovations.
CONCLUSIONS
As mentioned above, the development and implementation of the “Liquid Hospital” concept is largely underpinned by the harnessing of the technological revolution in which we find ourselves. Advanced telemedicine platforms are increasingly enabling the incorporation of expert early diagnosis systems, remote monitoring and assessment functionalities, the integration of artificial intelligence models (AI) capable of processing large volumes of data to identify patterns and predict potential complications, as well as personalised resources for the prevention and management of chronic diseases. In addition, portable devices connected to the internet are increasingly able to generate previously unavailable information and to share it continuously and automatically with the medical team. This information, combined with the latest advances in advanced analytics, will make it possible to efficiently manage the health information of the entire population, facilitating the personalisation of care and improving the decision-making process.
Despite all these benefits, the implementation and consolidation of the “Liquid Hospital” among health and healthcare organisations still requires answers to certain technological, regulatory and operational issues and challenges, which may hinder its widespread use (Figure 5). In particular, it is crucial to ensure effective social and health care coverage through secure, stable and high-speed communication networks throughout the country. In addition, system interoperability is essential, which implies the connectivity and digitalisation of health systems, facilitating the exchange of data between social and health organisations and remote devices, taking into account the General Data Protection Regulation (GDPR) and meeting the highest standards of cybersecurity.
Above and beyond the technical issues mentioned above, it is also essential to consider certain aspects related to the so-called Human Factors, such as usability, adaptability, simplicity and physical and cognitive ergonomics, which are vital to ensure that patients use and adhere to these systems. The involvement of social and health professionals is also therefore essential, and they must be adequately trained to use these technologies, adapting them to their needs and to the new organisational processes resulting from their implementation.
Figure 5. Main challenges to be addressed in the context of the Liquid Hospital
ACKNOWLEDGEMENTS
“Liquid Hospital” enjoys the collaboration of companies in the health and technology sectors, in areas such as home and remote care, sensorisation, monitoring technologies and software development, such as Atès a casa, Domotik, Mysphera, Tic4care and Tyris Software.
This project is supported by the Department of Innovation, Industry, Trade and Tourism of the Generalitat Valenciana, through IVACE+i, and is funded by the European Union, through the ERDF Programme Comunitat Valenciana 2021-2027. Programme (IMDEEA/2024/13)
AUTHOR’S AFFILIATION
Instituto de Biomecánica de Valencia
Universitat Politècnica de València
Edificio 9C. Camino de Vera s/n
(46022) Valencia. Spain
