AI 4 MultimorbidityConditions

Twinning solution

Software solution for cognitive stimulation and training for elderly

Twinning type

Full adoption

Main policy priority

Digital tools for citizen empowerment and for person-centred care


FollowHealth SL (Spain)


Centro Clínico Académico – Braga, Associação (2CA-Braga, Portugal)

Short description

In this twinning solution, a digital health company from Spain and a state-owned hospital from Portugal come together to put into use an AI system capable of monitoring and predicting future relapses of patients suffering from multimorbidity conditions, which are a large and growing segment in the world population and require the attention of different medical specialists given the uniqueness of their particular conditions. The system consists of a remote monitoring platform and an integrated AI prediction algorithm. The project will start with a needs analysis in order to identify which variables need to be controlled, and how the platform needs to be personalized. Then, the population will start to be monitored with the humanITcare platform in order to gather all crucial information. Data from the EHR will be also collected to have a bigger picture of the patient’s journey. Once all the gathered data have been validated in a unified clinical format, the data analysis will start to develop the AI algorithm able to predict acute events in the coming months. What is remarkable about this partnership is that the product is specially tailored to multimorbid patients.
Therefore, patients will feel more empowered and understood, whereas doctors benefit by being able to anticipate disease outbreaks and development in an improved way.


Twinning activities

The project started with a customer needs and requirements analysis to identify which variables were needed to be controlled in the studied population and if smart devices were required to make specific health measurements. The platform permits a high level of flexibility, thus allowing to personalise the monitoring for each medical condition. Once all the requirements were established and the ethics committee approved the study, the population started to be monitored with the humanITcare platform to gather all crucial information. The platform collected data from personalised questionnaires and from the connected smart scale. After the data gathering, the data analysis focused on analysing what the impact of the use of our platform was on the monitoring of these patients compared to those who were not using the platform.


The digital solution used in this twinning has been successfully implemented in the clinical practice of 2CA-Braga and in the daily routines of the patients. However, given the shortage of the project (1 month monitoring period for each patient), the twinning partners conclude that the level of transfer and adaptation was lower than expected. This shortage of time was derived given the desertion of the first adopter of the project and due to the COVID-19 pandemic, so the twinning partners adapted the original work plan to achieve the highest implementation possible. With longer implementation times, the solution could have been used extensively in the clinical practice and more functionalities could have been added to the platform, so both doctors and patients could have a more detailed monitoring at home. Additionally, the COVID-19 situation and the shortage of time led to a low patient recruitment, which could have been higher in a normal situation. A higher number of participants would have let to a better comparison with actual clinical practice to better analyse the impact and benefits of telemonitoring platforms as humanITcare. Despite all of that, the humanITcare platform has been translated to Portuguese and it is currently being registered in Infarmed as a medical device, so the twinning has been successful in learning more about the implementation of that kind of platform in a Portuguese hospital.

Added value and benefits

The expected benefits for patients involved offering them a monitoring platform that could mitigate poor adherence and engagement problems and increase their quality of life. With the smartphone app and the medical devices used, the twinning partners can continuously collect all data from each patient, which allows all doctors involved with the patient to visualise the daily data in real-time and receive alerts when something is wrong. Knowing that they are constantly monitored and that their risks are going to be predicted should make patients feel safer, thus increasing their engagement. Additionally, daily monitoring of weight might contribute to patients’ accountability and to be more aware of their health status. The expected benefits for the adopter included the elimination of the gap between data reported by patients in on site visits and their real daily data. This data can be used to check patients’ evolution together with the alerts system, which will help to improve the knowledge of clinical outcomes and advance the understanding of the management of multimorbidity patients.

Barriers and success factors

The first barrier that was found as an originator was that the first adopter withdrew their participation in the project once it was already approved, given the burden of COVID-19 on their hospital. Considering that, there was the need to search another adopter in the same region, which was found successfully. This caused a significant delay to the start of the project together with the impact of the global pandemic, which led to a shortage of time to implement the twinning successfully. Moreover, the ethics committee and the DPO’s approval took some time to be achieved given that all documentation had to be reviewed carefully before involving patients to the project. Another barrier that was encountered was that due to COVID-19 restrictions, less patients attended on site visits at the clinical, so patient recruitment was affected too, leading to a decrease on the total number of participants included in the study.


The originator’s solution has been used during the twinning in the adopter centre, which has allowed the twinning partners to access their medical knowledge and to get their feedback once the twinning has ended. This shows the potentiality of the digital solution in the Portuguese region and with that experience the partners hope to be able to continue expanding their product. Moreover, the study has shown that doctors were not able to make medical decisions based on the data and alarms received from the system if the platform was not registered as a medical device in Portugal. So due to that fact, humanITcare has started the registration in Infarmed (the government agency accountable to the Health Ministry of Portugal that evaluates, authorises, regulates, and controls human medicines as well as health products, namely, medical devices, homeopathic products, and cosmetics for the protection of Public Health).