Kerubin for Medical Team
The Kerubin advantage

Too much information, no information at all: even in the medical field, the law declared by Umberto Eco and well-known in the journalistic field applies. Today's technology allows the patient to easily collect and transmit a large amount of potentially useful information to those who care for them. If the doctor is available to provide their email or WhatsApp contact, the patient will send them everything they believe could be of use, often subjecting them to an overload of work.

Many technological solutions to support assistance embrace this philosophy, simply attempting to bring some order to the flow of information, but without reducing its impact and indeed with the risk of increasing it. Kerubin reverses the paradigm: it is the platform that interrogates the patient and directs them to provide the data they need, eliminating background noise and providing only the relevant information, already processed by Artificial Intelligence, to the Doctor and his Team.

According to Article 13 of the Code of Medical Ethics, "it is the doctor's obligation to promptly report any adverse reactions that may have occurred during the course of a drug treatment to the competent authorities". Suspected adverse drug reactions must be reported within 2 days from when the doctor or healthcare provider becomes aware of them (source AIFA).

The main limitation of a spontaneous reporting system for an adverse drug event is under-reporting or underreporting, which can affect the estimate of the true incidence of adverse events in the population exposed to drug therapies.

For this reason, a collaboration was already begun in 2018 with the Pharmacovigilance of the Campania Region, which addressed and validated the design choices of the platform: for patients followed through Kerubin it is the platform that intercepts the potential adverse event and automatically proposes the relevant reporting, usually through the Pharmacy of the competent hospital.

However, the doctor or patient can report a suspected adverse reaction in one of the following ways:

  • by filling in the suspected adverse reaction report form and sending it to the Pharmacovigilance Manager of their own facility via e-mail or fax;
  • logging onto the VigiFarmaco website and following the guided procedure.

One of the more delicate aspects of care for chronic patients in home care is the need to monitor the various symptoms, verifying the impact of treatment on known disease symptoms and at the same time monitoring the possible appearance of side effects of drugs.

Kerubin’s primary objective is preventing and mitigating Adverse Events in Chronic Patients in home care. For this purpose Kerubin collects, analyzes and makes the information available on subjective symptoms to Doctors and Case Managers, provided by their patients in self-reporting mode. This information is integrated with that relating to laboratory tests and with treatment adherence data to provide the Medical Team with a constantly updated clinical picture.

Kerubin's strategy begins with the observation, confirmed by multiple scientific studies, that the active involvement of the patient has a positive impact on the outcome of the treatment. In particular the use of self-reporting, an approach consisting in the communication of subjective information on one's symptoms by the patient, has been demonstrated as valid. This usually occurs through the patient's compilation of questionnaires, carried out with the assistance of a Doctor or Case Manager. The novelty of Kerubin's approach lies in the fact that the questionnaires are administered to the patient through a specially designed App, adopting the most modern usability criteria. The patient's responses are analysed in order to grade the symptoms they report and take the necessary actions.

A similar approach is used to periodically profile the patient from various points of view (Questionnaires on the Quality of Life, on the frailty of the elderly, on the adherence to the Mediterranean diet, etc.).

At the initial stage, the grading of subjective adverse events is done by analysing the single questionnaire with simple algorithms. As the platform steadily acquires knowledge about the patient's history, the answers, provided by the same patient at different times, and the results of laboratory tests will be correlated. It will therefore be possible to apply Artificial Intelligence techniques, to increasingly improve the results of the grading of adverse events.

Kerubin's ambition is to improve the patient's level of assistance without adding to the Medical Team’s workload. To achieve this, among other things, the platform provides a system of notifications, which report the situations requiring attention to healthcare professionals on a monitoring dashboard, available on the move. Within the dashboard, the Doctor and Case Manager will also find all the other information available on the platform about their clients.