Analysis

Use of new technology to help patients receive care at home

Innovative technology is being piloted in the NHS to help older people receive more care at home and keep them out of hospital

Picture credit: Justin Slee

Innovative technology is being piloted in the NHS to help older people receive more care at home and keep them out of hospital.

The first wave of seven pilot schemes to deliver more home-based care to older people, and those with long-term health conditions and mental health problems, was launched across England in January.

According to NHS England, front line staff involved in the NHS innovation pilots will pioneer and evaluate the use of devices, such as wearable monitors, data analysis and new ways of working that will help patients monitor their own conditions.

Unnecessary admissions

The pilots are intended to reduce unnecessary admissions to hospitals and care homes, and some could reduce the number of visits from community nurses to patients’ homes.

NHS England chief executive Simon Stevens says that the programme ‘aims to cut through the hype and test the practical benefits for patients’.

Announcing the NHS pilots, he said: ‘Over the next decade, major health gains won’t just come from a few “miracle cures”, but also from combining diverse breakthroughs in fields such as biosensors, medtech and drug discovery, mobile communications, and artificial intelligence computing.’

Adopt and adapt

Successful innovations will then be available for other parts of the country to adopt and adapt to the particular needs of their local populations.

The pilots bring together local NHS trusts, universities, clinical commissioning groups, social care providers, technology companies and many other organisations to deliver care as part of the NHS Five Year Forward View.

Those intended specifically for older people include a two-year project in Lancashire to reduce admissions among older, frail patients who have dementia and other long-term conditions. Run by the Lancashire and Cumbria Innovation Alliance, it will involve telehealth combined with improved patient education.

Range of technologies

Lancashire Care NHS Foundation Trust chief executive Heather Tierney-Moore, who is a nurse, says that a range of different technologies will be used to see what patients and staff find easy and helpful. She says that equipment such as tablets and web cameras connected to televisions will be used with around 150 patients, who could provide details such as weight, respiratory rate and blood pressure on a regular basis for healthcare staff to analyse.

Nurses in the community could see caseloads alter as technology helps keep patients out of hospital, Professor Tierney-Moore says. In addition, specialist nurses in hospitals could be consulted more often by primary and community colleagues on how to provide care to their patients.

She said that the project would be a success ‘if patients find it helpful and acceptable as a means of support, and if they remain in their homes longer and without frequent trips to hospital, GP and clinics. But the prime factor is improving quality of life’.

Preventing isolation

One difficulty could be that patients often like visits from community nursing staff because they are lonely. ‘It is about finding local community and voluntary support so that people do not become isolated, and using people’s skills and expert resources in a cost-effective and appropriate manner,’ she says.

Surrey and Borders Partnership NHS Foundation Trust will lead on a project to improve care for patients with dementia. A range of different technologies will be tested in homes to see how they support health and social care staff to monitor a patient’s wellbeing remotely. Those under consideration include a virtual personal assistant that can provide individual medical advice, and a product that can learn a person’s routine and detect deviations from it.

Consultant psychiatrist Ramin Nilforooshan said that the team would build a test flat to decide which types of technology could be useful. It would then try out the selected solutions in the homes of a few people with dementia before implementing them in about 300 homes.

Easy to operate

Community nurses will be involved in selecting the technology used, Dr Nilforooshan says. Researchers will seek devices that people with dementia find easy to operate. One option could be a tablet that allows patients to speak directly and simply to their local nurses.

‘The reason we are moving in this direction is to find out how we can help patients stay in their homes,’ he says. ‘If carers can get a couple of hours on their own when they are not worried about their relatives, it is a bonus. This is welcomed by most community nurses, who spend half their time travelling.’

Older people in north east London are set to benefit from a pilot scheme to promote healthy ageing. This will include an online tool for those with dementia, a social network app that offers safe peer-to-peer support online and a device which assesses falls risk and mobility.

Funding

The £1.7 million of funding received by the Care City project will be spent on innovations such as a mobile heart monitor for individuals to detect, monitor and manage their heart conditions.

The monitor can provide instant feedback and improve diagnostic pathways, particularly for those with undiagnosed palpitations. Meanwhile a monitoring and notification system, called Canary, will allow family members of older people to see via mobiles, tablets or laptops any movements, temperature changes and visitors’ attendances at the older people’s homes.

According to RCN policy adviser Mark Platt, previous research suggests nurses are open to using more technology, but that the equipment they are provided with rarely works well or has been developed without the input of clinicians.

‘We like people being supported to look for improvements in how they deliver services and we welcome opportunities for staff to be involved,’ he says. ‘As long as the people providing care are involved in deciding and designing the kit, it is potentially supportive.’

Erin Dean is a freelance health writer

 

 

 

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