Predicting health decline in older persons using AI on data from smartwatches: A study protocol of the PAI project.

<ns5:p> Background The global shift towards an ageing population and workforce shortages increases demands on health and social care systems. Proactive, personalized, and resource-efficient care models are therefore needed. Continuous monitoring using wearables, together with artificial intelligence (AI), offers potential for early detection of health deterioration and timely intervention. Still, existing solutions often target single diseases and lack integration into clinical workflows. Objective This article presents the study protocol for the project <ns5:italic>Predicting Care Needs of Older Adults in the Healthcare System through AI-Enabled Analysis of Patient Monitoring Data</ns5:italic> (PAI), which aims to develop an AI-driven predictive model based on data from wearables (smartwatches) to identify health decline among older persons in the near future. In addition, the project will evaluate the pilot implementation of this model within health and social care settings in three countries and generate recommendations for future adoption. Methods To answer the project aim, the AI model will be developed using historical datasets from wearables linked to emergency health care visits. To guide and evaluate the pilot implementation in Sweden, Norway, and Spain, staff from health and social care, managers, and IT professionals will be interviewed before implementation to explore current work practices and relevant contextual factors. Users of the smartwatch (older persons) will also be interviewed to explore their experiences, needs, and expectations. Follow-up interviews will be conducted after implementation to capture users’ and health and social care staff’s experiences of use. In addition, quantitative data on the AI model’s performance will be collected. The recommendations will be developed in an iterative process, including both researchers and stakeholders. Expected Results The project will identify key data requirements, deliver a predictive AI model, and develop evidence-based recommendations to support the responsible and scalable implementation of the proposed AI-solution in healthcare and social care settings. Conclusions By combining technical innovation with real-world implementation research, the PAI project seeks to advance the use of AI in care for older persons, support proactive and person-centered interventions, and contribute to more sustainable healthcare systems. </ns5:p>