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1 October 2015

Is connected and cloud technology the key to improving the health of the nation?

The Internet of Caring Things is transforming the way that we are able to manage and improve our health. 

By Becky Slack

A woman gets up in the morning and brushes her teeth using her smart toothbrush that charts her brushing activity and shares it with her dentist. She then exercises using an app on her smart phone that visualises muscle activity and tracks her progress, and makes a note of the calories she consumes at breakfast – important if she’s to maintain a healthy weight.

Her journey to work is by scooter, which has an electronic alert system that automatically alerts her relatives in the event of a crash. Once at work, she sits at her smart desk, which part way through the day notifies her that she’s been sedentary for too long and then orders her lunchtime salad. She also makes the most of her wearable device that tracks her alertness – using her smart sleep mask for a power nap if needing to boost her productivity.

Once it might have sounded like a scene from Back to the Future but today this technology exists, and there’s an increasing appetite for it.

The Internet of Things, as it is known, is growing in size, momentum and economic value. In 2005, there were 2.5 billion connected devices, mainly PCs, smartphones and tablets. By 2020, Gartner predicts this figure will have risen to more than 30 billion, with most devices not being PCs but other objects such as those listed above, adding an estimated $1.9tn to the global economy. Not all of these devices will add value to people’s lives, certainly not in a health context. But of those that do, they have the power to transform the way in which we deliver and receive healthcare.

The Internet of Caring Things (IoCT) has been coined to describe a network of connected objects that serve to actively care for an individual’s physical and mental wellbeing, safety, security and oversight of their loved ones. The vision is for the network to connect an individual’s personal space, and everything they need and value, including health and social services, charities and third sector groups, gyms and leisure activities, and so on. For the NHS, where less than 2 per cent of patient interactions are currently digital, the challenge is how to connect the dots in a way that will create the scale and breadth needed for it to play a full and effective role within this new age.

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The NHS isn’t alone in facing such a challenge. Wireless technology is causing disruption across all sectors. In retail, customers are wirelessly comparing products and prices while shopping in store; in the hotel industry, Wi-Fi is now considered the most important amenity to offer guests; and Wi-Fi is even expected to be provided on planes with fliers keen to maintain connection with their favourite apps and social networks while up in the air. As universal connectivity becomes an accepted part of everyday life, it is natural that our healthcare and how we manage our wellbeing should also benefit from the multitude of innovative technologies available today.

There are a number of factors that are driving demand. Cheaper and more efficient wireless chips, barcodes and sensors are making it viable to add connectivity to more objects; Wi-Fi speeds have increased significantly; expansion of the cloud means there is more storage for all the data created by the IoCT; while geo-location tools make it possible for an individual’s location to be known almost to the nearest centimetre; and previously the development of new hard and software would have been the remit of big technology companies with large budgets, but thanks to crowdfunding, anyone with the right skills can do it. Meanwhile 5G is about to significantly speed up downloading and uploading times.

A key priority within the NHS England’s Five Year Forward Review is the shift in focus to helping prevent and more effectively manage long term health conditions. It’s here that the opportunity for the IoCT is greatest, particularly in terms of predicting human behaviour and empowering individuals to manage their own health.

Shared responsibility: shared benefits
The rise of self-care, which empowers individuals to manage their own health with the support of healthcare professionals, has an important part to play in enabling the collection of data used by the IoCT. One organisation that is making great strides in this area is Philips, which believes that cloud-based and connected technologies, combined with the use of big and small data, hold the key to improving health outcomes.

“Healthcare is the last industry that still does everything face-to-face but that is going to change as a result of new technologies that allow us to monitor people’s health,” says Jeroen Tas, chief executive of healthcare informatics solutions and services at Philips.

He explains how by using phenotype and genotype modelling – a system of assessing bio- and physio-logical characteristics and traits – along with complex algorithms that are pre-programmed into devices and associated databases, patients can be educated on the changes they need to make to lifestyle and diet. They can also be provided with the tools they need to monitor their health – ranging from smartphone apps that count the steps they walk, to home-based devices, such as blood pressure monitors and insulin readers. In addition, health coaches can be used to provide motivation and cost-effective, on-going support; while prescriptions can be re-ordered and delivered without the need to visit a surgery.

“We can also collect patient data and stream it to a telehealth centre where it is then analysed and compared with the profile of the patient. If any red or amber flags occur, a healthcare professional can then prioritise and dynamically allocate key healthcare resources to where they are needed most,” he says, emphasising how this gives the patient greater control over their own lives and frees up the NHS to concentrate on the most needy and urgent cases, enabling faster diagnosis and more effective clinical decision making.

For example, as part of its digital HealthSuite, Philips has developed a prototype solution that continuously monitors patients with chronic obstructive pulmonary disease (COPD), including while they are at home. The solution collects patient vital signs from a wearable sensor as well as feedback the patient enters directly into a mobile application. This data is tracked and compiled in the Philips HealthSuite digital cloud, which is then monitored by care providers who are able to make adjustments to the care package if needed. Meanwhile, the patient has access to the same data, giving them, their family and carers much greater insight into their condition.

Given that shortness of breath is the third most common emergency call and that COPD results in 24,000 deaths each year, the need is immediate. For a nation that is grappling with how to reduce A&E admission and GP appointments, and to provide cheaper care in the home, being able to better manage just this one condition represents a significant opportunity for greater efficiencies and improved patient outcomes.

It isn’t just individuals who can benefit from the IoCT. The aggregated data can help Healthcare professionals understand population trends and their impact upon service delivery, and it can help hospitals and medical centres manage their in-house technology more effectively. For instance, technical problems with a heart monitor can be tested, diagnosed and even fixed remotely – dramatically reducing time and repair costs – while devices needing supplies, such as helium in an MRI scanner, can be tracked and refuelled before they run out, thus avoiding downtime. Meanwhile, managing all of this via the cloud allows doctors to easily see which machines and teams are in use and where there are gaps in scheduling – helping to reduce waiting lists.

The Secretary of State for Health, Jeremy Hunt, is keen to see the NHS maximise the opportunities self-care and connected health have to offer. He has recently taken steps to bring about the changes needed by announcing that by 2018 all patient records are to be online and accessible from any location by both medical professionals and patients themselves.

“Evidence from all over the world shows that when patients start accessing their medical records then they start to think about their health in a different way. When you have shared access healthcare becomes a shared endeavour,” he said during his speech at the recent NHS Innovation Expo in Manchester, highlighting how this results in better health outcomes for the patient.

Modern 21st century healthcare  has to be fit for purpose, patient-centred and capable of dealing with a population that lives longer but not necessarily healthier lives. And it has to achieve this while finding savings of £30bn by 2020. The Internet of Caring Things looks set to make achieving that goal a whole lot easier. 

This article is part of a thought provoking series on living health brought to you by New Statesman in association with Philips, that looks at how technology, innovation and big data are helping to improve your health and our healthcare system.

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