Project name: H2020 ENVISION Intelligent plug-and-play digital tool for real-time surveillance of COVID-19 patients and smart decision-making in Intensive Care Units, Grant Agreement number 101015930

Coordinator: Dana Tomescu

Title: University Professor, Head of Section ATI III Fundeni Clinical Institute

Organization: "Carol Davila" University of Medicine and Pharmacy

1. The theme of the project and the medical need it covers

“ENVISION” is financed by the European Union through the H2020 program, subprogram E.U. 3.1.- Societal Challenges - Health, demographic change and well-being. The project focuses on one of the most important and current topics in public health: the management of critically ill patients infected with SARS-CoV-2 in intensive care units. The project, implemented in 17 major hospitals across Europe, aims, on one side, at collecting multiparametric data in order to develop prognostic scores in order to identify specific patients who require advanced medical care and, on the other side, at developing algorithms in personalized medical care for severely ill COVID-19 patients. Hence, this project is aimed at improving public health, one of the most important medical problem in nowadays Romania, especially in the current pandemic context, and its objective is to optimize patients access to medical services and intensive care by promptly identifying those who are prone to develop severe SARS-CoV-2 infections, all in the context of a limited number of intensive care unit beds and understaffing of hospitals. This project is centered on one of the most innovative area of medical research, artificial intelligence, that is able to relief the pressure on the national healthcare system while, in the same time, maintaining the high standards of medical care and patient safety.

2. Description of the research project: objectives, methods, stages, expected results

The main objective of this project is to develop a clinical and paraclinical database (big data) for critically ill COVID-19 patients to develop a diagnostic and treatment protocol for the severe form of the disease. Continuous monitoring, collection and analysis of data from multiple sources, including multiparametric monitors and mechanical ventilators allow doctors to guide medical care in a patient centered and evidence-based manner and promptly respond to critical care situations in COVID-19 patients and, hence, decrease the workload and burden already existing on the medical staff. Collected data will bring new insights into the epidemiology and clinical course of this not fully understood disease that can be the basis of future medical research. The project is implemented over 18 months in 17 of the most important in intensive care units in Europe. Data will be collected automatically by a dedicated software and further processed to develop a diagnostic and treatment algorithm.

The aim of ENVISION is to develop an artificial intelligence protocol (Sandman.ICU) to aid doctors in promptly treating COVID-19 patients and decrease overall mortality and the risk for medical errors due to the high workload.

3. The theoretical and practical importance of the research project

ENVISION tries to answer the current, most pressing problem of public health: the combination of high mortality associated with COVID-19, the lack of specialized medical staff in intensive care units and the lack of patient-centered protocols in severe forms of the disease. This problem can be resolved theoretically by developing and implementing of a innovative solution in public health: artificial intelligence. Theoretically, patients’ benefits are: decrease in mortality, improving patient safety (reducing healthcare associated complications, providing evidence-based medical care and decreasing hospital length of stay) and increasing patient satisfaction by improving patient-medical staff interaction. From the public health point of view, theoretical benefits are represented by a decrease in healthcare associated costs, decrease workload and increase safety for the medical staff. Statistical analysis has demonstrated that implementing an artificial intelligence protocol can reduce overall mortality by 20%, from 30% to 24%.       

4. The innovative dimension of the project

Artificial intelligence represents the novelty in scientific research that brings unparalleled benefits in numerous social and economic areas. In the medical field, artificial intelligence is still at the beginning and has been not fully developed and implemented in any medical specialty. The current pandemic situation and its effects on public health offers the premises for the worldwide development of such a system aimed at resolving an important problem with tremendous implications on the medical system: acute care for the COVID-19 patient. This project, financed by the H2020 program, with the endorsement of the European Society of Anaesthesia and Critical Care, is the first research grant implemented in a Romanian intensive care unit and represents a national premiere. Anticipated results are innovative from a social and medical point of view but also by demonstrating the potential benefits of such a system and opening a new are of research and innovation in all medical fields.   

5. Applicability of the project

Developed in the most important 17 intensive care units in Europe, ENVISION can be universally applied in all medical wards treating COVID-19 patients. One of the projects main objectives is to apply artificial intelligence on a large scale with the aim of providing optimal and personalized treatment to these patients so that the same standards of care can be applied successfully and with decreased workload irrespective of healthcare settings. Implementing such a project on a large scale can be done without any economic burden since it requires only an internet connection and a tablet. On the other hand, demonstrating the potential benefits of artificial intelligence in anaesthesia and intensive care opens a new area of medical science worldwide by extending applicable areas. The ENVISION consortium is already working on a new grant proposal for the improvement of the platform so that it can collect big data from anaesthesia and perioperative medicine in order to increase patient safety in the operating theatre.

6. The plan for the dissemination of the research results

Dissemination of the projects results are part of the grant agreement with the European Union and include media campaigns (television, radio, social media, information leaflets) for the general audience and the development of the project information site. The results will also be disseminated with the aid of the European Commission to the relevant national medical authorities in member states for large scale implementation. At the end of the project, the consortium will apply for CE registration. Our Health Technology Assessment expert partner will demonstrate the economic and societal value of Sandman.ICU and will manage the innovation process in view of an immediate market uptake. The rollout will be supported by the European Society of Anaesthesiology and Intensive Care.