Optimizing the Management of Patients After Hospital Discharge Using Artificial Intelligence, Telemonitoring, and Integrated Virtual Support

Regional Program under the
European Regional Development Fund/ERDF Regional Program 2021-2027
www.fesr.regione.lombardia.it

Requirement

The RecoverAI project aims to develop an advanced technological platform to optimize the management of the post-discharge phase, reducing hospital stays and improving the quality of care. The project includes real-world trials at two IRCCS hospitals in Lombardy.

Research and Development Project – Through the “Collabora & Innova” call for proposals, the Lombardy Region aims to unlock the full potential of new tools, technologies, and digital solutions for a healthy society.

RecoverAI rises to this challenge by offering a solution based on Symbiotic Artificial Intelligence to support continuity of care in the post-discharge phase through tools that assist—rather than replace—human intervention. The research and development project will be applied to two main clinical areas: cancer patients discharged after breast surgery and caregivers of patients with mild neurocognitive disorders.

Project abstract

RecoverAI integrates natural language conversational systems, supports psychological and emotional monitoring, and provides information services based on validated clinical content. It also offers motivational support for physical activity and a home lighting system that mimics natural sunlight.

At the heart of RecoverAI is a digital platform designed to support patients, caregivers, and healthcare professionals during the most critical phase of returning home.

Expected benefits

The expected outcomes include a better understanding of the care pathway among patients, a reduction in the communication burden on healthcare staff, more consistent support for physical and mental well-being, and greater informed adherence to clinical guidelines, thereby promoting a more sustainable, personalized, and patient-centered model of care.

Exprivia serves as the project coordinator and is actively involved in research and development in the digital field:

• Design and development of the Symbiotic AI Platform, designed for installation in hospital settings with a particular focus on security and data protection, and to ensure transparency in AI decision-making, thereby fostering trust among patients and healthcare professionals and adhering to the principle that AI should not replace human intervention.
• Development of empathetic avatars, digital twins, and information services to enable symbiotic AI-human interactions that foster emotional engagement and reduce the burden on the healthcare system.

• Tailoring the solution to the needs of cancer patients who have undergone breast surgery, optimizing it for information services, motivational support for physical activity, and reminders to ensure treatment adherence, with an emphasis on validated clinical content.
• A specialized solution for caregivers of patients with mild neurocognitive disorders, focusing on emotional monitoring, practical advice, and reducing the caregiver burden.
• Implementation of conversational systems that facilitate empathetic dialogues on well-being, treatment adherence, and motivational support;
• Integration of messaging channels into the platform to enable two-way communication between patients/caregivers and healthcare providers, reducing response times and improving continuity of care.