One of the areas in which technology is making the greatest difference to healthcare is in the provision of services beyond the hospital and surgery, right inside citizens’ homes. “Citizens” is the correct word to use – because telecare is helping individuals and their families not only to manage conditions in the more comfortable environment of the home, but also to take responsibility for their health and wellbeing long before something goes wrong and they become “patients”.
Mike Telford, Medical Business Manager - Telehealth Europe, of device manufacturers A&D says “Earlier advances in telehealth focused on providing comfort and care for the chronically sick in the home, but we see ‘wellness’ as coming ahead of ‘independent living’ – it’s for people in their 20s, 30s and 40s, not just the elderly.”
The tools to take healthcare into the home
A chain of independently developed but symbiotic technologies has come together to create the perfect environment for home care devices. There has been no shortage of computer equipment and connected devices in the primary and secondary care environment for some decades (even though some of it may be archaic); the challenge has always been to extend beyond the perimeter and into the home.
The internet has allowed data transfer and general connectivity to become a reality. Then, several companies have made medical devices both user-friendly enough to deploy and use on a daily basis, and portable and reliable enough to fit into the relative chaos of the home environment.
The last remaining issue has been the way in which these devices were connected in any meaningful way. That includes:
- The complication of connecting to a PC – particularly for less tech-savvy consumers
- And how to store data securely and then share or use it in a way which will affect outcomes; after all, a one-way repository is of no clinical or wellbeing benefit.
Connection to a PC has been possible for many years, but even the most advanced protocols so far – wi-fi and Bluetooth – have both required complex, unreliable, and sometimes fairly Heath-Robinson efforts to work properly. They have not been reliable enough for consumers to be left (literally) to their own devices to set up and get healthy. In the words of Arif Govani, Director, HealthVault, Microsoft UK, “We need to make it easy for ordinary citizens to use devices. The Nirvana of devices is that you obtain a device to help monitor, for example, your blood pressure; and after an initial consultation you go home and use it with no further intervention, whether from a salesperson or a healthcare professional. Innovation in healthcare is about ‘hiding the technology’.”
A&D is in the vanguard of companies augmenting their medical devices with a new technology called NFC (Near Field Communication), which allows devices to communicate automatically when within a few millimetres of each other. NFC has been a staple in Japan for a couple of years, and is now becoming prevalent in the UK, thanks to the efforts of finance companies (Barclaycard’s PayTag is NFC), travel systems (London’s Oyster Card is NFC-enabled) and several mobile phone manufacturers (the Samsung Galaxy S3, several next-generation Windows 8 Phones), who are beginning to include NFC support in their handsets. You might even have seen Steve Redgrave on TV paying for his lunch at the Olympic Park using an NFC-powered card.
NFC truly removes the technology from home medical devices. David Morris, UK Sales Manager, A&D Medical says “With NFC, there’s no wires, no pin number or password, you can simply hold your device next to your mobile phone and everything else happens automatically.”
In fact, there’s no PC either. Mobile phones are massively more prevalent than computers in key healthcare user groups (the elderly, lower social demographics). With devices able to connect and upload over the air through a handset with which the user is both familiar and comfortable, home healthcare can finally be truly democratised. A&D currently produce an NFC-enabled blood pressure monitor, weighing scales and an activity monitor. On the horizon are thermometry, further scale products (e.g. BMI/body composition) and glucometry.
All of these are direct-to-consumer devices which will be on sale in the high street and at prices which are favourably comparable in price to equivalent non-NFC devices. Morris says, “Usage is completely user-friendly. Unlike a PC, you don’t even have to open a program. Simply hold your phone next to the device and the App (available free) will open and automatically upload the data over the air.” Incidentally, for those without an NFC-enabled phone (the technology is expected to become ubiquitous in the next 12-24 months), A&D will also be offering a Sony NFC “dongle” which will replicate the NFC experience to a PC.
Share and Compare
Where does the data go? The second challenge we noted above was the secure storage and use of data. A&D has engaged in a groundbreaking partnership with Microsoft to integrate its devices and App with Microsoft HealthVault, the company’s consumer health information repository.
Again, integration is natural and easy. Telford says, “Using the App, there’s a one-time logon to HealthVault, and that’s it- the App does the rest automatically.”
HealthVault allows consumers to easily and securely store an unlimited range of personal healthcare data, either to refer to later, to use with other apps and devices, to share with their medical professionals, or to share more widely– using carefully controllable permissions - with family and friends. Morris says, “We know, for example, that it’s easier to lose weight when you go on a programme with a group of other people. By linking our weighing scales with HealthVault, we empower consumers to share and compare their weight loss performance with their peers. It means goals can be ‘socialised’ and members of groups can offer each other mutual encouragement.”
Microsoft’s Govani says, “In the US, we already have over 80 third-party devices connecting via a PC; so we are already experts in managing personal medical data. But we need to look ahead. We have invested to provide a platform for innovation, and A&D have invested in NFC to drive take-up of hardware. In being our first HealthVault partner with this technology, they are unlocking telemedicine to the mainstream. We have no doubt that this will drive down the cost of telehealth whilst making it more relevant to a wider community of citizens.”
Adds Telford, “HealthVault is a fantastic package for device developers – it’s free, it’s easy to integrate, and it’s something we’re proud to be a part of. As consumers, occupational health specialists and private insurers take an ever greater interest in wellbeing and individual health, partnerships like this between device and software specialists hold the key to simple, manageable personal healthcare.”