Background:

Introduction: Home-based programmes for cardiac rehabilitation play a key role in the recovery of patients with Coronary Artery Disease. However, their necessary educational and motivational components have been rarely implemented with the help of modern mobile technologies. We developed a mobile health system designed for motivating patients to adhere to their rehabilitation programme by providing exercise monitoring, guidance, motivational feedback, and educational content. Methods: Our multi-disciplinary approach is based on mapping "desired behaviours" into specific system's specifications, borrowing concepts from Fogg's Persuasive Systems Design principles. A randomised controlled trial was conducted to compare mobile-based rehabilitation (55 patients) versus standard care (63 patients). Results: Some technical issues related to connectivity, usability and exercise sessions interrupted by safety algorithms affected the trial. For those who completed the rehabilitation (19 of 55), results show high levels of both user acceptance and perceived usefulness. Adherence in terms of started exercise sessions was high, but not in terms of total time of performed exercise or drop-outs. Educational level about heart-related health improved more in the intervention group than the control. Exercise habits at 6 months follow-up also improved, although without statistical significance. Discussion: Results indicate that the adopted design methodology is promising for creating applications that help improve education and foster better exercise habits, but further studies would be needed to confirm these indications.

Comparability between CPX and the GEX device was acceptable for HR measurement and moderate for BF; arrhythmias were reliably detected. HR processing and display on the PDA was even better comparable. The whole system seems suitable for monitoring home-based CR. Further studies are now needed to implement training prescription to facilitate individual exercise.

Diabetes is one of the metabolic disorders with more growth expectations in next decades. The literature points to a correct self-management, to an appropriate treatment and to an adequate healthy lifestyle as a way to dramatically improve the quality of life of patients with diabetes. The implementation of a holistic diabetes care system, using rising information technologies for deploying cares based on the thesis of the Evidence-Based Medicine can be a effective solution to provide an adequate and continuous care to patients. However, the design and deployment of computer readable careflows is not a easy task. In this paper, we propose the use of Interactive Pattern Recognition techniques for the iterative design of those protocols and we analyze the problems of using Process Mining to infer careflows and how to how to cope with the resulting Spaghetti Effect.

HeartCycle is a large European Integrated Project (IP) and develops technologies and services for Telehealth, which is to remotely monitor and manage patients at home and motivate them to be compliant to treatment regimens and to a beneficial lifestyle. Telehealth allows healthcare professionals to better control the progress of the therapy, detect upcoming adverse events early and react in time with personalized care plan adjustments, leading to prevent relapses, stabilizing the patient and avoid costly hospitalizations.

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Chronic cardiovascular diseases directly account for millions of deaths, billions of Euros and a big number of disabilities affecting the world's population. Even though primary and secondary prevention factors are well known, the awareness and the concern of citizens and patients is not big enough to cause a significant change in lifestyle that modifies the increasing trends. Patients and families, professionals and healthcare systems are not prepared to fight against this burden in an effective and aligned way. Some disease management programmes based on ICT solutions have and are currently being tested around the world but their relative impaction has been very limited. This paper proposes a new turn into Personal Health Systems applied to chronic disease management by increasing the capabilities for personalization, providing the patients with motivation and coaching support and enabling the work of the professionals with intelligent tools for strategic and clinical decision making based on the newest medical evidence.

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