Technologies provide link between hospital treatment and homecare

By March 03, 2017
at-home hospital

Technology solutions – ranging from remote monitoring and alerting systems for healthcare staff to personal medication prompters and mechanisms for keeping patients’ spirits up – now exist to help those needing non-acute medical care to stay in their homes in most circumstances.

According to UK-based mobile online and digital market research specialist Juniper Research, by 2021 seventy-five million Americans will be using activity trackers such as connected wristbands Fitbit, Garmin and Jawbone and smart watches. Juniper’s latest report, entitled Health & Fitness Wearables: Business Models, Forecasts & Vendor Share 2017-2021 predicts that the current number of users will double in less than five years. This is proof, if proof were needed, that these innovations – positioned halfway between the medical field and the consumer products sector – have found their market. Jeroen Tas, CEO of Connected Care & Health Informatics at Philips, pointed out during a webinar hosted by the non-profit Healthcare Information and Management Systems Society HIMSS in January that nowadays “consumers prefer to communicate using their mobile devices and their apps and like to manage just about everything online. So clearly they will also want to have greater control over their own health.‟

Digital health technologies are becoming more widespread.  Source: Philips

Arranging data collection, such as on a patient’s daily activities and interactions, will enable him/her to stay at home when convalescing or during periods of ill health. In the past, the patient would have had to be admitted to hospital. Recent tech innovations are now blurring the boundaries between hospital and home: the patient can stay at home and still receive close monitoring from healthcare staff. San Francisco-based Home Care Assistance, whose CEO is Lily Sarafan, is camped right at this crossroads. Working in collaboration with healthcare institutions, the company provides care in the home for senior citizens “Having access to medical files transmitted by the hospitals and then being able to share what happens when the customer or patient has been cleared to return home means that we can make a real clinical impact,‟ she told the audience at the Annual TechWadi Forum ‘17, held in San Francisco in late January.

At-home patients retain links with healthcare staff

The plethora of tech innovations now appearing means that a huge amount of data – on cardiac rhythm, body temperature, blood pressure, number of paces taken, number of hours slept, and so on – can be gathered. But you still have to understand and analyse the data. Some players have really grasped this. One example is the Oakland, California-based integrated managed care consortium Kaiser Permanente cited by Jeroen Tas at the HIMSS webinar: “Half their consultations take place online. They see their network as a place where patients can benefit from good healthcare in the right place at the right time, through the use of digital innovation.‟  These new tools are offering a way for patients to stay in their own homes, overcoming any problems that might arise.  

Even when well equipped, a stay-at-home patient must continue to be monitored by professional carers. Now that the telemedicine approach is becoming more widespread, there is often no need to travel to a medical appointment. Israeli startup Tytocare, named ‘Best Connected Health Device’ by Tech50+ at CES this year, offers a solution using connected objects to set up virtual consultations. Some data is sent directly to doctors to be processed, for example the data gathered by San Jose, California company VitalConnect’s band-aid-like disposable vital signs monitor VitalPatch or by HealthPatch, a patch which inter alia monitors your heart rate.

Information collected by the patch is forwarded to the patient’s doctor via Bluetooth.  Source: VitalConnect.

“These patches transmit information on patients’ vital signs to healthcare practitioners while allowing them to walk around free of any wires or cables. In this way the hospital can keep an eye on the patient and warn him/her of any deterioration or anomaly that arises,‟ explained Jeroen Tas.

Medication: the right dosage at the right time

While in their own homes, patients may also find it difficult to follow their medication schedules properly. Tas revealed that “half of all patients don’t take their pills at the right time or don’t take them at all‟. Connected pillboxes would seem to provide a solution. The pillbox invented by students at Johns Hopkins University in the US opens on contact with the patient’s fingerprint and is programmed to deliver only the prescribed dose at intervals pre-determined by the doctor. Such technology also ensures that the pillbox really does belong to the person using it and that no mistakes are made with the medication.

Families often want to be sure that their nearest and dearest are looking after themselves properly. With this in mind, ‘smart’ pillboxes such as PillDrill, a CES 2017 Innovation Awards recipient in the ‘Tech For A Better World’ category, are designed to notify the healthcare worker or a relative of the patient when s/he has taken his/her medicine. All the patient has to do is scan the pillbox containing the doses s/he is scheduled to take.

If the patient is prone to dizzy spells or memory loss, the system is also equipped with an alarm to remind him/her that it is time to take the pill(s). Last but not least is the risk that a patient might actually refuse to take the prescribed medicine. S/he is free to decide and will have the last word, but can indicate that s/he is feeling unwell by telling the device how s/he feels. Each of five faces on a small ‘mood cube’ that forms part of the system corresponds to a reply to the question ‘How are you?’ The patient can reply by simply scanning ‘Great’, ‘Good’, ‘OK’, ‘Bad’, or ‘Awful’.

At-home patients manage their chronic illnesses on – or almost on –  their own using the latest technology. Source: Philips (HIMSS Webinar)

If the patient is depressed or has an accident, there are tools designed to enable these independent patients to alert someone.

Alerting a family member, friend or doctor in an emergency

The US Center for Disease Control and Prevention reports that every 11 seconds in the United States a person aged 65 or over is treated in an A&E department following a fall. Patients thus risk losing their independence and the consequences may be even more serious if they are living alone and no-one comes to their aid for several hours. To avoid this happening a number of medical alarm systems have been designed to alert a family member or friend or someone from the healthcare team.

Jeroen Tas explained how his company’s device is used: “Lifeline is the smallest mobile phone in the world. It has only one number. If someone is in trouble, all s/he has to do is press the button to get connected to someone who can immediately provide help or guidance. If the person faints or falls, the device automatically connects and the person called on to help will be given access to the patient’s clinical history.‟  Other emergency buttons are worn on the wrist or around the neck.

This type of device heralds a new approach. “Instead of dealing with ad hoc incidents, we’re starting to look at treating patients holistically‟, underlined Jeroen Tas. In other words, the patient is treated in the round, psychologically as well as physically, with due regard to well-being as well as purely health issues.

Patients keeping track of their own well-being and morale

Vulnerable people and patients whose condition prevents them leaving their home may suffer from loneliness. Robot-companions such as those made by French company Blue Frog Robotics seek to provide an effective means of communication here. Meanwhile the robots manufactured by Santa Clara, California-based OhmniLabs are designed for senior citizens living at home alone. They can be monitored remotely by a member of the family and stand in for family members at mealtimes or at any other moment in senior citizens’ daily lives.

Virtual Reality can also improve the lives of stay-at-home patients. Here the goal is not to provide treatment for an illness but to make the person feel happier by offering him/her a way of escaping, of travelling without leaving home. The New York Times cites the example of a patient whose heart condition prevented him from travelling long distances. Using VR-based tools, he was able to revisit a restaurant in Berlin where he had worked in the past, and went to Caribbean resorts to see the colourful fish in the sea and even feel the sand under his feet. Rendever has begun to provide this sort of service. The MIT graduates behind the startup are working to provide sensory stimulation so as to make the experience more realistic.

Nevertheless, Lily Sarafan sounded a warning about the recent surge in the number of devices intended to help patients. “The risk in this type of environment is that we will see too many startups motivated by hyper-mediatisation and the popularity of certain technologies, whose only thought is to gather ever-more data. One of them might set out to track the smallest movement and invest a lot of money in a product that can do so, but that is not really necessary. At the moment, as far as at-home care is concerned, if we can monitor basic data and prevent people from falling, prevent dehydration and prevent patients from having to return to hospital, that will be enough to save billions in healthcare costs,‟  she explained to the TechWadi Forum audience.  

And now that Obamacare – whose stated aim was to enable US Americans to obtain more affordable healthcare – looks likely to be rolled back or even repealed, tech innovations designed to reduce health costs are especially welcome.

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