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NHS and internet of things: 'The future of care is about the patient taking control' | NHS and internet of things: 'The future of care is about the patient taking control' |
(1 day later) | |
Healthcare is seen as one of the most promising arenas for the internet of things. The potential for doctors and nurses to monitor patients remotely through internet-connected devices could lead to a much more efficient health system – with fewer needless checkups and quicker identification of problems. | Healthcare is seen as one of the most promising arenas for the internet of things. The potential for doctors and nurses to monitor patients remotely through internet-connected devices could lead to a much more efficient health system – with fewer needless checkups and quicker identification of problems. |
NHS England is beginning to experiment, through its NHS Test Bed programme. But it is early days for most healthcare professionals. The NHS has a reputation for introducing new technologies later than other organisations – and there are specific concerns with the internet of things. These include problems integrating data from devices with heavily-secured patient record systems, as well as concerns about overloading professionals with data. | NHS England is beginning to experiment, through its NHS Test Bed programme. But it is early days for most healthcare professionals. The NHS has a reputation for introducing new technologies later than other organisations – and there are specific concerns with the internet of things. These include problems integrating data from devices with heavily-secured patient record systems, as well as concerns about overloading professionals with data. |
Healthcare professionals pioneering such technology say that the key is to manage the data generated by patients. Dr Shahid Ali, a GP in Bradford and professor of digital health at the University of Salford, has run a trial with six of his patients in association with Virgin Media Business, in which devices including weighing scales, blood pressure monitors and fitness devices are linked by Bluetooth to the patient’s mobile phone. This automatically relays data to a VitruCare system used by the practice. | |
Dr Ali says that seeing this data has saved him time, as he can focus on the patients who most need his help. “A lot of GPs have got the idea that technology makes their lives more difficult,” he says. “I wouldn’t use any technology that made my life more difficult. This is about proactive management and exception management.” | Dr Ali says that seeing this data has saved him time, as he can focus on the patients who most need his help. “A lot of GPs have got the idea that technology makes their lives more difficult,” he says. “I wouldn’t use any technology that made my life more difficult. This is about proactive management and exception management.” |
Of the six patients in the initial trial, five had long-term conditions such as diabetes, and one simply wanted to measure fitness. Dr Ali says that there are advantages to patients using a system that integrates with electronic patient records, but adds that he is happy to spend time looking at data collected by patients on other devices. “I have no problem with patients saying ‘I’ve been monitoring my blood sugar’, and sharing the data with me,” he says. “I think the future of care is about the individual taking control.” | Of the six patients in the initial trial, five had long-term conditions such as diabetes, and one simply wanted to measure fitness. Dr Ali says that there are advantages to patients using a system that integrates with electronic patient records, but adds that he is happy to spend time looking at data collected by patients on other devices. “I have no problem with patients saying ‘I’ve been monitoring my blood sugar’, and sharing the data with me,” he says. “I think the future of care is about the individual taking control.” |
Data security requirements can mean that internet-connected devices are not able to provide what would be useful functions. The rheumatology department at King’s College Hospital NHS Foundation Trust has introduced an app produced by Ampersand Mobile to help patients with chronic arthritis, allowing them to provide data in advance of appointments. But Dr James Galloway, a consultant in the department, says the app is not allowed to connect and add this data to the electronic patient record system. | |
“It would save a lot of time, as well as being a lot more efficient. I think there’s an enormous opportunity,” he says. Galloway would like the app to allow patients to cancel or rearrange appointments at the press of a button, but again, security considerations preclude this. | “It would save a lot of time, as well as being a lot more efficient. I think there’s an enormous opportunity,” he says. Galloway would like the app to allow patients to cancel or rearrange appointments at the press of a button, but again, security considerations preclude this. |
There is an exception: when patients first arrive in clinic, they are given an iPad rather than paper for an initial questionnaire. As these are owned by the trust, the iPads are deemed secure enough to add information directly to the electronic patient record. | There is an exception: when patients first arrive in clinic, they are given an iPad rather than paper for an initial questionnaire. As these are owned by the trust, the iPads are deemed secure enough to add information directly to the electronic patient record. |
Croydon Health Services NHS Trust does something similar. Its telehealth team (PDF), which also involves the local council, clinical commissioning group (CCG) and a social enterprise firm, issues medical devices to patients with complex, long-term conditions to take measurements such as temperature, blood pressure, blood oxygen levels and weight, which are relayed back to the trust. There, a team monitors the results, with healthcare professionals alerted by text message if readings move outside ranges they have previously set. | Croydon Health Services NHS Trust does something similar. Its telehealth team (PDF), which also involves the local council, clinical commissioning group (CCG) and a social enterprise firm, issues medical devices to patients with complex, long-term conditions to take measurements such as temperature, blood pressure, blood oxygen levels and weight, which are relayed back to the trust. There, a team monitors the results, with healthcare professionals alerted by text message if readings move outside ranges they have previously set. |
Patricia Robinson, a consultant nurse specialising in long-term health conditions, says this means staff spend less time travelling to patients to take routine measurements. “It absolutely frees you up. This enables you to prioritise individuals with symptoms that require intervention,” she says. “We’re into rituals as healthcare professionals, saying ‘come back in two or four weeks and we’ll check you out’. Telehealth reduces the number of routine reviews required.” | Patricia Robinson, a consultant nurse specialising in long-term health conditions, says this means staff spend less time travelling to patients to take routine measurements. “It absolutely frees you up. This enables you to prioritise individuals with symptoms that require intervention,” she says. “We’re into rituals as healthcare professionals, saying ‘come back in two or four weeks and we’ll check you out’. Telehealth reduces the number of routine reviews required.” |
It also provides reassurance: “Instead of having a nagging doubt, you can see objective data. This applies to the person, too,” says Robinson. “An empowered patient is one who is informed, and knows when to ask for help.” This means she spends more time treating patients who need help, as well as being less likely to miss problems. “It helps you to take a much more targeted approach.” | It also provides reassurance: “Instead of having a nagging doubt, you can see objective data. This applies to the person, too,” says Robinson. “An empowered patient is one who is informed, and knows when to ask for help.” This means she spends more time treating patients who need help, as well as being less likely to miss problems. “It helps you to take a much more targeted approach.” |
This is particularly useful in treating more vulnerable patients. A system used in two of Croydon’s care homes can spot the onset of delirium, which can be particularly distressing for patients living with dementia. “If you can pick up delirium quickly, and treat reversible causes, this avoids an unnecessary emergency admission,” says Robinson. | This is particularly useful in treating more vulnerable patients. A system used in two of Croydon’s care homes can spot the onset of delirium, which can be particularly distressing for patients living with dementia. “If you can pick up delirium quickly, and treat reversible causes, this avoids an unnecessary emergency admission,” says Robinson. |
As for concerns that collecting a lot of data can overwhelm healthcare professionals, Robinson says: “I think professionals can be threatened by it – it is another website to look at, another set of figures.” But by setting alerts, she rarely has to look at the underlying data. If there are too many alerts that are not clinically significant, they can adjust the parameters. | As for concerns that collecting a lot of data can overwhelm healthcare professionals, Robinson says: “I think professionals can be threatened by it – it is another website to look at, another set of figures.” But by setting alerts, she rarely has to look at the underlying data. If there are too many alerts that are not clinically significant, they can adjust the parameters. |
“It’s like anything new. There is a learning curve for professionals. But for me it’s a no-brainer,” she adds. | “It’s like anything new. There is a learning curve for professionals. But for me it’s a no-brainer,” she adds. |
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