Abstract:The proposed paper is related to a case of study of an e-health telemedicine system oriented on homecare assistance and suitable for de-hospitalization processes. The proposed platform is able to transfer efficiently the patient analyses from home to a control room of a clinic, thus potentially reducing costs and providing high-quality assistance services. The goal is to propose an innovative resources management platform (RMP) integrating an innovative homecare decision support system (DSS) based on a multilayer perceptron (MLP) artificial neural network (ANN). The study is oriented in predictive diagnostics by proposing an RMP integrating a KNIME (Konstanz Information Miner) MLP-ANN workflow experimented on blood pressure systolic values. The workflow elaborates real data transmitted via the cloud by medical smart sensors and provides a prediction of the patient status. The innovative RMP-DSS is then structured to enable three main control levels. The first one is a real-time alerting condition triggered when real-time values exceed a threshold. The second one concerns preventative action based on the analysis of historical patient data, and the third one involves alerting due to patient status prediction. The proposed study combines the management of processes with DSS outputs, thus optimizing the homecare assistance activities.

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Environmental context has an important impact on health and well being. We aimed to test the effects of a visual distraction induced by classical hospital waiting room (RH) versus an ideal room with a sea view (IH), both represented in virtual reality (VR), on subjective sensation and cortical responses induced by painful laser stimuli (LEPs) in healthy volunteers and patients with chronic migraine (CM). Sixteen CM and 16 controls underwent 62 channels LEPs from the right hand, during a fully immersive VR experience, where two types of waiting rooms were simulated. The RH simulated a classical hospital waiting room while the IH represented a room with sea viewing. CM patients showed a reduction of laser pain rating and vertex LEPs during the IH vision. The sLORETA analysis confirmed that in CM patients the two VR simulations induced a different modulation of bilateral parietal cortical areas (precuneus and superior parietal lobe), and superior frontal and cingulate girus, in respect to controls. The architectural context may interfere with pain perception, depending upon the status of subject. Many variables may change patients' outcome and support the use of VR technology to test the best conditions for their management.

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