Amir Hajjam | UTBM - Academia.edu (original) (raw)

Papers by Amir Hajjam

The MIPS Laboratory (Modelling, Intelligence, Process and Systems) is an interdisciplinary resear... more The MIPS Laboratory (Modelling, Intelligence, Process and Systems) is an interdisciplinary research laboratory hosted by the Haute Alsace University. It is involved in several research projects that deal with signal processing, software engineering, microscopy imaging and modeling and identification in automatic and mechanic. Since March 2012, the MIPS laboratory is involved in the telemedicine project E-care (www.projet-e-care.fr) piloted by the NEWEL society. This project rallied economics and scientific community to keep patients in the comfort of their own home with a higher level of care and all this with reduction cost. The E-care project aims to develop best practices and a platform for awareness raising, knowledge exchange and policy making in this field. The project is closely linked to the thesis contribution of Ali Moukadem (Moukadem, 2011). Indeed, this thesis fulfilled in MIPS laboratory and HUS “Hôpitaux Universitaires de Strasbourg” co-financed by “region Alsace” and ...

Médecine des Maladies Métaboliques, 2018

Contexte : Nous réalisons ici une revue de la littérature centrée sur les projets de télémédecine... more Contexte : Nous réalisons ici une revue de la littérature centrée sur les projets de télémédecine développés dans le domaine de l'insuffisance cardiaque. Nous détaillerons tout particulièrement le projet de télésurveillance appelé E-care, dédié à la détection précoce des situations à risque de décompensation cardiaque. Les perspectives du développement du système E-care dans le domaine de la diabétologie seront également abordées. Résultats : De nombreux projets de télémédecine, s'appuyant sur les objets connectés ou sur les technologies des sciences de l'information et de la communication ont vu le jour, ces cinq dernières années, ou sont en cours de développement dans le domaine de l'insuffisance cardiaque. C'est le cas du projet de télésurveillance E-care qui s'inscrit parfaitement dans le cadre des projets de télémédecine 2.0. Leur apport potentiel en termes de mortalité ou de morbidité, en nombre d'hospitalisations évitées, est actuellement en cours d'étude ou de documentation. Leur impact en termes d'économie de santé est également en cours de validation, en sachant que les projets de télémédecine les plus anciens avaient déjà validé des bénéfices médicoéconomiques apportés par les solutions de télémédecine.

Soins Gérontologie, 2019

The objective of the GER-e-TEC™ project is to provide a personalised medical follow-up of residen... more The objective of the GER-e-TEC™ project is to provide a personalised medical follow-up of residents in nursing homes with the aid of a telemedicine intelligent platform. It will assist the nursing staff by automatically processing information obtained from sensors and questionnaires in order to give an early warning about high-risk situations. This telemedicine tool will enable health professionals to optimise residents' care.

Current Aging Science, 2019

Telemedicine is now in vogue, allowing computer and communication tools to be deployed in differe... more Telemedicine is now in vogue, allowing computer and communication tools to be deployed in different fields of health, such as Cardiology, Dermatology, areas in which it has received interest, and in international studies. As the population ages, older people are increasingly concerned about this innovative practice. This is a narrative review of both the literature and Internet pertaining to telemedicine projects within the field of geriatric subjects in France. Since the beginning of the 2000’s, several telemedicine projects and trials focused on chronic heart failure have been developed in the elderly, and also in the field of dermatology. The potential contribution of second-generation telemedicine projects in terms of mortality, morbidity, and the number of hospitalizations avoided is currently under study. Their impact in terms of health economics is likewise being investigated, taking into account that the economic and social benefits brought up by telemedicine solutions were ...

European journal of internal medicine, May 1, 2018

Heart failure is thus responsible for more than 100,000 hospitalizations per year in France [1]. ... more Heart failure is thus responsible for more than 100,000 hospitalizations per year in France [1]. It accounts for 5% of all hospitalizations and is the main cause of hospitalization among elderly subjects. Some of these hospitalizations could be avoided if patients took greater responsibility for their disease and were followed up better [1]. This last point has been particularly well documented in heart failure and diabetes. Telemedicine may be of aid in this setting. Indeed it may even optimize the management of such chronic diseases, particularly by preventing emergency and repeat hospitalizations [2]. It may also make it possible to structure integrated care pathways, with, again, the most important evidence to be found in heart failure. Since the beginning of the 2000s, numerous telemedicine projects have been conceived and developed in the area of heart failure [for review see the reference [3]]. It is worth bearing in mind that those projects, particularly the earlier ones, more closely resembled telephone follow-up with care providers (such as a nurse) traveling to the patient's home [4]. Hence in our opinion those studies represent the first generation of telemedicine (1.0 telemedicine) projects [3]. Over the last 4 to 5 years, a second generation of projects has emerged in the heart failure area, particularly in developed countries [for review see the reference [3]]. These projects are known as "telemedicine 2.0", because they utilize the new Information and Communication Technology (ICT) and the web. Most of these projects rely on the usual connected tools for monitoring heart failure, such as blood pressure meters, weighing scales, and pulse oximeters, which relay the information collected via Bluetooth, 3G or 4G and incorporate tools for interaction between the patient and healthcare professionals like telephone support centers, tablets, and websites [3]. Some of them also provide tools for motivation and education, and occasionally, questionnaires about symptoms, such as dyspnea, palpitation and edema as experienced by the patient. In this setting, we report our experience of a telemonitoring project called E-care. This project is run with the aid of the telemedicine 2.0 tools discussed above [5,6]. The E-care project has been developed to optimize the home-monitoring of heart failure patients. It detects situations in which there is a risk of cardiac decompensation and re-hospitalization, and it does this via a telemonitoring 2.0 platform. The E-care platform generates indicators of a worsening of the patient's health status. These "warning alerts" are generated for any decompensation of a chronic disease (particularly heart failure) that may lead to hospitalization if not treated. The platform makes use of nonintrusive medical sensors that record blood pressure, heart rate, oxygen saturation and weight [5,6]. These sensors are connected by Bluetooth and relay real-time physiological data about the patient's health status. The platform also includes a touchscreen tablet that is connected by Wi-Fi and a router or 3G/4G, making it possible to interact with the patient and provide education on treatment, diet and lifestyle. The E-care system includes a server that hosts the patient's data and a secure Internet portal to which the patient and the various hospital-and non-hospital-based healthcare professionals can connect. E-care is based on a smart system comprising an inference engine and a medical ontology for personalized synchronous or asynchronous analysis of data specific to each patient and, if necessary, the sending of an alert [5]. The E-care telemonitoring platform was made available to patients as part of an experiment conducted by Strasbourg University Hospital. Between February 2014 and April 2015, 175 patients were given the chance to use the E-care platform. During this period, the E-care platform was used on a daily basis by patients and healthcare professionals according to a defined protocol of use specific to each patient. The mean age of these patients was 72 years and the ratio of men to women was 0.7. The patients suffered from multiple concomitant diseases and had a mean Charlson index of 4.1. The five main diseases were: heart failure in more than 60% of the subjects, anemia in more than 40%, atrial fibrillation in 30%, type II diabetes in 30%, and chronic obstructive pulmonary disease in 30%. During the study, 1500 measurements were taken in these 175 patients, which resulted in the E-care system generating 700 alerts in 68 patients. Some 107 subjects (61.1%) had no alerts during followup. Analysis of the follow-up of these 107 patients revealed that they had no clinically significant events that might eventually have led to hospitalization. Analysis of the warning alerts showed that the E-care platform automatically and non-intrusively detected any worsening of the patient's heart status. Indeed, it was in this setting that the system yielded the best sensitivity, specificity, and positive and negative predictive values, respectively 100%, 72%, 90% and 100%. Both the healthcare professionals and all the patients, even the frailest, used the E-care system without difficulty until the end of the study. During the study of non-autonomous patients, the system was employed by a nurse in addition to other tasks like washing and administering medication, as well as by close ones and family members. To our knowledge, the E-care project is the first to have been conducted in heart failure patients who were elderly (mean age of 72 years), who

European Research in Telemedicine / La Recherche Européenne en Télémédecine, 2015

Contexte Le suivi au quotidien des patients insuffisants cardiaques par des professionnels de san... more Contexte Le suivi au quotidien des patients insuffisants cardiaques par des professionnels de sante empeche la decompensation cardiaque. L’utilisation de systemes de telemedecine est un moyen potentiel pour faciliter le suivi, optimiser la gestion de ces patients. Nous rapportons ici l’experience du developpement et deploiement d’une telle plate-forme de suivi des patients presentant une insuffisance cardiaque a travers le projet E-care. Methodes Le projet national de telemedecine E-Care a developpe une plate-forme communicante et « intelligente » permettant le suivi des patients insuffisants cardiaques en stades III et IV de la NYHA en utilisant des capteurs non invasifs. Ce projet a ete deploye a partir d’octobre 2013 dans un service de medecine interne, participant a une filiere de prise en charge de l’insuffisance cardiaque, au CHRU de Strasbourg. Tous les patients consecutifs hospitalises ont ete inclus. Resultats A ce jour, plus de 180 patients ont ete inclus et plus de 1500 mesures realisees. Ces patients sont âges, poly-pathologiques dans plus de 90 % des cas, presentant notamment une insuffisance cardiaque dans plus de 60 % des cas, et une perte d’autonomie dans 25 %. Durant cette periode, le systeme a fonctionne sans defaillance. Les infirmieres et medecins utilisent au quotidien les dispositifs de mesures E-care lorsqu’ils effectuent leurs tournees aupres des patients ou leurs visites. Une enquete de satisfaction et de pratique aupres des soignants et des patients a permis de valider l’ergonomie du systeme et les choix technologiques. La collecte en continu realisee lors de cette experimentation nous a permis d’avoir le nombre critique de patients pour analyser plus finement la pertinence des alertes. Cette analyse semble montrer la pertinence des alertes generees. Conclusion Le deploiement du systeme E-care en milieu hospitalier semble montrer la pertinence des choix technologiques, des outils et des solutions developpees et adoptees pour le suivi des insuffisants cardiaques.

Médecine thérapeutique, Apr 1, 2014

Le suivi a domicile des patients atteints de maladies chroniques devrait contribuer a limiter les... more Le suivi a domicile des patients atteints de maladies chroniques devrait contribuer a limiter les depenses, favoriser l’emergence de nouvelles organisations plus efficaces et plus securisees que la pratique conventionnelle, et offrir une meilleure qualite de vie des patients. Il repose sur la collecte d’informations comportementales, environnementales et physiologiques du patient. Dans les premiers systemes, ces donnees etaient envoyees directement aux experts medicaux pour les interpreter. Avec les avancees technologiques actuelles, des logiciels et des applications ont ete developpes pour traiter directement ces donnees. Dans cet article, nous presentons l’architecture de la plate-forme de telesurveillance de patients atteints d’insuffisance cardiaque, E-care, ainsi que la premiere phase de l’experimentation realisee aux hopitaux universitaires de Strasbourg. E-care est composee d’un module chez le patient pour la transmission des donnees, et d’un module serveur qui recoit et traite ces donnees. Le module serveur combine les technologies du web semantique et de l’intelligence artificielle. Des ontologies generiques sont utilisees pour s’adapter a differentes pathologies et differents types de capteurs et de donnees. Un moteur d’inference est utilise pour la surveillance de l’evolution de l’etat de sante du patient. La premiere phase de l’experimentation, realisee aux hopitaux universitaires de Strasbourg, a permis de valider l’ergonomie de cette plate-forme et la coherence des donnees remontees.

2012 IEEE 24th International Conference on Tools with Artificial Intelligence, 2012

ABSTRACT In most developed countries, life expectancy has been increasing steadily and burden of ... more ABSTRACT In most developed countries, life expectancy has been increasing steadily and burden of chronic disease continues to grow. The chronic diseases are responsible for increasingly growing health spending. Telemonitoring systems provide a way to monitor patients and their needs within the comfort of their own homes. In the first systems, the data were sent directly to the medical experts to be interpreted. With technological advancements, software and applications have been developed to process the data. In this paper, we will focus on e-Care platform that combines the semantic web and artificial intelligence, for telemonitoring. e-Care is based on generic ontologies to accommodate different conditions and types of sensors and data. A decision support is bases on an inference engine, this engine is used for following up the health of the patient and the detection of abnormal situations and react accordingly, by providing recommendations and informing his physician with alerts.

Health and Technology, 2012

Conventional auscultation is subjective and not easily shared. Modern medical technology allows u... more Conventional auscultation is subjective and not easily shared. Modern medical technology allows us to optimize ausculatory findings by physically characterizing sounds through recordings, visualization and automated analysis systems. The development and availability of novel tools based on innovations in Science, Information and Communications Technology provide the clinician with an invaluable aid in order to achieve an early objective diagnosis, as well as offering increased sensitivity and reproducibility of auscultatory findings. Such advances have not only led to the development and use of new intelligent communicating stethoscope systems, but they have also significantly contributed to the revival of telemedicine, particularly as a diagnostic and teaching aid.

IISA 2013, 2013

ABSTRACT In most developed countries; telemonitoring is increasingly used, due to the increasing ... more ABSTRACT In most developed countries; telemonitoring is increasingly used, due to the increasing of life expectancy and chronic diseases that accompany them. Indeed, chronic diseases are responsible for health care costs increasingly growing and remote monitoring systems provide a mean to monitor patients and their needs in the comfort of their own homes, with minimal costs. In older systems, the data were collected and sent directly to the medical experts to be interpreted. With technological advancements, software and systems have been developed for on-site data processing. In this paper, we present E-Care a telemonitoring platform that combines the semantic web and artificial intelligence. E-Care is based on generic ontologies and a decision support system. Ontologies provide knowledge for decision support. The decision support system is based on an inference engine; this engine is used for monitoring the health of the patient and the detection of abnormal situations. System reactions consist in alarms and recommendations for informing physicians. E-Care has a generic open architecture; in this paper we extend the platform by adding a module for auscultation sounds in this architecture.

IRBM, 2012

ABSTRACT Alors que l’auscultation conventionnelle est subjective et difficilement partageable, la... more ABSTRACT Alors que l’auscultation conventionnelle est subjective et difficilement partageable, la qualification physique des sons à travers des systèmes d’enregistrement, de visualisation et d’analyse automatisée, ainsi que le développement et la mise à disposition de nouveaux outils s’appuyant sur les innovations des sciences et technologie de l’information et de la communication devraient apporter une aide au diagnostic objectif et précoce avec une meilleure sensibilité et reproductibilité des résultats issus de cette auscultation. Ces progrès et innovations devraient ou pourraient à terme déboucher sur le développement et le déploiement en clinique de nouveaux systèmes de stéthoscope communiquant et intelligent et être un des acteurs du renouveau de la télémédecine, notamment dans l’aide au diagnostic et l’enseignement.

La fragilite est un concept actuellement tres etudie, et la litterature qui lui est consacree est... more La fragilite est un concept actuellement tres etudie, et la litterature qui lui est consacree est abondante. En geriatrie, elle est un enjeu de sante publique majeur, du fait de ses consequences. Elle demeure neanmoins difficile a apprehender pour de nombreux cliniciens, tant sa definition, ainsi que sa physiopathologie et les moyens de la mesurer et de l’evaluer restent encore a eclaircir. Nous proposons une revue de litterature exhaustive afin de mieux comprendre cette notion importante.

Gériatrie et Psychologie Neuropsychiatrie du Vieillissement

International audienceThe aim of the GER-e-TEC™ project is to study the contribution of telemonit... more International audienceThe aim of the GER-e-TEC™ project is to study the contribution of telemonitoring residents in nursing homes of Rouen University Hospital, with astructuring and recording of medical care in order to avoid situations of acute decompensation and complication of geriatric risks.E-care platform will provide personalized care for the main geriatric risks, to avoid the occurrence of an acute decompensation factor in the elderly patient. The collection of information by the platform will increase knowledge of the patients and provide a particularly effective tool for transmission between nursing staff and general practitioners in nursing homes. This information collection will allow the extraction of markers to improve the early detection of any decompensation and thus improve patient monitoring and reduce the number of hospitalizations. The platform will also provide any paramedical and medical health professional with the resident's geriatric data, which will be ...

CO à la 8ème conférence francophone en Gestion et Ingénierie des Systèmes Hospitaliers GISEH, Casablanca, Maroc, 2016

The Journal of Nursing Home Research Sciences, 2019

To the Editor, Year on year, the number of patients in the emergency departments from nursing hom... more To the Editor, Year on year, the number of patients in the emergency departments from nursing homes continues to grow. It is necessary to provide tools to health care teams for these nursing homes, such as assistance in the prevention of decompensation of some geriatric syndromes. The aim of the GER-e-TEC™ project is to study the contribution of telemonitoring residents in nursing homes of Rouen University Hospital, with a structuring and recording of medical care in order to avoid situations of acute decompensation and complication of geriatric risks. The objective of the project is to experiment with recorded personalized medical monitoring of the residents of the Rouen University Hospital nursing homes using the E-care intelligent telemedicine platform, winner of the Investissements d'Avenir in 2012 and then of the Fondation d'Avenir (Future Foundation) in 2015 and 2017. The latter assists caregivers by automating the processing of information from sensors and from questionnaires in order to detect and make an early diagnosis of medical risk situations. E-care will provide personalized care for the main geriatric risks, to avoid the occurrence of an acute decompensation factor in the elderly patient. The information collected will be supplemented by codified therapeutic management, following international recommendations, directly usable in nursing homes. The E-care platform uses an intelligent algorithm to process the data and generate alerts based on medical knowledge of the pathologies treated and modeled by ontologies. The general principle adopted by this platform is the anticipation of decompensation through the detection of warning signs that ultimately lead to hospitalization.

In France, nearly one million people are affected by heart failure (HF), with 120,000 new cases e... more In France, nearly one million people are affected by heart failure (HF), with 120,000 new cases emerging each year [1]. HF is characterized by high mortality (30% of deaths within 5 years of first symptoms in more recent studies) and major disability in daily life (shortness of breath, fatigue, etc.), in addition to prolonged and recurrent hospitalizations [2]. Chronic HF diminishes patients’ quality of life and has a major economic impact. This is primarily accounted for by healthcare costs resulting from re-hospitalization, especially for people aged over 65 years, due to the recurrent episodes of cardiac decompensation [1]. Current patient care aims to improve patients’ quality of life by alleviating symptoms (shortness of breath, fatigue, etc.) and allow them to perform everyday activities, and by preventing cardiac decompensation episodes. As a result, hospital stays are likely reduced, as well as disease progression and mortality rates.

International Archives of Nursing and Health Care, 2018

European journal of case reports in internal medicine, 2020

Introduction We tested the MyPredi™ e-platform which is dedicated to the automated, intelligent d... more Introduction We tested the MyPredi™ e-platform which is dedicated to the automated, intelligent detection of situations posing a risk of decompensation in geriatric patients. Objective The goal was to validate the technological choices, to consolidate the system and to test the robustness of the MyPredi™ e-platform through daily use. Results The telemedicine solution took 3,552 measurements for a hospitalized patient during her stay, with an average of 237 measurements per day, and issued 32 alerts, with an average of 2 alerts per day. The main risk was heart failure which generated the most alerts (n=13). The platform had 100% sensitivity for all geriatric risks, and had very satisfactory positive and negative predictive values. Conclusion The present experiment validates the technological choices, the tools and the solutions developed. LEARNING POINTS Patients with chronic conditions can be monitored with telemedicine systems to optimise their management, particularly during the C...