Two of the leading NHS innovation testbed projects talked through their experiences at the Internet of Healthcare conference in London yesterday, although concerns were raised on IoT and Big Data.
In a panel session moderated by Nicholas Robinson, vice president, Royal Society of Medicine Telemedicine & eHealth Council, the Lancashire and Cumbria Innovation Alliance and the Heartlands Hospital in Birmingham detailed how they are using technology, such as VoIP, sensors, mobile apps and predictive analytics, to improve patient care and operational efficiency.
This forms part of NHS England’s seven new testbeds, which Internet of Business reported on in January of this year. Two of the seven testbeds are IoT-focused and part of IoTUK, the UK government’s £40 million three-year program which is looking to drive IoT innovation in the region.
The key message throughout the panel was about patient empowerment, and changing clinicians’ approach to innovation (even if the testbed in question is not necessarily successful) – although data management was cited as a potential barrier to IoT adoption in the NHS in the coming years.
Lancashire using TVs and VoIP for remote care
Glyn Jones, innovation programme manager for the Long Term Conditions Early Intervention Programme at the Lancashire and Cumbria Innovation Alliance, discussed how his trust has developed a program to monitor 1,600 patients with chronic conditions like COPD (chronic obstructive pulmonary disease), atrial fibrillation or diabetes.
These patients are split them into four separate cohorts, with three based on their level of risk of hospital admission, and the fourth cohort consisting of dementia patients.
Jones explained that this fourth cohort has been given a Motiva VoIP hub which connects to their TV, enabling them to see their own health on screen. Data is then transmitted automatically back to the clinicians.
After applying to take part in the testbed, the group spent six months negotiating with suppliers and today works with seven commercial companies, including Philips.
There will be an evaluation of the testbed two years after its start date, although Jones was keen to stress that its findings — and subsequent action plan — “won’t be a prescription for everywhere in England.”
Birmingham hospital leverages analytics to help the elderly
Professor George Tadros of Heartlands Hospital addressed how technology is being used to tackle the mental health and dementia in the region.
The hospital’s testbed — the RAIDPlus Integrated Mental Health Urgent Care — is designed to offer more proactive support and intervention for people in Birmingham and Solihull with mental health problems.
He believes that newer technologies, including the Internet of Things, offer clinicians the benefit of getting early insight into patient behavior, adherence or need for medical care. This value could already help in provisioning beds.
“All the technology today tells me how many beds I have at this moment in time…and most of the time the answer is none,” he said. “We need technology to predict the beds available over the next period of time.”
Interestingly, for the RAIDPlus Integrated Mental Health Urgent Care Test Bed, Tadros’ team is working with Accenture on predictive analytics tools which can predict when patients are about to fall into mental health ‘crisis’.
The NHS hospital also has access to the software portal, Patient Knows Best, for patients to enter their medical details at their own leisure on laptop, tablets or mobile phones. On receiving this patient data, the hospital is then able to introduce a crisis and intervention plan based on data points relating to their mood, sleep, clinical condition or compliance to medicine.
Tadros adds that this lets him know not only “what is happening in the city but I can also predict what is going to happen.”
AI can solve The Big (Data) Issue for NHS
Technological innovation like this, however, is not without its complications or criticisms. In the first morning of this Internet of Healthcare conference, culture, data privacy, and security were mentioned as potential barriers to adopting IoT. Then, there is also the question of building the technology around the clinical pathways that have been established for decades.
Arguably the biggest issue to arise in the panel though was on the issue of data management, with attendees concerned of the accumulation, management, and analysis of this ‘Big Data’. Is this done on-site, or by a third-party partner? Who analyzes the data to make it into something tangible? Does it need to be sent to a data center or a cloud provider for storage and analysis?
Tadros believes that this ‘data fuzziness’ — where it is not necessarily clear how the data can be used to offer value to the organization — can be cleared up by Artificial intelligence, with platforms like IBM’s Watson advising clinicians and other healthcare providers on patterns of behavior. He says, too, that this withdraws the human role, an importance with so many data-driven decisions still reliant on human inclinations or feelings.
One NHS clinician in attendance interestingly added on the data issue: “The big problem is that data accumulation has been divorced from the process of clinical care – it’s done by other people at another time point.”
“By the time it is available in any sort of form, and it becomes anything approaching knowledge, it is too late.” This importance around real-time data was also earlier highlighted by citizen health hacker Tim Omer, who reverse engineered his CGM to connect with his Android smartwatch.
Yet Tadros ultimately believes that IoT may take us to a time where the data can be collected and processed in real-time, while still adhering to clinical care timelines. He said that hospitals must look to upskill staff, patients and other stakeholders on the technology if these benefits are truly to be realized.