Remote Monitoring for Elderly Care in Portugal: A National Use Case of the RM4Health Project

As Europe’s population ages, public health systems face increasing pressure to ensure safe, personalized, and efficient care for older adults. This paper presents the Portuguese use case of the RM4Health project, which aims to design and implement an interoperable ecosystem for the remote monitoring of elderly individuals living in institutional and in-home settings. The system integrates wearable wristbands, a smart medication dispenser for intake verification and emergency virtual communication, and a secure cloud platform that supports real-time alerts, routine monitoring, and structured data collection. A socio-technical approach guided the development process, involving engineers, healthcare professionals, and caregivers to ensure that technology aligned with clinical workflows and was compliant with ethical standards. The platform uses HL7 FHIR for data interoperability and REDCap for research data management. The solution is designed to detect critical situations, such as missed medication, abnormal inactivity, and orthostatic hypotension, which can lead to falls, while also enabling caregivers to respond through real-time dashboards and configurable alerts. These features contribute to a proactive care model that enhances autonomy, adherence, and safety for older adults while reducing the burden on formal and informal caregivers and improving cost-effective monitoring.