Using data from sensors and wearable devices to move from reactive to proactive care is a hot topic in health and aged care, and while very much an emerging area, many are working on solutions, writes Natasha Egan.
Can you guarantee prevention on top of all the monitoring that you are doing? There was wide interest from delegates when this question was posed at an aged care technologies conference in August last year.
Forum panellist Terry Kearney expressed his concern about the “phenomenal” amount and type of monitoring being done in health and aged care, at Feros Care’s knowledge sharing Smart Technologies Bootcamp.
Kearney is chief executive officer – education and health enterprises at the Springfield Land Corporation, which is master planner and developer of Greater Springfield, a new city near Brisbane that has technology as one of its key pillars.
The links between monitoring, reporting and prevention need to be in perfect balance otherwise it could create a whole new world of liability in the future, Kearney says.
“The challenge is, is it actually a complete value proposition? I don’t know if I really value the option of knowing I am going to die in two or three minutes if I don’t know that someone is coming to stop me.”
Making more meaningful use of data is a hot topic in health and aged care. Capability to prevent is still an emerging area and many companies are working on solutions that harness data to help service providers offer proactive, rather than reactive care, or to assist individuals improve self-care.
In November, Essence, the Israel-based global provider of internet of things (IoT) and cloud-based home-care solutions, launched Care@Home to the Australian home care sector through its local partner Hills Health solutions.
The intelligent monitoring platform has been available elsewhere since the beginning of 2015 including in field testing in 11 pilots around the world, Rafi Zauer, head of marketing at Esssence, tells Technology Review ahead of the product’s Australian launch.
Care@Home uses movement and presence sensors around the home with algorithms to learn the daily routines of residents over the first month. Using this information and some advanced analytics, it can notify the appropriate contacts if deviations from a routine indicate a potential health issue.
“We are talking about actionable information that can give you some idea, for example, of deterioration of health,” says Zauer.
The system might pick up a night of interrupted sleep, the rest of the day not eating and going to the bathroom more than usual.If the system predicts a potential issue it might suggest the client check in or visit the doctor. It is not necessarily an emergency alert system. It is more a lifestyle system,” he says.
This solution focuses at the small data level by collecting information from devices around the house and using that to assist the resident, but the future of intelligent care is much bigger, he says.
“The next level is in the big data field, taking all the data we collect and using that to give more actionable intelligence to our customers in the wider healthcare community. That is a work in progress.”
In the wearables market, Peter Apostolopoulos, director and founder of mCareWatch, says their focus is shifting from device to software.
Over the last three years, mCareWatch has evolved its SOS Mobile Watch, a medical alarm with remote care giving capability for inside and outside the home, to include the ConnectiveCARE platform for aged care providers.
Having released a new generation in late 2015, Apostolopoulos says the now device-agnostic ConnectiveCARE is heading to include smarter algorithms to facilitate proactive care.
“Service providers are looking for the ability to monitor daily living patterns. They want to move more into the mobile health space so that is where we are taking the platform,” Apostolopoulos tells Technology Review.
“When we first launched, it was all around being responsive when an emergency occurred. The SOS button was a trigger to respond to a health condition or not feeling well, or for a family member to respond to a particular emergency situation.
“Now they want the ability to be a bit more proactive in remotely caring for an individual; to do that, it is all about how to collect details about specific health conditions,” he says.
The second phase of ConnectiveCARE, which is due for release in September 2016, will use smart algorithms to provide predictive analysis, diagnostics and visualisation, Apostolopoulos says.
The algorithms will provide real-time diagnostics based on biometric measures captured by sensors people wear on their body that are communicated by the watch, which becomes like a wireless hub, he says.
“It will need to be smarter in the way we manage the information. At the moment we collect all this data from our wearable devices but we don’t do much with it.”
He says they are developing the solution with business partners and service providers while also working with academic research groups piloting their devices and will take the learnings to apply more broadly.
“There are already products in the marketplace that prompt users to be more active, prompt them on their daily eating habits and that sort of thing. We want to take it to the next level based on what biometric measures you capture and using baseline and research-based protocols and predictive analysis to prompt them to do certain aspects or change their behaviour,” Apostolopoulos says.
Also looking to the future, pharmacist Cathie Reid, managing director at EPIC Digital, says their sights are set on using sensors and data to predict medication-related falls to intervene before that happens.
A spin-off from EPIC Pharmacy Group, a supplier of pharmaceutical and clinical services for the hospital, oncology and aged care sectors, EPIC Digital was founded to address the siloed nature of data in these industries that hinders access to patient information, she says.
Its foundation program, Health Director, is a cloud-based offering hosted by Microsoft Azure, and the first application available from February is medication adherence program Medication Manager. The app allows aged care residents and their family who are customers of the EPIC Group pharmacies to control who has access to their drug information, such as family members, health professionals and community care providers.
“The next steps are about marrying the known data that we already have with data that’s now accessible through the Internet of Things. We can blend the two together to become much more proactive and much more targeted in the healthcare we’re delivering,” says Reid.
Epic Digital is in the early stages of piloting a passive non-intrusive sensor patch that can monitor a range of metrics, such as heart rate, skin temperature and posture, to initially look at falls.
“Every medicine for over 65s impacts on heart or blood pressure and many others in between just have that increased risk of falls,” Reid tells Technology Review.
They are aiming to test whether the sensor can support people prescribed with medicine that may increase the risk of falls through giving them confidence that someone is watching and will see when they start to get wobbly and hopefully intervene proactively, she says.
The other goal is to gather a broader dataset to look for patterns to determine whether the medication increases the risk of falls, or if other measures, such as body weight, low blood pressure or low health rate, are key, says Reid.
“Then starting to get that increased level of confidence in what the real ramifications of prescribing this medicine for a person with these characteristics are, rather than just the very broad brush stroke potential side effect we are governed by now.”
Reid says a medication profile tells a story about a person’s health but the list of dispensed medications or prescribed medications doesn’t tell a full story.
“Being able to add data that sensors and wearables can deliver is like turning a story that is only words into an illustrated story to provide a much bigger picture about what has happened… The way we access information at the moment means much of healthcare is reactive rather and proactive. Flipping that around can make a really significant difference.”
For the full version of this article, see the current edition of Technology Review magazine (January).
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