Projects and Studies

The strands of work include exploratory studies for problem specification and identification of opportunities for digital solutions, the development of digital prototypes and outcome measurements for physical activity, activities addressing data governance, privacy, and interoperability, and the setting up of OIS processes and structures. The COVID-19 pandemic posed unexpected challenges, but also provided opportunities to progress the institute’s work in the context of COVID-19.

One of the program lines aims to thoroughly explore current practices in prevention and rehabilitation for people with cardiovascular disease, to identify mechanisms and opportunities for innovation. To this aim, several distinct research studies were designed and are currently underway. For example, twenty-five in-depth qualitative interviews have been conducted with current and former cardiac rehabilitation patients to explore personal views and experiences of exercise, physical activity, and digital technology in the context of CVD. Data are currently being analyzed (EXPEC study[1]; Lead Johanna Gutenberg, PhD Candidate; Supervision: Prof. Rik Crutzen, Dr. Stefan Tino Kulnik).

In response to the COVID-19 pandemic, additional funding from the LBG Open Innovation in Science Center was accrued to support open innovation activities linked to COVID-19 (CODIS project). A mixed methods study of the impact of the COVID-19 lockdown in spring 2020 on a cohort of 27 cardiac rehabilitation patients[2] has completed recruitment (Co-lead Dr. Stefan Tino Kulnik, Dr. Mahdi Sareban). Within this study the development of a tool for exercise and physical activity (Activity Planning Tool) was identified as a missing key feature of current digital CVD-specific systems. The Activity Planning Tool software application will be evaluated in a clinical pilot study at REHA Zentrum Salzburg[3], creating a test-case for digital health technology evaluation in a clinical outpatient rehabilitation setting in Salzburg.

Jointly with Prof. Jens Blechert from the psychology department of the Paris Lodron University Salzburg (one of the consortium partners) we set up a study to quantitatively assess the impact of psychological, physiological, and environmental factors that influence behavior change towards increased physical activity. This study (SmartPA) combines an Ecological Momentary Assessment (EMA) of psychological factors, such as stress, motivation, and self-efficacy, with automatically sensed physiological data from a smartwatch and environmental factors derived from the smartphone. The study is central for personalized Just-In-Time Adaptive Interventions (JITAIs) to increase physical activity. Next year we will focus on the recommendation part of JIT interventions. The recommendations will jointly be developed with the patients and the health professionals in the team. A recommendation and personalization module for behavior change interventions will be created. A larger follow-up study of the SmartPA study will be conducted, which includes JIT recommendations.

In Connect2Move, which is funded by the EU Interreg program, the relation of physiological data from a wrist-worn wearable and the lab-based gold standards for physical fitness are being studied. Also, the feasibility of submaximal technology-assisted fitness tests is being researched. These fitness tests can be used as motivational feedback. The aim of the project is to support hikers in the selection of routes that match their physical fitness. Further information about the project:

Digital Health (DH) data is the crucial enabler for personalized medicine[4]. Thus, another program line aims at providing more accurate, protected and integrated health data[5]. The main research activities were integrated to address the massive amount of Patient-Generated Health Data (PGHD), mainly generated by DH apps and platforms. Accordingly, the Data Protection project is being conducted to provide a roadmap for implementing the EU General Data Protection Regulations (GDPR) in the DH domain.

While the COVID-19 pandemic leveraged the DH adoption at a broader scale, it created the challenge of accelerating healthcare digitalization[6]. This evolution of the DH landscape is expected to last beyond the times of COVID-19. Thus, the challenge of shaping future health through technological innovation and data interoperability has been placed at the top of the EU policies and research agenda.

Dr. Rada Hussein's DH-Convener concept won the BMK's Nexus Digital Health Innovation Challenge in the use case category of future health data organization[7]. The project aims at providing interoperability and security as a service. Interoperability is a prerequisite for the digital innovations envisioned for future medicine[8]. Through the project, an open personal health platform for collecting PGHD will be developed. This platform will empower the users to own and control their health and fitness data stored in commercial apps. Then, the PGHD will be integrated with the Electronic Health Record (ELGA). At the public health level, the platform could be integrated with the new World Health Organization (WHO) Blockchain platform for tracking SARS-CoV-2.

Open Innovation in Science (OIS) activities were implemented in LBI processes by OIS manager Ing. Andreas Stainer-Hochgatterer, with contributions from Dr. Stefan Tino Kulnik to Patient and Public Involvement (PPI). For example, a PPI group of 30 experts by experience (patients with cardiovascular disease) has been set up, which will contribute to ongoing research-related activities at the LBI in an advisory/consultative function. Furthermore, several activities have been carried out to reach out to industry for scoping opportunities for collaborations.

[1] Gutenberg J, Kulnik ST, Hussein R, Stuetz T, Niebauer J, Crutzen R. Physical Activity in Cardiac Rehabilitation: Towards Citizen-Centered and Evidence-Based Digital Interventions. (Short Paper). In: EFMI Special Topic Conference STC (Virtual Conference); 2020 Nov 26-27; Helsinki, Finland.
[5] Hussein R. Medical Informatics in the Digital Personalized Health and Medicine Era: A SWOT Analysis and Actionable Strategies. Stud Health Technol Inform. 2020 Jun 16;270:869-873. doi: 10.3233/SHTI200285. PMID: 32570506.
[8] Lehne et al. NPJ Digit Med, 2019;2:79.