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4Frailty – Diagnostic Telemedicine

Diagnostic Games for the Early Identification of Cognitive Impairment.

Itemoxygen srl involved us in the tailored develop of a patient management platform for the early detection of cognitive impairment, through a series of games to be repeated according to a per patient dedicated program, in order to track the timing and thus be able to outline a neuro-motor picture comparable with average academic values.

As in the Fisiosmart project, we have designed and developed a management platform that digitally reconstructs the typical activity of an orthopedical motor rehabilitation centre to track daily exercises and process neuro-cognitive performance at the end of the rehabilitation cycle, re-processing it according to the kpi provided by the medical staff during the project phase.

European project

4FRAILTY – Intelligent sensors, infrastructures and management models for the safety of fragile subjects (Notice for the presentation of industrial research and experimental development projects in the 12 areas of specialisation identified by the PNR 2015-2020
– Directorial Decree no. 1735 of 13 July 2017) – project code no. ARS01_00345, CUP: B36G18000480005
Link to the website dedicated to the National Operational Programme Research and Innovation 2014-2020:

Implemented functions

  • ACL system with role and permission management to regulate access to functions in a precise and granular manner
  • First access with QR code for choosing credentials
  • Multi-tenant system for independent management by each healthcare facility
  • Fully anonymised data for patient management
  • Game design engine and customisation of related activities
  • Management of different difficulty levels to adapt the system to the cognitive level of the patient
  • Integration with eye tracking and synchronisation of tracked data with game timing
  • WebApp optimised for running on tablets
  • Game data export
  • Detection of response and interaction timing during game play
  • REST API with OAuth2.0 authentication for use of sensed data by external platforms

Used stack

  • Laravel (backend PHP)
  • Livewire (Dynamic UI )
  • Bootstrap (CSS)
  • JQuery (JS)
  • PhpUnit (Test)
  • PhpStan (Static Analysis)
  • PHP CS Fixer (Code Style fixer)

CI/CD system

In order to simplify and accelerate the development cycle of the platform, a pipeline of Continuous Integration (frequent and automatic integration of changes to the source code) and Continuous Deployment (rapid and downtime-free delivery of the updated code to the production system) has been set up.
Each phase is subject to a preliminary check of the formal and functional correctness of the source code, in order to detect any bugs and/or weak points in the code as soon as possible.

Docker Containerization

The code is organised on a container architecture, where each functional area of the architecture is maintained within its own container. This allows both the processes isolation and their execution to be abstracted from the server infrastructure on which they run, making it easy to replicate the system for development, testing and debugging purposes. The entire cycle of container creation, code updating and management is managed through a proprietary system that simplifies and automates container operations.


Implementation of a patient management platform for early detection of cognitive impairment

  • Strategy

    Development of a platform inspired by the analytical management of medical offices, but with the typical potential of advanced management.

  • Design

    Modern interface, rational and user-friendly design.

  • Client

    Item Oxygen srl

  • Technologies

    Laravel, Tailwind CSS, PestPHP, Bootstrap, Docker, Livewire, PHPStan, PHP CS Fixer

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