An ageing population combined with limited resources is putting increasing pressure on UK healthcare. As funds dwindle and hospitals fail to meet targets, many are looking to technology for answers.
Progress may be too slow for some, but systems and wearable devices are measuring conditions and compliance, which in turn is cutting costs, increasing efficiency and enabling better quality of care.
This technology – machines that monitor vital signs through to web reporting systems logging thoughts and moods – is giving patients autonomy over their rehabilitation. They can be discharged quickly and manage conditions at home, avoiding numerous trips to a clinician, therapist or counsellor.
Technology companies are already responding as prices are coming down and hardware is getting smaller, says George Jijiashvili, an analyst at CCS Insight.
On the software side, firms are now able to build new capabilities quickly, which lends itself well to the medical environment, says Jon Collins, Gigaom research analyst. “It allows [healthcare providers] to trial these things in a secure way at low cost.”
This assists the NHS in its aim for patients to be discharged sooner, as well as reducing hospitalisation in the first place. “Certainly there’s a cost drive, but the way [healthcare providers] are looking at this is changing,” says Steve Gowers, head of human factors and design research at technology consultancy firm TTP. “They are still trying to get their heads around the business case against the overall economic argument and business cases tend to be quite complicated.”
Of course, the NHS has a vested interest in the technology’s success. If a patient is not compliant, therapy will fail which has an impact on the healthcare system, says Mr Gowers’ colleague, Allan Carmichael, TTP head of business development.
Technology companies are already responding as prices are coming down and hardware is getting smaller
Ensuring a patient is compliant does not have to be complex or expensive. “Something as simple as an electronic reminder can prompt someone to take a pill,” Dr Carmichael says.
Despite the benefits, several obstacles are slowing the move to digital health services. The NHS is large and its approval processes complex and clunky, often taking up to three years to come into effect.
Therefore, much of the technology is still in trial phase and will take years to filter down to patients. One such trial is currently being undertaken by Jane Burridge, professor of restorative neuroscience at the University of Southampton. Her recent work centres on neuroplasticity, and changes in the neural pathways and synapses in the brain due to bodily injuries such as stroke.
“Previously, when you had a stroke, it was thought you had to adapt your behaviour,” she says. “But we have learnt that there can be neural recovery if people are placed in the right environment.”
Wearable sensors can be embedded into clothing to receive information on how the patient is moving. This can be done at home and the data transmitted to a therapist, Professor Burridge says. “It is cost saving, but also one of the key principles in neuroplasticity is the impact of the rehabilitation – you can do a lot more at home.”
Professor Burridge’s team has developed a website encouraging patients to adhere to the programme and is hoping to convert this into a mobile app.
Meanwhile, at Headley Court Defence Medical Rehabilitation Centre, significant advances in upper and lower-limb prosthetics are boosting proprioception and control. Tests have seen significant improvements in timed walking, with some double amputees being able to progress more than 50 per cent further in a given time. Real-time Bluetooth feedback to a laptop computer helps the practitioner ensure the limb is correctly aligned and programmed to give optimal results.
Another product gaining traction in the rehabilitation space is a system by Physitrack. Due to launch in the UK during the second quarter of 2015, the web-based platform is available through an app, within which patients can download exercise programmes. The product tracks how much of each exercise was completed, noting any pain experienced. This is then fed back to the physician. “It’s similar to the way a music teacher knows when pupils have practised – it gives accountability to patients,” says Nathan Skwortsow, chief technology officer at Physitrack.
The technology itself is useful, but even more valuable is the vast amounts of information it generates. Doctors can identify trends by looking at groups of data, for example. And this approach could be transformational. It presents the possibility of improving healthcare delivery efficiency in the UK by up to 6 per cent, with the potential to save the NHS between £16.5 billion and £66 billion a year, according to Volterra Partners and EMC.
But there are also concerns about the anonymity of sensitive patient data. It must be compliant with evolving regulation, says Matthew Godfrey-Faussett, partner at law firm Pinsent Masons. The Data Protection Act imposes fines of up to £500,000 for those who abuse this information.
However, this can be overcome as data can be aggregated together and anonymised so the patient is unidentifiable, says Mr Godfrey-Faussett.
Rehabilitation technology has a vast array of uses and these are growing exponentially. However, it is often difficult to get projects up and running and once proven, the technology takes several years to reach the patient.
“There is a lot of technology out there, but it’s difficult to see because there are not enough proven cases at the moment,” says Professor Burridge. “As someone doing the research, I really want to see that it’s benefiting patients. It’s making the leap into clinical practice from research trials and we need that to happen more quickly.”
1. BATTERY-POWERED PATCHES
This lightweight patch by Sensium Healthcare is attached to the chest to measure heart rate, respiration and temperature, sending updates wirelessly to the clinician every two minutes. Designed for in-hospital monitoring, an alert is sent to a handheld device if a patient exceeds the thresholds. The patch, which frees patients from wires so they can move around the ward, costs around £7 a day and the battery lasts for about five days. It works over a low-power radio, with data transferred from the patch to a hub and from there to the hospital IT system.
2. CONNECTED SOCKS
Sensoria has infused textile pressure sensors in the underside of socks, which connect to an anklet to detect gait. Designed to provide virtual real-time feedback to runners, the sock could be used by people with neurological disorders, such as Parkinson’s and Alzheimer’s, or by stroke patients. After a stroke, the company says, gait is the first thing impacted. If the sock detects this is out of alignment, it can alert clinicians that the patient has failed to take their medication. Sensoria is developing a traffic light system to warn doctors if a patient is not being compliant.
3. 3D-PRINTED PROSTHETICS
Depression is a major concern for many new amputees. Founded in 2014, UNYQ produces stylish covers which protect prosthetic limbs, as well as re-establishing symmetry with the intact leg. 3D-printing technology allows the company to offer the custom-fit prosthetic covers at an affordable price, with the cheapest costing around £350. In the UK, the product is available through independent rehabilitation provider Pace Rehabilitation and availability will grow further in the coming months. The company’s founders, one of whom is an amputee, started UNYQ because they wanted to “humanise” prosthetics. A number of designs are available.
4. BLUE ROOM
Third Eye Technologies’ Blue Room is a 360-degree patented immersive reality technology that requires no additional equipment such as goggles or headsets. The Blue Room module, which measures approximately 4m x 4m, is designed to replicate a fear or phobia. All surfaces are screens, with visual sequences embedded into a virtual “safe” environment allowing the user to navigate and interact. Among its uses in healthcare, the interactive environment was last year part of a research project by Newcastle University to help children with autism overcome real-life fears.
5. WEB-BASED REPORTING
Web-based reporting systems can track thoughts and moods in depressed patients, or be used in conjunction with hardware to assist in rehabilitation after a heart attack or stroke. One such system, developed by Southampton University using a unique set of open source software tools, is dubbed LifeGuide by researchers. It allows designers with no experience of programming to create interactive web-based interventions to support healthy behaviour. The programme includes a self-assessment, which allows tasks and targets to be personalised to each user, offering feedback on progress as well as motivational support.