This project is being developed within the framework of the Horizon 2020 programme, promoted and funded by the European Commission.

Gatekeeper project main objective is to harness the full potential of new technologies, such as the Internet of Things, Artificial Intelligence and Big Data, to improve healthcare services associated with the most common chronic diseases in Europe. 46 organisations including hospitals, universities, technology centres, large companies, SMEs and service providers are participating in this project.

The project started in 2019 and will continue until 2023. It will deploy eight pilots in seven Member States on a large scale with innovative and remote management solutions in which 40,000 elderly people are expected to participate. In addition, three further pilots in Asia have been added, with the aim of validating solutions and services in healthcare systems outside European borders. As a result, the aim is to generate scientific, technological, economic and social evidence, supported by quality indicators, on the positive impact that technologies provide for the early detection and intervention of diseases that are highly prevalent in the elderly, such as Parkinson’s disease, diabetes and heart failure.

World Older People’s Day was celebrated on 1 October. Gatekeeper wanted to publicize the work being done by the project aimed at improving the health and well-being of this population. The following is an interview with Germán Gutiérrez Rubio, Director of Integrated Healthcare Solutions at Medtronic Ibérica and Coordinator of the Gatekeeper project.

What challenge does the Gatekeeper project address?

The project has a global challenge that affects all health systems. It is to address chronicity and demonstrate how digital health services can identify and treat chronic diseases early, continuously and with a more personalized approach. To address this challenge, a digital ecosystem has been created to connect healthcare providers, businesses, and entrepreneurs, as well as citizens and the communities in which they live. In turn, this will create an open environment in which the real needs of each actor can be identified, and tailor-made solutions can be offered.

What is the main innovation that the project brings to older adults?

The over-65s represent a larger percentage of the total population. Associated with this demographic change, we can see how the number of chronic patients is also increasing with a clear upward trend. In this context, Gatekeeper considers it essential to implement new technologies, such as the Internet of Things, Artificial Intelligence and Big Data, with a dual focus. On the one hand, offering digital services through devices as familiar as our mobile phone or tablet, allowing both healthcare professionals and patients themselves, their caregivers and relatives to manage the disease more efficiently thanks to the collection of data on health habits and lifestyle. On the other hand, to take advantage of and exploit this data to predict risk situations, adapt care guidelines to the specific situation of each patient and thus slow down the progression of the pathology.

Which organisations are involved in this project?

The Gatekeeper project currently involves 46 organisations, including healthcare technology companies, leading research institutes or universities, healthcare providers and European and international networks of technological innovation, coordinated by Medtronic Ibérica and under the leadership of the European Commission. Tele-management initiatives are being deployed in the following regions Basque Country and Aragon (Spain), Saxony (Germany), Greece, Puglia (Italy), Milton Keynes (UK), Cyprus and Poland. Outside Europe, other sites include Singapore, Taiwan and Hong Kong.

What stage is the project currently at?

We are at a key stage of the project. The pilots are currently in the recruitment phase. This means that patients, healthcare professionals and caregivers are joining this large-scale pilot to include mature solutions in everyday care. Planned technologies include external devices and wearables, capable of collecting measurements on health or daily activity. Other technologies include digital applications for the web or smartphones integrated into a digital ecosystem where collected information is made available, along with educational content for patients and caregivers to help them better understand their condition and promote self-care.

Has the pandemic helped to show the value of digital health services?

It certainly has. We are facing an unprecedented health emergency, in which health systems have been forced to prioritise the treatment of a large volume of new patients to the detriment of the proper monitoring of other ailments. In this scenario, we have seen how existing digital services, or those adapted for this new pathology, have served to efficiently monitor Covid-19 patients, avoiding unnecessary face-to-face consultations. This is applicable to the field of chronic patients, and this is what we are developing at Gatekeeper with a clear objective: to provide effective remote follow-up that also allows professionals to monitor the status of patients in real time, limiting face-to-face consultations to priority cases and allocating quality time to them.

From what you tell me, it’s just the beginning of something much bigger, isn’t it?

Gatekeeper is a flagship project in the implementation of the EU strategy on the digitisation of industry and health systems. In this respect, continuous evaluation of the results will be key to generate evidence on the benefits and validity of the solutions deployed.

Another important pillar is the standardisation strategy on which the project focuses to ensure interoperability. This means that the digital platform developed in Gatekeeper is open and allows other services and devices in the market to be included in the service catalogue. This will ensure the scalability of our approach to more patients and healthcare systems across Europe, while guaranteeing the privacy and security of shared data.

This will enable remote patient monitoring to become a core product for healthcare systems, helping to maintain the quality of care despite the significant burden of care.