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Are sensors set to revolutionise social care?

Our resident technology expert Che Smith digs deep as he looks at how the building of a sensory network in his grandad’s home helped the family manage his support when he started to suffer with Dementia.

A few months ago, my grandad died. Now that’s not the normal start to a technology article but bear with me! My Grandad was a keen cricketer and he would have said that dying in his 90s was a good innings. Unfortunately, after a wonderful life full of business and sporting successes, he lived his last decade afflicted with dementia. He took care of my grandma until she sadly died and then slipped into the mind twisting disease himself for the last few years of his life.

If I speak honestly, dementia is a devastating disease, and not just for the person that has it. Throughout his final years, my grandad no longer recognised his own family, but we didn’t want to put him into a care facility. We wanted to be able to keep him within his own home for as long as possible. But he lived in a large house that some might say was more of an obstacle course for a frail man in his 80s who sometimes found it challenging to remain vertical.

His comfort became the most important thing, and that’s when I began to think of a techie solution to my grandad’s social care needs. Whilst I was installing the system my grandad was nervous and thought I was putting the system in to prove that he needed to go into a home, where it was for the exact opposite reason and we wanted him to stay in his family home as long as possible.

Within 15 minutes he was unaware that the sensors where there. Installing the system was easy, the app is simple and easy to read. The system gave us that additional peace of mind that he had some protection when the family were not physically with him.

A combination of door, cupboard and movement sensors connecting back to a gateway device via the home broadband/Wi-Fi, all linking to an app that then reports on any activity that moves outside of his day to day pattern. That app then fed back to my own smartphone, so I would know whether he’d followed his usual daily pattern which looked something like this:

  • Trigger one, bedroom sensor when he gets up
  • Trigger two, bathroom sensor
  • Trigger three, tea cupboard
  • Trigger four, fridge
  • Trigger five, movement sensor in his living area.

If any of the triggers were missed, we would receive an alarm on an app rising in severity based on the number of triggers missed. External door sensors would also help monitor any unplanned visitors or night time escapes. It would even tell us how many times he visited the bathroom which could alert us that there might be additional health-related issues that we might need to help with.

With lots of talk about modernising the NHS now it has reached 70 I think the time is right for new technologies to be part of the solution our healthcare system faces.

The addition of a wearable device to help track him when he did leave the house and proximity readers that monitored the health care workers’ time in and time out each day were also available so that we knew he was getting the interaction that he needed when the family were not around.

Are sensors set to revolutionise social care?Before the system was installed my grandad relied purely on family and one evening he had a fall and suffered a small cut on his foot. He lay on the kitchen floor all night and lost a lot of blood. We found him the next morning and he was admitted to hospital where a routine check-up then discharge turned into a 4-week bed blocking stay in an environment that was unfamiliar and unsettling to him as he was cared for by different nurses and doctors on a daily basis.

His discharge was only agreed once a full Adult Social Care plan was put in place from the council, so he could be assessed. This entailed 2 to 4 visits per day for up to 4 weeks then 2 visits per day following that. These visits were often carried out by different care workers which again was unsettling but at least he was home.

This does at least show that there is a duty of care attitude that prevails, however, it screams a lack of efficiency. How different it would have been if the care package could have included a sensory network and one visit per day by the same care worker. Savings for the NHS/Local Council, peace of mind for the family and some consistency for my grandad.
With the system in place we could monitor how much activity he was getting, how many visitors were dropping in, how many times he went to the toilet, what time of day he was having his meals and what time of day he was opening his medicine cabinet.

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As time went on and his dementia advanced even the technology was not enough and he needed more specialist care, but I can say that without the technology he would have had to have gone into a home some years earlier. At the time I had to call in favours from friends of mine who worked within the tech sector as the solutions I was looking for weren’t commercially available (though this has since changed). As a society, we should be using solutions like this in our homes as soon as we reach a vulnerable age, maybe before there is a problem. Monitoring trends and patterns of behavior early would help predict the future care plans required.

It’s not all doom and gloom. A few forward-thinking housing trusts and local authorities (for example London Borough of Haringey’s partnership with Your Alcove) have started to explore and trial sensory networks to support their long-term illness communities but it’s far too few. Care Homes, Local Authority care packages, GP care plans and Housing schemes should all include supportive technology.

I have always been an advocate of finding ways to use both digital means and technology to fix some of society’s major challenges. With lots of talk about modernising the NHS now it has reached 70, I think the time is right for new technologies to be part of the solution our healthcare system faces.

Technology can sometimes be held back by bureaucracy and regulation, and I sometimes think that taking a small risk that might have a big pay-off cannot be a bad thing, especially considering the current demands on our NHS. That means the big technology giants and public-sector organisations working pragmatically and intelligently to drive forward the change that is necessary.

Up next

Digitising the NHS – Celebrating 70 years

This year marks the 70-year anniversary of the National Health Service (‘NHS’). That’s seventy years of fixing broken bones, delivering babies, and providing ongoing treatment for diseases such as diabetes and combating cancer to name just a few.

Digitising the NHS – Celebrating 70 yearsThe NHS deals with over 1 million patients every 36 hours. On the 5th July 1948 when Aneurin Bevan (the Health Secretary of Clement Attlee’s Labour government), decided to launch the NHS at the now Trafford General Hospital, it was heralded
as one of the biggest and most ground-breaking initiatives to revolutionise the healthcare sector

in the UK. Hospitals, as well as all the staff that keep them running around the clock, were joined together beneath the NHS umbrella to provide free healthcare at the point of access. In 2018, its mantra is the same as when it was first created in 1948: the NHS is a health service available to all and funded through taxes which means you pay according to your means. With life expectancy rising by five hours a day and a steady stream of emerging technologies and techniques, is the NHS in a position to face the future and survive beyond another seven decades?

Digitisation is the process of converting information into a digital format that creates binary data that can be processed and handled by computers.

The challenges faced by the NHS in 2018 are drastically different than those faced by the Labour government of 1948. At the outset, the focus was on treatment, and not preventing illnesses in the first place. Today, we’re faced with ever-increasing levels of obesity, and a rise in the number of patients suffering from type 2 diabetes which hinder the work of the NHS, and last year, the Red Cross labelled the state of the NHS a ‘humanitarian crisis’.

With staff shortages, waiting times in Accident & Emergency departments nationwide exceeding the government’s 4-hour window, and tens of thousands of operations being cancelled, should the focus of the NHS be on digitising its services? Or will making the transition into the digital age empower the NHS to provide better and more efficient healthcare which could help to reduce repeat visits to a GP or hospital?

The NHS Five Year Forward View

As part of the NHS’ strategic outlook for the next five years, they pledged to ensure that all patient records would be paperless by 2020. This also extends to the way that GP practices are helping patients to use online services, for example to seek advice or to book their own appointments.

The digitisation of the NHS allows it to continue to transform the healthcare sector, and to support patients. In 2015, local healthcare systems produced Local Digital Roadmaps which set out how they would become more digital by 2020.

These road maps give a clearer sense of the areas a patient might live in, how many Clinical Commissioning Groups (‘CCGs’) there are, the authorities in place, and the different Health and Wellbeing Boards. Knowing what’s on offer, and how to access it empowers patients to approach the right organisations with their specific needs. It also helps each of the different healthcare organisations to understand the best way of sharing patient information to create a more joined-up and comprehensive experience.

To digitise the NHS, it’s all about implementing healthcare’s Triple Aim: better health, better healthcare, and at a lower cost which will hopefully result in £22 billion in efficiencies.

Making the NHS more digital

In order for the National Health Service (NHS) to continue to provide a high level of healthcare at an affordable cost, it has to move with the times. This digital transformation will involve a wide scale cultural shift, revisiting the existing structure, greater governance, an energized workforce, and sufficient training. But it’s creating a fully digitised NHS that is one of the greatest challenges.

Impressively, the English GP sector began digitising in the 1980s by installing practice-based microcomputers that had tailored software. In 1982, a ‘Micros for GPs’ scheme saw 150 practiced buy microcomputers for £2.5 million with over 2000 practices vying for a piece of the tech revolution.

The goal was to better aggregate, review and plan the delivery of health at a practice level. By the mid-2000s, GP practices were nearly 100% digital. By contrast, an ambitious programme to digitise the secondary care sector – the National Programme for Information Technology (‘NPfIT’), which was launched in 2002 – was shut down in 2011 after having mostly failed to achieve its goals. A post mortem of the NPfIT criticised the fact that it was too centralised, failed to engage with trusts and their healthcare professionals, and that it ignored the old adage of ‘slow and steady wins the race’.

In late 2015, the National Advisory Group on Health Information Technology in England advised the Department of Health and NHS England on its efforts to digitise the secondary care system. Their recommendations fell into 2 broad categories: 10 overall findings and principles, followed by 10 implementation recommendations.

To digitise the NHS, it’s all about implementing healthcare’s Triple Aim: better health, better healthcare, and at a lower cost which will hopefully result in £22 billion in efficiencies. Rather than digitising the NHS at a rapid pace, it’s about doing it in a staged fashion. The return on investment from digitally modernising the NHS won’t be just financial, it’ll also result in improvements in safety and quality terms.

Digitising the NHS – Celebrating 70 yearsThe improvements in technology, training the workforce, and adapting to digital technologies will also create a more innovative outlook for the NHS in general. The focus should be on sharing information between local and regional levels, which also includes giving patients access to their own electronic data. Especially in light of GDPR, privacy is increasingly important, but not sharing information can hinder research and prevent improvements to patient care.

The new Health IT Systems are going to be built with end-users in mind to make them easier to work with and minimise human error. Attitudinally, the NHS’ digital strategy has considered that a lot of clinical leads or management might not have the understanding of IT systems, and to be able to implement a truly digital NHS, there will need to be a willingness to adapt by all staff. Alternatively, there’s the option to source a trusted managed service provider who might be able to bear the burden of managing your NHS trust’s network, and keeping it secure and productive on a daily basis.

With a goal for all trusts to be digitised by 2023 in light of the £4.2 billion that was made available by the Treasury to promote digitisation, that won’t be enough for every trust. However, with the help of local government, and a staged implementation process, the hope is that we’ll all see a much more digital NHS in 2023 than we do in 2018.

Is the digitisation of healthcare a health-risk?

E-health systems are gathering momentum, not just in the UK but overseas. Removing legacy systems that stop effective data integration is a big driver for not just the NHS but other organisations looking to support clinicians and patients. Likewise, smartphones allow us to do so much more than make calls and texts: we can check our bank balances, watch TV, and reserve seats on trains, so we should be able to hold our health in the palms of our hands?

What does the future of digital healthcare look like?

One thing we all need is access to healthcare. Digital health innovations will help us to cut long-term healthcare costs, treat patients better, empower both patients and clinicians to have real-time data and connections with each other, and will also allow others to join the healthcare system.

A model of healthcare that lives alongside you, gathering data about what you eat, how often you exercise, what your environment looks like, and then feeds into your healthcare record can make your interactions with your doctor more meaningful. With the help of smartphones and smart watches, cloud storage, and data analytics, digital health will be able to help in predicting diseases you might contract, and in some cases can help to shape your behaviour to prevent them.

How is Intercity driving innovation in healthcare?

We work alongside Virgin Media Business to bring Cumbria and Lancashire NHS Trust its out-of-hours stroke thrombolysis (‘clot-busting’) service, which ensures that anyone from the area’s population of 2.2 million can benefit from treatment to reduce the likelihood of disability or death resulting from a stroke. The network remotely connects a team of 15 specialist Stroke Consultants who can provide advice from their own homes to eight hospital sites. Each consultant has a secure broadband connection to a video-enabled Telecart which is placed at a patient’s bedside.

The Telecart enables a two-way consultation, so that the stroke specialist can see and hear the patient, view CAT scans and recommend treatment. With strokes being the 4th most common cause of death and the most common cause of permanent disability, the quicker that surgical intervention can take place, the better the outcome for the patient. Telestroke is an example of IT being used to save lives and proves that technology has a vital role to play in driving forward our healthcare system.