EIC Pathfinder Challenge: Towards the Healthcare Continuum: technologies to support a radical shift from episodic to continuous healthcare

Today, episodic (symptom-triggered) healthcare remains the norm. To a large extent, individuals are entrusted with the responsibility to self-monitor and trigger requests to the health system upon identification of relevant symptoms. In spite of the growing number of screening programmes, the diagnosis of a vast majority of disorders, including those in which early action has a direct impact on morbidity or survival, still relies heavily on the individual to initiate the process. Further, a substantial fraction of outpatients manage the post-treatment phase, particularly of non-life threatening conditions, with qualitative self-monitoring, seeking help only upon perceived evidence of disease recurrence. In essence the current approach to healthcare is mostly reactive.

While the episodic (reactive) model could be perceived as economically advantageous, drawing on healthcare resources only intermittently, it is clearly not optimal. In self-assessing their health status independently, individuals miss early signs of disease, sometimes with devastating results. The large spectrum of possible conditions and associated symptoms, particularly as age progresses, and the high behavioural resistance to seek medical assistance without clear symptomatic evidence, compounds the problem. Often the prodromal phase advances to full blown symptomatic phase before the diagnosis is triggered by the patient. Further, the emotional burden under the episodic healthcare model in which individuals are responsible to gauge severity and make decisions on when and how to seek help, should not be underestimated. Periods of raised health awareness, chronic conditions, slow convalescent recoveries, etc. in adult and pediatric populations can be particularly emotionally draining for patients and families under the episodic care model.

Technology can support much needed progress towards continuous and preventive healthcare, in which individuals are accompanied continuously and unobtrusively by health monitoring technology and practitioners, proactively offering diagnosis, treatment or follow up at the optimal pace and with the optimal protocol as dictated by clinical evidence. Under this model, human beings will heavily rely on technology seamlessly integrated in their lives, becoming recipients of proactive healthcare with minimal disruption and cognitive load. The burden of early spotting of disease will be shifted to unobtrusive technology. This requires careful consideration of all potential ethical issues that may arise, particularly related to data processing, data ownership and trustworthy artificial intelligence. Successful examples of such technologies already exist. Continuous Glucose Monitoring (CGMs) devices in skin-patch formats, for instance, offer diabetics relative unobtrusive and uninterrupted detection of inadequate glucose levels, with the possibility for remote diabetes care. Furthermore, body motion sensors (e.g., accelerometer-based), respiration monitors and oxygen saturation (SpO2) sensors, cell phone-enabled behavioural analysis, fitness devices and many others are also available.

However, the full potential of the continuous healthcare model has not been fully realised as, for most conditions, diagnostic technologies do not exist with the required attributes: unobtrusiveness (environment-embedded, body-embedded, object-embedded, home-integrated, etc.), clinical grade reliability, affordability, etc. For example, fauling-free on-skin, under-skin or implantable bio-sensors for long-term use, new modalities for Volatile Organic Compound (VOC) sensing (breathomics), new personal imaging systems e.g. THz-based or optoacoustic, unobtrusive continuous gut microbiome monitoring, etc. still require substantial groundwork.

The objective of this EIC Pathfinder Challenge is to develop systems and technologies starting at very low TRL for unobtrusive monitoring of human health with new continuous and personal imaging and sensing modalities, implementing continuous assessment, processing and analysis of the data to identify early signs of disease.

This call can support innovative technologies ranging from the sensor level up to the system level for effective integration of multimodal data.

Proposals can aim at monitoring a family of conditions or a wider mix of health factors, using the optimal combination of single-point or historic multi-point sensor data and, if appropriate, clinical records, genomic data, etc. to realise maximal performance.

Involvement of relevant stakeholders (e.g., clinical experts and patient organizations) from an early stage is recommended.

The gender dimension in research content should be considered, where relevant as well as the involvement of relevant stakeholders (e.g. clinical practitioners, patient organisations, etc.) from an early stage.

Specific objectives

Proposals submitted to this EIC Pathfinder Challenge should tackle the following specific objectives:

• develop a novel technology (device, instrument or full system)for unobtrusive proactive healthcare. The targeted technology should offer life-long health status monitoring and elements of predictive medicine with methodologies grounded in existing scientific evidence;
• the end objective must be a Proof-of-Concept and preliminary data suggestive of adequate safety and performance, while paying attention to minimising false positives that could hamper its real-world use;
• the targeted technology should make the case for a clinically acceptable solution amenable to successful evaluation under common Health Technology Assessment (HTA) methodologies;
• the path to future integration in the European healthcare workflow, specifically in relation to the inter-operability with existing infrastructures, as well as take up and compliance by appropriate patient populations, should be plausible.

Expected outcomes and impacts

The expected impact should be the establishment of the basis for the transformation of the prevailing episodic, symptom-triggered, healthcare system into continuous healthcare, in which individuals are accompanied continuously and unobtrusively by health monitoring technology and practitioners, proactively offering diagnosis and treatment.

Specific conditions

Proposals for this Challenge can be submitted by single applicants or by consortia, as dictated by the activities to be performed.

For more details, see the EIC Work Programme 2022 and Challenge Guide for this topic (available on call opening).

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