Project

The aim of the ATTICUS project is to have a hardware and software system for monitoring non-invasive vitality and behavior of users. ATTICUS offers a tangible and measurable benefit in terms of improving the quality of life of older people, and not only that. Its flexibility, retained as the primary objective in system design, extends its usage areas to a wide range of operating environments for various types of people (from the elderly, to the sportsman, to people at high risk):

• In-home monitoring: in this scenario, the “smart wearable” measures the vital parameters of the person and traces the position, by means of indoor location techniques, and posture (lying down, standing, walking). The measurement data is sent in real time to the “ambient intelligence” device for storage and preliminary analysis. This analysis is based on the detection of the vital parameters and on the behaviors of the monitored user (local knowledge). The home station verifies the presence of any anomalies in real time and it communicates to the monitoring station’s decision support system if there is a warning situation. The decision support system, using a wider knowledge, based on the characteristics of all monitored users (global knowledge), confirms, (i.e., it alerts the monitoring station’s personnel), or it ignores the alert.
• Out-of-home monitoring: the “smart wearable” measures the vital parameters of the person, and it traces the position through the GNSS satellite system. The measurement data is stored locally and it is sent to the home station when the user is back home. The “smart wearable” also has the ability to analyze monitored data, identify any anomalous situations and report them directly to the monitoring unit.
• Personal check-ups: using an app, the user can query the data stored in the “ambient intelligence” devices to check the status of the parameters and their time pattern. It is also possible to enrich the monitored data with additional data related to the user’s health status, such as laboratory analysis, in order to populate a medical electronic record.
• Specialized check-ups: a medical practitioner or healthcare worker can query the monitoring station’s database to verify the status of a monitored individual’s parameters and possible alert events.

From the aforementioned scenarios, it is easy to deduce that ATTICUS has significant benefits in managing patients with monitored medical conditions. For example, by studying and constantly monitoring the ECG, it will be possible to get a general view of a person’s heart condition based on historical and statistical trends that can also be cross-lined with lifestyle. At the same time, these data provide the predictive algorithms of ATTICUS with a basis for suggesting lifestyle changes that are viable and contiguous with the vital and operational parameters of the monitored subject. Finally, localization and inertial moves are particularly helpful in tracking older people, allowing you to locate the user on a map and identify critical events such as falls. ATTICUS is therefore intended as an instrument to break down the barriers that naturally arise among institutions capable of controlling patients or individuals with disabilities and individuals, using a modular, intelligent, non-invasive and inclusive mechanism that allows continuous monitoring and a possible rescue action in the shortest time and with the least amount of resources.

Below are some usage scenarios of ATTICUS, namely:

• main scenarios that describe the environments where ATTICUS will be experienced (e.g., home-based);
• secondary scenarios, considered for the design of the solution and to underline the social impact of ATTICUS, but which will not be subject to experimentation;
• maintenance scenarios and extreme scenarios.

MAIN USAGE SCENARIOS

• Scenario SPE1. Antonio is 74 years old, lives alone and is cardiopathic. At the advice of his doctor, decide to use ATTICUS. One day while in the kitchen, he has a heart attack. The S-WARE communicates the data to the S-BOX, which, by detecting extremely faulty vital parameters, sends a signal to the monitoring station (red code). The DSS installed at the monitoring station analyses the data with maximum priority and confirms that the situation is strongly abnormal. The operators are instantly warned and, being aware of the seriousness of the situation, immediately send an ambulance to Antonio’s home.
• Scenario SPE2. Francesco is 78 years old; he is a widower and, due to a past fracture to the femur, he moves with difficulty using crutches. Despite this, he is basically autonomous, so he lives alone. At the advice of the physician, he decides to use ATTICUS to monitor all of his movements and to be assisted in case he falls. Francesco usually wakes up at 6:40, goes to the kitchen and has breakfast until 7:00 am, then moves to the couch in the living room and stays there until his assistant and personal nurse arrives to prepare for lunch. One day Francesco gets up from the bed at 6:40 and stays in the kitchen for much longer than expected. The S-BOX does not record Francesco’s passage in the kitchen according to his usual habits, controls the vital parameters through the S- WARE, and realizes that the beat and breath are slightly slower than usual, vital signs are faint. The S-BOX concludes that Francesco might be in a condition that could lead to the loss of senses and sends a signal to the DSS, which, confirmed the anomaly, sends an alarm (with yellow code) to the staff of the operating centre. An operator, try first to contact Francesco and, if you do not answer, try with his son Angelo. The latter says he is in the area and he goes to his father’s home. Angelo finds Francesco unconscious on the table. Angelo knows that the father is not in immediate danger of life, because ATTICUS still detects the beating and the breathing, then tries and begins to make Francesco find out.
• Scenario SPE3. Teresa is 75 years old; she is married and lives only with her husband. Since the doctor has conceded to her husband to use ATTICUS, because he needs to be monitored constantly, Teresa decides to use it herself in spite of having no known health problem because she is a very cautious and health-conscious person. One day, Teresa goes shopping. At one point, while in a shop, she gets a lot of nausea and goes to the toilet. Here, however, she loses consciousness. S- WARE, in the meantime, unable to connect to the S-BOX, using its inter-module to analyse the vital parameters of Teresa, had noticed a strong anomaly and sent a signal (with red code) directly to the DSS of operations centre. At this point, precisely in the time Teresa has lost consciousness, the operators receive a warning of the problem. They immediately contact the store, asking them to check in the toilet, and in the meantime also call an ambulance to attend Teresa immediately. Medical emergency personnel arrive on the spot and immediately bring her to the emergency room because he has had a stroke. Thanks to the timely intervention, the consequences of the episode are extremely limited.
• Scenario SPE4. Angela is 82 years old and she is suffering from Alzheimer’s disease. For this reason, she is admitted to a centre specialized in assisting elderly people with various types of senility dementias. This centre decides to use ATTICUS to monitor all patients in the event of an escape. Angela, one day, has a spell of disorientation and escapes from the centre. S-WARE, being unable to connect to the S-BOX installed in the residence and having checked the displacement of Angela’s personal location, activates the GSM module to quickly communicate the position to the monitoring station. The S-WARE then sends an alarm (with green code) to the DSS of the operating unit. Operator of the operating centre then contacts Giuseppe, the nurse who aids Angela following her own track. The control panel transmits Angela’s position to Giuseppe’s monitoring device – Giuseppe can find Angela and bring her back to the centre.
• Scenario SPE5. Luigi is 54 years old. His father died of heart attack in the past, and he himself had a mild infarction at 53 years. Given the familiarity and the risk of past infarction, doctors advise Louis to use ATTICUS and he reluctantly accepts. After 8 years, Luigi goes to the cardiologist once a year. Six months after his last visit, the S-BOX records abnormal variations in Luigi’s ECG. For this reason, S-BOX sends an alarm (with a green code, as these changes do not seem to cause a serious problem) to the control panel. Further verifying the anomaly with historical data, the DSS warns an operator. The operator asks for the intervention of a specialist who reads the EKG and confirms to him that there are anomalies and a specialist visit is required. The operator, therefore, contacts Luigi and urges him to anticipate his periodic visit by the cardiologist to allow a more deep diagnosis of his situation.

SECONDARY USAGE SCENARIOS

• Scenario ALT1. Giovanna is 38 years old, and has been practicing cycling at an agonistic level since she was 16 years old. Considering the intense workouts, he decides to control his vital parameters with ATTICUS. Uses, therefore, S-WARE only when training. One morning, at 6 o’clock, after a shower, Giovanna decides to train and goes out on a bike. His habitual path includes a narrow way. Being wet because of the rain, Giovanna loses control of the bike and ends in a cliff. Because of the fall, he loses knowledge, and can not call for help. Also, being a little popular, hardly anyone can go from there and help. Indeed, the S-WARE detects the danger situation, both for sudden braking and abnormal shift from the usual path, to abnormal vital parameters, and for detecting, thanks to the accelerometer, bumps that he suffered. The S-WARE connects to Giovanna’s cell phone (which had previously made the Bluetooth association in order to monitor its vital parameters on the dedicated app) and sends the alarm (red code) to the DSS system of the central monitoring. The operator sends an ambulance to help Angela.
• Scenario ALT2. Antonio is 23 years old and has recently joined the National Fire fighters’ Corps. One day, his team is called to intervene to tame a vast fire in a forest. Arriving at the scene of the fire, Antonio realizes that the situation is really critical. The entire team is monitored through ATTICUS and the monitoring station is installed directly on a car park, where an operator constantly analyses the moves and vital parameters of his colleagues. At one point, Antonio goes away from the team because he realizes that the flames are heading toward a barn. Antonio only tries to tame the flames, but the situation soon becomes unmanageable. Smoke encircles Antonio who has difficulty re-spin and is about to lose knowledge. The DSS, constantly receiving Antonio’s vital parameters, identifies anomalous situation (respiratory difficulty, irregular heartbeat) and sends an alarm. The operator of the monitoring station, received the alarm, warns Francesco, the team leader, and guides him to the place where Antonio is, who in the meantime has lost knowledge. Fortunately, Francesco reaches Antonio in time to save him.
• Scenario ALT3. Maria and Mario have a daughter, Anna, 10 years old. The family lives 800 meters from the school Anna attends. Joanna, Anna’s older cousin, does the same trip, so the little girl asks parents to go to school with her. Maria and Mario, initially doubt-yes, decide in the end to consent. However, they decide to use ATTICUS to monitor their daughter and to detect abnormal situations when moving. One day, however, Giovanna must stay in school even in the afternoon, but Anna decides she wants to go home alone. On the way, however, he gets distracted and can not find his way home again. S-WARE notes Anna’s abnormal behaviour and sends data via the GSM module to the DSS of the monitoring system. The DSS confirms abnormal behaviour (i.e., abnormal route) and warns Maria and Mario directly, sending them their daughter’s position. The parents then succeed in finding her daughter right away and bringing her back home.

MAINTENANCE AND MORE EXTREME SCENARIOS

• Scenario MAN1. Luca uses ATTICUS. Every night the S-WARE warns Luca (through sounds) that he needs to recharge the battery. Luca releases the main battery from the device and places it on top of the S-BOX. This will charge it by induction. During the night, the S-WARE is powered by a backup battery, which recharges the main battery during the day. In the morning, just as the S-WARE realizes that Luca is awake again, reminds him (via sound alerts) to hook up the main battery back to the device.
• Scenario MAN2. Luca uses ATTICUS and wants to wash his shirt. He then releases the entire device from the wearable shirt and can wash the shirt as a separate object. All the sensors in the T-shirt are able to withstand water and washing strains. While the mesh is lidded / dried, Luca can use another spare shirt, mounting the same device previously disconnected from the shirt which is currently drying.
• Scenario MAN3. Luca uses ATTICUS. After three years of use, due to an impact, a sensor stops working. The S-WARE identifies the problem and warns Luca through flashing light alerts and / or sound signals. Luca then buys a new shirt.

EXTREME SCENARIOS

• Scenario EST1. Mario uses ATTICUS. In the evening, before going to sleep, he unplugs the main battery from the S-WARE to recharge it on the S-BOX. One night, however, he wakes up to go to the bathroom and, as he returns to bed, stumbles. The S-WARE backup battery allows the device to operate even without the main battery. As a result, the alarm is sent to the operating units, which act accordingly eventually signalling an anomalous situation.
• Scenario EST2. Vincenzo uses ATTICUS. One day, after showering (without wearing the S-WARE), he slides into the tub and knocks his head. The S-BOX, detecting anomaly due to too much time spent showering (that is, without the S-WARE) sends a signal to the operating centre (with yellow code), which acts accordingly sending in a medical rescue team.
• Scenario EST3. Rosa is 78 years old and uses ATTICUS for heart problems. One day, while alone at home, Rosa falls. The fall, unfortunately, involves breaking the electronic device of the S-WARE. The S-BOX, detecting the sudden absence of the S-WARE, not caused by the low battery, promptly sends out a (yellow code) alert to the monitoring station, which, in turn, acts accordingly to the extreme situation.

The reference market area of ATTICUS is that of Medical Device (WMD) wearables, which can be defined as a portable electronic device (e.g. clothing or accessories) mounted on the organism performing a number of functions, including but not limited to data logging and relaying, reporting, analysis and timely communication with third parties or specific services. The market trend within WMD is affected by the constant development of new applications for different domains and scenarios, offering new tools for data analysis and real-time visualization. Currently, the global WMD market is estimated at $8.58 billion, and is expected to grow at a rate of 44.1% over the next 4 years, amounting to $37.03 billion in 2018. At the same time, the national and international health service is expanding and already shows several needs for remote monitoring: these needs will require effective and cost-effective means in the near future, to increase information awareness in different scenarios but also to implement predictive policies and algorithms using intelligent triangulation from non-invasive and user-friendly remote monitoring devices. According to the 2013 International Service Management Report, the total market available for such low intensity monitors was EUR 1,77 billion, with a CGR of 7% and an even faster growth rate than the WMD market of 40% in the next 5 years.

Within the global WMD market described above, ATTICUS can be found both in the Healthcare wearables segment and in the remote monitoring segment. Also on healthcare wearables, ATTICUS retains a huge potential, which accounts for 5.8% of the WMD market in 2014, corresponding to $500 million, but that market is estimated to grow to $2 billion by 2018, as a further higher market presence of medical devices and social telemetry of various kinds is expected, with an expected total growth rate of around 77.1% [4]. It is expected that the emerging WMD market segment such as heads-up displays, smart fabrics/fabrics and wristbands will play a higher role in this market in the coming years, integrating different features to clinically monitor particular diseases (such as CVD) against the smart watches segment, specifically dedicated to non-clinical applications.

Recent times have seen a massive proliferation of documents coming mainly from the Ministry of Health, which have a decisive role in enhancing and positioning remote and remote territorial assistance within the SSN. For example, consider the following as purely illustrative items: “Urgent provisions to promote the country’s development through a higher level of health protection” of 12/11/2012 (Balduzzi decree); “Understanding between the Government, the Regions and the Autonomous Provinces of Trento and Bolzano of 10/7/2014 – Health Agreement “; “Act of Address for the Minister of Health 2016”; the “White Paper on the Development of the Social Welfare System of the Lombardy Region, 30.05.2014”; the “Digital Healthcare Pact” being discussed at CSR; LR 33/2009 “Standards on Integrated Lombard Health, Social Welfare and Social Welfare”; LR 23/2015 “The evolution of the Lombard sanitary system: changes to Title I and Title II of LR 3/2009”; the “National Program for Health Research 2014-2016” is still being approved. In line with this massive trend of attention devoted to remote telemetry, the Network, known as HTA (Health Technology Assessment), has been proposed as an organ for the support of various international and national experiences to foster the development, diffusion, and propagation within the National Health Service, organizational models, technologies, specific instrumentation, research and development efforts to support every possible use of ICT in the field of teleservice. The Molise Region, the leader of this project, has already proposed as a HTA member to provide substantial investments in this direction and therefore proposes, with ATTICUS, a practical, intelligent, proactive, modular and economically viable tool that is able to cover , at least in part, the needs expressed by notes, protocols of understanding, and the standards outlined in some examples above.
In short, the ATTICUS project is perfectly in-line with the following european and national strategic agendas:

Project Coordination Committee (PCC)

The PCC consists of a representative of partners and will meet quarterly, using telematics tools, and at least twice a year in plenary meetings. Partner representatives will also be able to request an extraordinary PCC meeting to be held at the discretion of the Project Coordinator. His main task is the government of the project: he will have general responsibility for all the technical, financial, legal, administrative, ethical and dissemination issues of the project. For this reason, PCC will monitor and evaluate the actual progress of the project and make any changes. The PCC will be responsible for the following tasks:

• resolve conflicts between members of the consortium;
• approve issues related to intellectual property rights;
• approve and accept project results;
• approve data management decisions.

Project Management Team

Under the control and in accordance with the decisions of the Project Coordination Committee, the Project Management Team will be responsible for the planning, execution and technical control of the project. In addition to these obligations, the Project Management Team will carry out the following activities:

• administrative and scientific coordination activities;
• implementation of all action plans;
• establish a budgeting and calendar control system and chronoprogram in the same;
• implementation of a quality assurance system;
• develop and maintain an attitude of communication and reporting;
• creation of local and efficient team structures to minimize the number of quarters, while maintaining an agile management structure;
• ensure and manage collaboration with partner administrations to ensure better integration of users in the project;

Scientific and Technical Coordinator

This role will focus mainly on the various aspects of the project’s scientific and technical activities. The focus will be to help the consortium develop a research strategy and synergic innovation by verifying the consistency of the results, as well as keeping track of progress in the state of the art.

Coordinator of Administrative Activities

His activities include financial reports, re-asking for costs, budgeting, planning, knowledge-sharing management, and oversight of contract management. Coincides with project manager.

OR leaders

They are responsible for managing the single OR: they coordinate, monitor and evaluate the progress of the OR to ensure that performance, budget, and output lines are met. Leaders will also be responsible for all data management issues for data generated in their ORs, according to the data management plan that will be defined by the PCC.

External Advisory Board (EAB)

It will consist of researchers and industrialists in neutral organizations and will advise on the strategic lines of the project, will help refine the requirements of the methodology and expand the basin of potential users, providing feedback on the quality of the results achieved.

Innovation Manager

Expectations for impact and exploitation are very high within the PON program, with particular reference to the Mezzogiorno and the impact that each PON proposition can exert on the so-called development area’s economy. For this reason, it was decided to have an Innovation Manager, which will periodically review the opportunities for industrial, social and corporate exploitation, dissemination and impact, coordinating the implementation of the steps and timely exploitation of the actions with the plans of individual and common exploitation. These activities will facilitate the management of innovation developed within the ATTICUS project as well as maximize the possibilities for adopting the developed technical solutions.