Imagine your doctor video calling you to diagnose the early signs of an illness and prescribing preventative medicine which avoids a stroke or heart complications. Picture having your healthcare data in an easily accessible portal, providing proactive support and telling you what to look out for and how to maintain your best possible health before medical intervention is necessary. New developments in technology mean that these scenarios are very much in the here and now, providing benefits for doctors and patients alike, and easing the load on our healthcare services globally.
Remote Patient Monitoring (RPM) and Electronic Health Records (EHRs) are the face of these new digital systems that continue to disrupt and improve our healthcare provision. Technology continues to change the way we manage our health and reflect the way we live now; ever-connected, mobile and tech-savvy. Can we really take healthcare out of the hospital and transfer power back to patients? Considering the pace that these systems are becoming mainstream, our current hospital-based provision may be part of our past, not our future.
Just as we now rely on our mobiles for most daily errands from banking to shopping, we can also use mobile technology to gather, store and communicate our health data. Remote Patient Monitoring, or RPM, is an electronic system used to transmit a patient’s vital signs to inform carers and doctors, in real time, of the patient’s wellbeing. Gathering data in itself is useless without the analysis and clinical decision-making element. RPM not only sends data to the clinician, but allows them to instruct and treat the patient, or enable the patient to administer the treatment themselves.
Common examples of these technologies are voice apps that remind diabetes patients to administer insulin and digital blood pressure cuffs that can send blood pressure and pulse information to a patient’s doctor. These systems have already seen huge reductions in hospitalisation; Dartford and Gravesham NHS Trust used a platform to monitor patients after they were discharged from hospital, and took that data to reprioritise home visits and reduce hospital readmissions by 22%.
RPM is a valuable tool for patients and doctors alike; it helps clinicians to treat more patients since they don’t require lengthy one-on-one care, and offers real-time information to help prevent severe illnesses. In the case of the Dartford and Gravesham NHS Trust, the Current device that one patient was wearing detected low levels of oxygen well before any other tests would have picked up on it, meaning the team could intervene with a visit at home and avoid a more serious outcome.
The benefits of RPM and telehealth have long been recognised by the UK. In 2010, the Department of Health conducted a trial to look at the use of telehealth technology across different parts of England, the London Borough of Newnham, Kent and Cornwall. The Whole System Demonstrator programme (WSD) was the largest randomised trial of telehealth in the world at the time, and aimed to show just how cost effective and efficient using technology could be for those suffering with long term illnesses. The key findingsdemonstrated that if used correctly, telehealth could deliver a 15% reduction in A&E visits, a 14% reduction in bed days and a 45% reduction in mortality rates for chronic conditions. In addition, the Department of Health estimated that savings from the widespread use of telecare and telehealth could save the NHS up to £1.2 billion over five years. The estimate was that at least 3 million people with long term conditions and/or social needs could benefit from telecare and telehealth. Hence the birth of the ‘3 million lives’ campaign, an initiative bringing together the NHS, social care and professional partners to achieve the goal of using technology for widespread reduction in mortality.
Alongside RPM, another exciting innovation is the digitisation of health records — Electronic Health Records, or EHRs. This is an electronic system of capturing a patient’s medical records, past and present, and delivering a unified view of all their treatments, diagnoses, immunisations, progress and vital statistics. The EHR automates this view of their care by a specific provider — in the UK this would be the NHS or their private healthcare provider. It has many clear benefits, especially in the UK where it is hard to get a clear and unified view of a patient’s medical data through the many different entities that provide care.
Using an EHR limits medical error and the duplication of tests, and benefits the patient by easily communicating with other areas of their care. For example, your GP could, at a glance, see that you’ve been admitted to hospital recently for a minor surgery, had follow-up medication and that you’re seeing an NHS counsellor for ongoing sessions. These different units that make up the healthcare system in the UK rarely communicate, which often causes delays in care, readmission to hospital or even a doctor or care-giver missing a vital element of a patient’s medical history.
EHRs reduce the risk of error, and more importantly give power back into the hands of the patient. It’s rare that patients ever see their medical history, which leads to lower levels of engagement with the health system and in their own care — with disastrous outcomes. A more transparent, open and responsive system empowers patients to play an active role in their health and promotes patient engagement. In a study at Beth Israel Deaconess Medical Center in Boston, 90% of patients who had access to their notes wanted to have continued access, and the vast majority reported an increased sense of control, understanding and an improved relationship with their doctor.
We’ve already seen a huge increase in the adoption of both of these ways of collecting and delivering data to improve patient health. They form part of the wider concept of ‘Connected care’ which William Morris, MD and Founder at the Clinical Solutions Center at the Cleveland Clinic describes as;
‘Connecting a patient to the right provider, at the right time, at the right place, with the right devices’
Connected care in essence is about ‘joining the dots’ and using data and digital tools to bring patients and care providers closer together for more effective and personalised care. To add to that, having an EHR provides real-time data to patients and doctors and can become an early warning system to prevent illness. When it comes to mainstream adoption, a body like the NHS can more easily implement a system than the US and other countries in Europe where private practitioners have to shoulder the cost of buying and implementation. It’s vital that our healthcare providers acknowledge and start to address the challenges faced by tech innovators and suppliers so patients and doctors can both benefit from these advances.
Delivering truly personalised care isn’t just about monitoring and holding data, it’s about understanding the full picture of the health needs of an individual, and delivering proactive support. With cAir:ID, patient data is all in one place, easily portable so it can go wherever the patient goes, and the wearables and medical devices monitor and collate real-time vital information, giving the ultimate reassurance that it will proactively alert care-givers to any change in condition such as a fall. Using AI to assess patterns in behaviour, movement and vital signs also means that it can also project future illnesses and recommend treatment, keeping all care-givers in the know. The two-way communication built into cAir:ID means that the patient can be easily reassured and checked on, preventing hospitalisation.
Since the NHS currently spends £7 in every £10 of total health and social care expenditure on treating those with long-term illnesses, cAir:ID could be the answer our healthcare system needs. An integrated, accessible system to relieve the burden on hospitals whilst improving patient outcomes, all at the touch of a button. Are we as a nation too wedded to the concept of care out of the home to embrace the solutions offered by new tech?
At Axela, we have a dual aim; to decrease the burden on our healthcare system, and enable patients to have a stake in their own care because we know that engaged, empowered patients taking part in their wellness improves the health of the general population. We have integrated cutting edge monitoring technology and the patient healthcare record with the revolutionary cAir:ID — a RPM and Electronic Health Record in one. Using data gathered from wearables, information submitted by the patient, and their existing medical and care data, the cAir: ID provides a 360 degree view of the patient that is accessible to all clinicians.
Are you a health-tech start-up trying to build a product to be used by the NHS or other health organisation or are looking to deliver enhanced patient care and quality within your services let us know? Would love to hear your thoughts and comments.