Project Departments of Excellence “ICT for Health”
The ICT for Health project was selected among the 180 national projects of the Departments of Excellence funded by MIUR in 2017. The project has a five-year duration (2018‒2022) for a funding share of Euro 9,330,030.00 and a share of co-financing equal to Euro 2,506,000.00. The Scientific Responsible of the project is Prof. Bruno Siciliano, Director of the ICAROS Center for Robotic Surgery of the University of Naples Federico II.
Research program
EHealth technologies and services in the coming decades will determine profound changes in the organization of the health system, with the aim of improving the quality and the efficiency of assistance and, at the same time, reduce its costs. In the short term, new technologies will have to be integrated with the current structures that provide health care, but in the long run they will produce significant changes both in the internal organization and in the architecture of the buildings that will house the hospitals and health facilities of the future. These structures must be able to guarantee patients personalized therapies, which can also be decentralized or delivered at home and monitored at distance. The ICT for Health departmental project, based on the pre-existing infrastructure of the DIETI laboratories and on the new laboratories to be established, is therefore developed according to the following lines of scientific and technological research.
Sensing for Health
Smart transducers will be developed for the Internet of Everything environment, such as the electronic syringe, intelligent sensors to integrate robotic microsurgery equipment, advanced biomedical instrumentation for automated and robotic surgery systems, and innovative systems for remote monitoring of patients' health status, both at hospitals or health facilities (for example, retirement homes for the elderly), and at private homes. In particular, solutions will be studied based on new sensors and wearable, portable or implantable devices, which will make it possible to monitor the state of health even outside traditional treatment centers. Particular attention
will be placed on Exergaming technologies based on Serious Games, in which rehabilitation or treatment takes place through Augmented Reality applications, and Brain Computer Interfaces, with low training and response times, and low number of electrodes, for patients with high rates of disability. The themes of sensor development and their interaction in augmented vision systems will be experimentally developed in the new laboratories planned for the program.
Data for Health
EHealth services and technologies generate enormous amounts of data and information which, for their treatment, require the use of non-traditional methodologies and technologies: the Cloud Computing, the Internet of Things and Big Data and Analytics are the new founding paradigms of a new generation of information management systems in eHealth. The data sources to be considered, in addition to having a high volume, are also heterogeneous due to their different type and origin. Typically, moreover, such data are collected and stored in a heterogeneous form and are rarely reused in an aggregate manner. The speed with which the information is produced and saved, together with the aforementioned volumes and variety, require systems and tools to collect, manage, analyze the data and information produced by healthcare systems, directing research towards methodologies and techniques of Big Data Analytics (BDA). The BDA in eHealth enables the transformation of a classic analysis of hypothesis driven information to an innovative type data driven, able to identify non-trivial connections between heterogeneous data and information. This requires the need to investigate: a) new cloud based architectures that allow the timely processing of information, from the Hadoop Ecosystem to that of Spark; b) new information management systems that integrate relational (SQL), non-relational (NoSQL) and new relational (newSQL) architectures; c) use of descriptive, diagnostic, prescriptive and descriptive analysis techniques; d) use of Data Mining tools and techniques on Massive Data Sets, which include the deepening of Deep Learning based systems. In this context, equally important are the digital infrastructures for the circulation of data and the interconnection of devices, following the paradigm of the Internet of Things.
Logistics for Health
Logistics services within hospitals impact 15-20% of operating costs. These services include the movement of patients, the transport of linen, meals, medicines, equipment and samples between clinics, wards, operating rooms, laboratories, warehouses. Digitization, automation and robotic technologies can optimize these processes through solutions that allow the automatic transport of patients and materials and the automatic management of the hospital warehouse. There, the main difference with respect to factory logistics systems is the need to operate in anthropogenic environments. During the project it is proposed to create robotic systems capable of
interacting with humans (patients, medical / nursing staff, visiting relatives) in an intuitive and safe way. In the "Hospital 4.0" model, the automation system for the logistics represents a further integrated node within the ICT network for the management of services, whose architecture is typically distributed in turn and whose methodologies management and analysis are typical of the Data Analysis presented in the previous point. Extending this integration also to a "smart grid" for the management of utilities, it is possible to increase the energy efficiency of the logistics system. However, such integration allows obtaining a considerable containment of power peaks demand from the grid ("peak shaving"), with consequent containment of electricity consumption costs. We want to evaluate the integration of typical optimization methodologies energy with the management of logistics automation in order to ensure the safe performance of all critical operations by controlling and, if possible, optimizing energy consumption.
Robotics for Health
In order to guarantee continuous and personalized assistance to patients in the wards or at their homes, solutions will be studied that involve the use of robotic nurses. Such intelligent machines will help patients perform simple daily actions, facilitate remote monitoring and communication with medical staff or relatives, will administer simple therapies, or can be used for entertainment (reading, telling stories, playing). In addition to robotic nurses, control devices and strategies will be designed for rehabilitation such as the development of virtual agents to be created in augmented reality that can interact with the patient through advanced automatic control techniques and provide real-time data to medical staff through telemedicine strategies. Robotics is already a widespread reality in several medical-surgical specialties. The use of tele-operated or computer-guided machines offers numerous advantages such as precision, repeatability, tremor filtering. Robots such as the da Vinci system for minimally invasive robotic surgery allow improving and reducing the life of the post-operative course of patients. In this context we want to improve the capabilities of the robots currently used through the use of new sensors, advanced techniques of image processing and sensory fusion, computerized procedures for surgery planning based on pre-operative images or for guidance through the processing of intra-operative images, virtual reality and augmented reality, of new human-robot interfaces. Such interfaces, connected to analog simulators or
software, will be used, thanks to the already structured collaboration of DIETI within the ICAROS center, for the training of surgeons. New sensorized surgical tools will be designed and controlled inspired by man's ability to manipulate. Anthropomorphic grasping tools will be developed for both surgery and rehabilitation.
Recruitment of Faculty Staff
It is planned to strengthen the 4 thematic areas of the ICT for Health project through the recruitment of a Full Professor in the Electronic and Computer Bioengineering sector, an Associate Professor in the Electrical and Electronic Measurements sector, and four RTD-B in the Automatic Control, Electromagnetic Fields, Electronics and Computer Engineering sectors.
Laboratories
The investment in infrastructures of the Departments of Excellence project will be used to create: 1) an Augmented and Virtual Reality laboratory for 3D monitoring of the sensor system envisaged in the "Sensing for Health" framework and at the service of technologies for rehabilitation and robotic surgery of the "Robotics for Health" framework; 2) an eHealth Big Data Analytic laboratory based on a Cloud infrastructure to support research in the Data Analysis field developed in the "Data for Health" framework and that on the automation of logistics developed in the "Logistics for Health" framework. A further share of the investment in infrastructures is also envisaged to acquire new instrumentation in order to strengthen the pre-existing infrastructure of the DIETI laboratories.
ARHeMLab — Augmented Reality for Health Monitoring Laboratory
The establishment of a laboratory (ARHeMLab — Augmented Reality for Health Monitoring Laboratory) is planned for the design, prototyping and experimental validation of hardware and software systems, based on immersive life-size environments of augmented reality, for monitoring biomedical parameters in real time. The applications will allow monitoring the body data of athletes, patients in rehabilitation, in an integrated way using augmented reality techniques. Currently, as a representative case, new concepts of life-size immersive augmented reality systems are being studied at DIETI in collaboration with other research institutions and companies in the area for monitoring the motor interaction between people and virtual agents for the rehabilitation of mental illnesses such as schizophrenia and autism. They combine the possibilities offered by VR (Virtual Reality) viewers or 3D immersive projection systems, with networks of transducers and measuring instruments to define the dynamic parameters of human movement in 3D in real time. The aim is to recreate immersive visualization operating modes that include motion within an intelligent environment, populated by virtual agents that can interact with patients and with each other in order to monitor patients with psychiatric problems and their operating conditions. Through suitable interactive interfaces, the specialist doctor can in turn influence or have immediate feedback on the patient's behavior for diagnostic and prognostic purposes. The operator's request for verification of motion parameters in real time constitutes an input data used within the motion monitoring logics in its final environment of use (for example, exergaming for rehabilitation). The virtual agents of the body in motion and its operating environment constitute animated and controlled avatars through the use of appropriate logical-mathematical models that make their motion and interaction with the medical operator as natural and immediate as possible. The purpose of the measurement and control system distributed in real time, underlying the integrated AR system of monitoring and design in an immersive life size environment, is to apply Ambient Intelligence to Health 3D, in order to improve and extend the usability of the 3D monitoring, interactivity with the motor modeling environment, and immersion in the 3D world of motor reference. Therefore, the laboratory will deal with prototyping and characterizing: networks of measurement transducers in real time; augmented haptic transducers, combining different channels (vibrations, thermal effects, and ventilation) to provide visual, auditory and tactile feedback of elements (water, fire, earth and air). It will develop multiple decision tree activity classifiers in meta-heuristic technique, to improve the performance of motion definition algorithms, with an activity recognition system based on multiple classifiers, to improve the performance of limb motion definition algorithms 3D, as well as an adaptive and distributed strategy for the creation of virtual avatars and their interaction online with patients and medical staff. It will also make use of a virtual reality vision system integrated into an immersive life-size 3D environment, to experience the integration of the measurement and control system in real time with the environment of 3D motion. The system allows for three different types of AR experimentation: (i) an AR experimental environment with viewer, complete with cameras where immersive monitoring activities of additive 3D productions can be experimented; (ii) life size with VR viewers (Oculus Rift type) in combination with a tracking system and a video add-on that adds the increased size to the Oculus viewer thanks to a dedicated software plug-in; (iii) an experimental immersive visualization environment with projector, where the 3D ultra-panoramic video projection system can be installed, to experiment with immersive monitoring activities of additive 3D life size productions, suitable for presentation to a wider audience and complete with multiprojection software with DMX support.
eHBDA Lab — eHealth Big Data Analytics Laboratory
The establishment of an eHealth Analytics laboratory based on Big Data technologies for the design and prototyping of architectural and algorithmic solutions for the management and analysis of eHealth data is planned. Summarizing what is described in the previous sections of the project, the Hospital 4.0 is conceived as the place where processes aimed at "producing value" are implemented, integrating technology and production processes and delivery of health, clinical or surgical services. Furthermore, it represents the place where different instruments and devices (from sensors to medical devices, from more or less complex devices linked to diagnostics to equipment in the operating room, up to the ward and on the patient's bedside) are interconnected in an ecosystem in which they send parameters that can feed the wealth of clinical information of each patient in real time, informing people about their state of health, helping to raise the expectation of a healthy life from a physical and mental point of view. Starting from this point of view, the architectural layout and the design of an information management system infrastructure must necessarily take into account new paradigms and new models that allow managing complexity, volume, heterogeneity and data speed. This requires the need to investigate solutions based on the Internet of Things paradigm, for the interconnection and acquisition of data from different ecosystem devices, and the analysis of new processing paradigms, in particular cloud-based. The solution we propose is cloud-based, preferable to a classic in-house solution as it allows you to save costs due to technological refresh (necessary every 3-5 years) as well as to reduce maintenance, installation and operating costs. Given the amount of data, the infrastructure proposed for the Analytics lab is based on the Hadoop and Spark ecosystems, taking into consideration new information management systems that integrate relational (SQL), non-relationship (NoSQL ) and new relational (newSQL). On these architectures we propose environments for the development and integration of descriptive, diagnostic, prescriptive and descriptive analysis techniques as well as on the use of Data Mining tools and techniques on Massive Data Sets, which also include the in-depth analysis of systems based on Deep Learning.
Research Doctorate
The Doctorate in ICT for Health is a candidate for the creation and training on a systematic and organic basis of the future class of protagonists who in this sector will dedicate themselves to research and technological innovation activities, capable of validly operating in private subjects, public bodies and universities: potentially everywhere in the world. It is aimed at a very select number of graduates, with excellent preparation, interested in the topics of the doctorate and motivated to improve their skills, competences and knowledge in the field of research and innovation. It is designed to create an intersectoral and specific training and research environment for teachers and students who, in relation to the ICT‒Health combination, refer to the Master's Degree, teaching or graduating in Automation Engineering, Biomedical Engineering, Electrical Engineering, Electronic Engineering, Telecommunication Engineering, Computer Engineering, Computer Science. By entering the third and highest level of DIETI training, it offers itself electively to the audience of 300 master's graduates per year of the 7 DIETI Master's degree courses, and can exhibit about 140 university teachers. The ICT for Health Doctorate is designed to attract students who have graduated externally from the University of Naples Federico II and abroad by presenting themselves with an innovative name in the educational offer of Italian universities but, at the same time, highly recognizable also internationally. As part of this measure, an entire ANVUR accreditation cycle is proposed consisting of two entire doctoral cycles (each with 9 funded grants).
Development Strategies
By exploiting the already existing institutional links with the School of Medicine (the ICAROS Center on Robotic Surgery), it is expected that DIETI will be able to increase its already prominent position in the University by strengthening its collaborations with other departments and making the infrastructures and the set of skills developed during the Departments of Excellence project to the entire University. The themes developed in the ICT for Health project will be further developed and strengthened by cooperation with the entrepreneurial and socio-economic network of the region. Numerous companies active in the areas of interest of the project have already expressed interest in the possible synergy with DIETI. There will also be synergy with popular structures such as the City of Science to make the activities developed in the project common to the entire regional territory. It is planned to interact with the University Office for technology transfer to support the creation of spin-offs and other business activities on ICT for Health issues particularly developed in the regional territory. The creation of a pole of excellence on ICT for Health issues will make it possible to participate in the main networks of European research laboratories in the ICT for Health field.