Momentum telemedicine service descriptions

Guttmann NeuroPersonalTrainer (ES)

Objectives, expected outcomes, main beneficiaries

The service’s objective is the continuous cognitive rehabilitation of a patient in their home through telerehabilitation systems. This rehabilitation reduces negative cognitive consequences, diminishes the level of patients’ disability, and makes their social and work reintegration easier. It also enables the personalisation of therapeutic plans, which is one of the most delicate and limiting aspects of cognitive rehabilitation. This platform reduces provider burden while, at the same time, optimises the intervention. It also promotes the professional-user relationship: this encourages the user to perform at his/her maximum capabilities and provides a means for monitoring the results.

Targeted population, number of patients

The target population is categorised as patients undergoing specific treatment. The Guttmann NeuroPersonalTrainer is a telemedicine platform that allows intensive cognitive rehabilitation. The conditions of the patients include cognitive impairment (Acquired Brain Injuries), dementia (through ageing), mental disorders, and intellectual disability.

Between 50 to 100 people receive the service each month. The estimated size of the targeted population nationally lies between 100,000 and 500,000.

Type of telemedicine service

The service is categorised as a rehabilitation service. The relationship between key actors in the service is patient to secondary care.

Set-up that was being replaced

The service replaces conventional paper-pencil tasks and face-to-face interventions for mental rehabilitation. There are no other alternatives to the telemedicine service described.

Outcomes and results expected after introduction

The service is expected to reduce the cost of the treatment (personnel, dedicated time) without reducing efficacy. It actually does so. In 60% of the interventions done with the platform there was a satisfactory clinical response.

Detailed description

There are currently 21 operating platforms: in hospitals, sociosanitari, integrated care centres, and sheltered/nursing homes.

The platform is based on open source web technologies. The main architecture of the platform is based on a client-server communication using HTTP and XML-RPC.

A Model-View-Controller pattern has been followed, so that the view and the logic to access and process data are separated. The web application requires Java (JDK 1.6, JRE 6.x) and it runs over Apache Tomcat 6.X, as it is based on Servlet/JSP. The database used is MySQL Server 5.X and MySQL Java Connector 5.X (JDBC). However thanks to this division between the data process and the view, the platform could be easily adapted to new other database models or new languages for the graphic user interface.  Relating to the programming languages, all the environment is Java 2 Platform (J2EE, Enterprise Edition), using JavaScript and AJAX (SACK library) to dynamically change the data showed on the HTML pages, thus avoiding reloading the page every time a user wants to show or edit contents.

Operational status

The service is operational, and is part of mainstream healthcare service.