TIMELY Study

According to the WHO, coronary heart disease (CHD) is still the main cause of the global burden of disease. Ageing predisposes patients to a high incidence and prevalence of CHD in both men and women. Secondary prevention through comprehensive cardiac rehabilitation (CR) is considered the most cost-effective intervention to ensure favourable outcomes for a broad spectrum of cardiovascular diseases. CR is a multifactorial, comprehensive and cost-effective secondary prevention intervention aimed at limiting the physiological and psychological effects of CHD, treating symptoms and reducing the risk of future cardiovascular events. Referral to CR is a Class I recommendation for all patients with CHD. This recommendation is based on a growing body of evidence showing that participation in CR can reduce hospital bed utilisation, cardiovascular mortality and cardiovascular risk factors, and improve functional capacity and quality of life. Although preventive cardiology has been a great success, as evidenced by the reduction in mortality, there is still much room for improvement in interventions as an integral part of the continuous care of patients with CHD and other cardiovascular diseases.

The TIMELY platform offers a unique opportunity to pioneer care pathway redesign and improvement as the platform builds on the ever-evolving innovations in eHealth and the integration of artificial intelligence (AI) for personalised care. TIMELY is a patient-centric, secure, modular and flexible platform for CHD patients that can be used by private cardiology practices, outpatient or inpatient CR providers and cardiology clinics in different settings along the care pathway. Throughout the course of the disease, TIMELY will constantly monitor and predict the individual risk of disease progression or serious events and complications. It will utilise validated risk scores, vital signs panels and AI agents located in the electronic health record (EHR). TIMELY will also utilise state-of-the-art AI chatbots to assess the mental state of patients, which is essential for appropriate and targeted interventions. As lifestyle changes are crucial in the prevention of CHD, TIMELY takes a strictly patient-centric approach, aiming to support patient self-care and, in conjunction with behaviour change models, initiate timely AI-supported guideline-based interventions.

The devices that will be part of the TIMELY platform (blood pressure/haemodynamic monitor, compact ECG patch, wrist-worn activity tracker) have been designed to be highly user-friendly and can be operated with a minimum of instructions, even by older and less experienced users. These include a one-button blood pressure/haemodynamic monitor and a compact ECG patch and wrist-worn activity tracker. TIMELY will pursue a living lab approach with inpatients in Phase II CR in Germany to track the requirements and test the acceptance of the solutions in an iterative and continuous manner.

The main hypothesis of the patient-centric TIMELY solution is that a modular, collaborative eHealth platform supported by AI for continuous and timely prediction of cardiac risks and complications and initiation of targeted behaviour change interventions is effective and cost-efficient for secondary prevention of CHD by limiting physiological and psychological impact and improving management of risk factors and symptoms. It is also expected to improve patient self-care and clinician efficiency. TIMELY is being evaluated in a multicentre RCT in Germany, the Netherlands and Spain.