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Traditional telehealth model is ‘dead’ as wearables take over: expert

A leading international expert in the use of ICT in aged care has urged providers to be agile when it comes to choosing technology, citing telelhealth boxes that have been “overtaken” by more suitable wearable devices.

Dr Kevin Doughty, director of the UK’s Centre for Useable Home Technologies, said the traditional telehealth model “is dead.”

“That equipment should be taken off from the shelf and put straight in the bin because they have been overtaken by things that are better, more usable, and far more conducive to the public,” Dr Doughty told Technology Review.

All the signs were pointing to a future involving wearable devices, rather than “telehealth boxes,” said Dr Doughty.

Kevin Doughty

Kevin Doughty

Clients were constrained by traditional telehealth equipment that had to be used in the home at a particular time, he said. Instead, devices needed to become ambulatory so they could be worn by individuals, who were increasingly interested in something that matched their persona.

Personalisation and preference would be key to choosing a wearable that kept the client engaged and ensured high levels of uptake and satisfaction levels, he said.

Dr Doughty was in Queensland recently to run a series of events with Community Resourcing Worldwide for community aged and disability care providers.

He said there was a danger that service providers would “get so firmly in bed” with some technologies that they stifle choice for clients. Providers should also realise that older people will be increasingly buying or bringing their own devices, he said.

Aged care providers needed to be agile when it came to the devices and technologies they used. What’s more, with the the rapid advancements taking place, providers also needed a view of the future when signing supply contracts, Dr Doughty said.

“It could be a five-year contract because there are reduced rates, but are you tying yourself into something that is ultimately going to make you look silly,” he asked.

Future of assistive technology on show

The future of assistive technology was in smart wearable devices that were connected, portable and can be personalised, said Dr Doughty, who showcased new and emerging devices ranging from expensive medical devices to the latest low-cost aids at a workshop in Brisbane.

He told delegates that computers, smartphones, sensors, longer-lasting batteries, new materials and fabrics, and sophisticated but affordable virtual reality headsets were among the key enablers for the rise of wearable devices, which included clothing for vital signs and activity monitoring, jewellery, attachables for telecare, sensory aids, and exoskeletons.

assistive technology dbGlvoe

dbGLOVE digitises touch-based alphabets to assist blind and deaf-blind people

Among the technology showcased were $15 cardboard VR viewers, touch and feel gloves for the blind, “hug suits” for those needing more contact, a vast range of GPS-enabled devices and clothing accessories to find people, and temporary tattoos for activity tracking.

Dr Doughty said the price of a wearable technology would indicate clearly whether it was a medical device or an aid, but both had a place in consumer directed care.

Offering choice and impartial advice were the key elements aged care providers needed to consider when helping clients decide which type was best for them, Dr Doughty said.

“Services need to have a choice for people that allows them to use the low-cost option that they are probably used to, because the low-cost option will almost certainly use existing technology, such as a smartphone or tablet,” Dr Doughty told Technology Review at the event.

Rather than be concerned about promoting a cheaper non-medical option, Dr Doughty said it was the responsibility of a good ethical service provider to offer a balanced argument and impartial advice.

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4 Responses to Traditional telehealth model is ‘dead’ as wearables take over: expert

  1. John Williams March 21, 2016 at 2:51 pm #

    Good article Kevin and enjoyed the presentation in Brisbane last month.

    Having been watching and getting involved in this area for last few years I can echo exactly what Kevin says about Telehealth boxes. Technology has moved fast in last few years and there are numerous systems and new ideas popping up based around Internet of Things and wearable technology.
    I cant agree that wearables are the answer to everything. There are two main platforms here. The collection of data to further ehealth and clinical assessments . This based on wearables that are bluetoothed into a gateway that provides input for clinicians to judge the well being of the person.
    The second platform is one of general care for the wellbeing of the person living independently. The faithful pendant still has its place but inevitably is only 50% efficient. What you are seeing now is the use of smart software, clever battery sensors using the IoT that removes the need for the person to call for assistance them selves. Smart software does that for them
    On top of that we are seeing emergence of collected data from the second platform which is able to look ahead to potential frailty problems. As Lord Kelvin said “You cant improve anything unless you have the data”
    This is the rich mix of technology which is making headway in the field of aged care

    regards

    john Williams

  2. Branko Celler March 21, 2016 at 3:44 pm #

    Whilst I can understand Kevin’s appealing and populist viewpoint I am not in agreement with it at all! We need to differentiate telehealth technology for the management of the chronically ill at home from devices designed for the digital health market. The former are medical devices typically CE marked, and TGA / FDA approved. The latter are consumer devices designed for the worried well, and few if any have any medical approvals. In addition they are usually horribly inaccurate, as was recently revealed at the IEEE EMBC conference in Milan. Indeed there is at present a class action suit in the US against Fitbit on the basis of the inaccuracy of their energy and HR estimates. I recently evaluated six different wearable devices for a research project and NONE were accurate enough or reliable enough to be used seriously. The reality is that monitoring physiological parameters from the wrist or falls via pendant is horribly difficult and no amount of good consumer design has yet been able to overcome the problems. Further, at a recent meeting of the American Telehealth Association I did not see ONE wearable product on display. Having worked with the aged chronically ill for some decades, I see little prospect for them to be adopting wearables for the management of their chronic condition, simply because they do wish to disrupt their normal lifestyle unless they have a potential life threatening condition, at which point they would be better off opting for implantables, such as insulin infudion pumps or ICD pacemakers/defibrillators.
    I am all in favour of supporting ongoing R&D on wearables but I suspect that at this stage a majority will end up in a drawer after some months of frustration!

  3. Jo Cleary March 21, 2016 at 3:54 pm #

    It would be nice to remember the human-centric side of things too, with people living at home longer, sometimes in an isolated environment. With wearables to the rescue thanks to the IoT, home visits may be fewer, with Just in Time rather than Just in Case.

  4. Kevin Doughty March 21, 2016 at 7:55 pm #

    I’m pleased to see that the article has provoked such interest. I believe that we are actually witnessing a revolution in the way that we provide care and support well-being. Technology is enabling us to take charge of the first line of defence of our health – and wearables are likely to be the key in self-management as well as in a form of triage that will drive the medics to take over with more sophisticated and accurate forms of medical monitoring. This will involve using more specialist (and much more expensive) items of medical equipment, often within our own homes where there can be more control, enabling our physicians to access accurate and trusted data as our second line of defence.
    Back in the home, we can indeed take advantage of all the Internet of Things technologies to connect us with the rest of the world – and the rest of the world with us. Not only does this offer us the Just in Time opportunities to prevent minor problems escalating into a crisis, but will support more social prescribing choices that focus on our human needs including opportunities to enjoy ourselves without suffering so much from the social exclusion that might haunt people as they live longer.
    There are lots of opportunities to use technology to add life to the years rather than years to life.

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