How eHealth and artificial intelligence can help prevent heart disease

Patients with coronary heart disease (CHD, a disease that affects the coronary arteries) are familiar with the situation - rehabilitation follows a heart attack. But what happens next? During the stay in the rehabilitation clinic, there is a structured therapy plan, intensive medical care, training on lifestyle changes and dietary changes, an individually adapted sports programme and advice on controlling risk factors and concomitant illnesses. The care is perfect for three to four weeks, and patients quickly feel resilient and fit for everyday life again. Afterwards, however, many patients become disillusioned. The rehab team is usually not involved in the aftercare, motivation for more exercise and sport dwindles and the fear of another heart attack increases again. To support patients in their everyday lives, scientists from the Chair of Rehabilitation Sciences at Witten/Herdecke University now want to develop a platform that offers intelligent and sustainable solutions.

"If you look at other European countries, it becomes clear that comprehensive, guideline-based medical rehabilitation for CHD patients is not well implemented everywhere and aftercare programmes are even less developed," says Dr Boris Schmitz, who is leading the project together with Prof. Dr Frank Mooren. As CHD is a lifelong chronic disease, it would also be necessary to support patients in self-management to cope with the disease and prevent the progression of CHD. Dr Schmitz: "In principle, these hurdles in care could already be overcome today through technological innovations in the eHealth sector, i.e. by means of digital technologies in the health care system."

Interdisciplinary team from different disciplines

For this reason, the researchers have dedicated themselves to finding a sustainable solution to the problem. The "TIMELY" project was developed together with an interdisciplinary team from various disciplines, including medicine, sports and health sciences, psychology and information technology, and in collaboration with a network of industrial partners in medical technology.

"The idea was to utilise the technology available today to provide patients with optimal support after rehabilitation. We initially want to enable them to manage their illness themselves on a daily basis," explains Prof Mooren. "The challenge is to create a platform that gives both patients and therapists access to current health data at all times. As patients are no longer in the rehabilitation centre but at home, we need technical solutions to continuously obtain information about them. Today, this is possible with the help of state-of-the-art devices for monitoring vital parameters."

Among other things, the researchers are using a recently developed "ECG patch" for this purpose. It is only 5 x 5 centimetres in size and can be used throughout the day, even during sport, and for several weeks. The data is transmitted automatically and wirelessly directly to the secure server via the mobile phone network. At the same time, other devices such as blood pressure monitors and blood glucose meters, as well as fitness wristbands, are also connected wirelessly. "The database must be integrative and able to understand the various pieces of information. The data is analysed and evaluated on the application's user interface. Improvements in fitness and goals achieved can also be displayed," says Prof Mooren.

However, the TIMELY platform is intended to do much more. Communication with the system will also take place via adaptive chat bots, among other things. "You may already be familiar with such systems from websites, where they act as virtual assistants. We want to use the systems to establish communication with the platform. The systems learn to recognise what questions you have, how you feel and how you communicate. In this way, the psychologists are trying to enable intuitive and interactive use," explains Prof Mooren. In addition, the project uses artificial intelligence to continuously calculate the individual risk of the disease progressing and the possibility of serious events such as another heart attack.

Project has the potential to enable a new approach to chronic diseases

"If the system detects a change in risk, we can initiate targeted intervention measures. The vision is for the system to recognise changes at an early stage and take customised countermeasures. Initially, this involves encouraging healthy behaviour such as more exercise and a healthy diet," explains Dr Schmitz. "If the vital signs deviate significantly, the therapists also receive a notification. The TIMELY project has the potential to enable a completely new approach to chronic diseases."

The project is being funded by the European Union with around 5.7 million euros over a period of three and a half years and is being carried out in collaboration with twelve other national and international partner institutions.