Health and Social Care Future Information technologies changing

health and social care: overview and examples of trends

Ray Jones

Wednesday 8/1/14

The Emailer was a landline phone that allowed you to send email from a keyboard built into the handset. The Emailer arrived in 2000. It cost £80 to buy and exorbitant usage costs could add up to £150 to your monthly phone bill.

Amserve, the subsidiary of Amstrad set up to deal with the Emailer, posted multi-million-pound loss after multi-million-pound loss. No-one bought them, despite Sugar's massive publicity drive.

What happened? People took to home broadband and real email, mobiles and text, and then smart phone email/text.

7 trends information technologies

• Electronic records, decision support

• Mobile

• Patient-led and social media

• Sensors, telehealth, telecare

• Wearable technology

• Big Data

• Robots

Electronic medical records (EMRs) have been

a long time coming

History

1960s

First hospital admin systems, first GP systems

1970s

Patient administration systems; departmental clinical systems (eg diabetes); imaging systems

1980s

Micros for GPs scheme, GP computing ‘takes off’

Departmental systems, decision support continue to develop

Biggest civil computing project Bit off more than they could chew

1998 NHS Executive commits to detailed EHR 2002 National Programme for IT for England starts 2003 10-year contracts awarded 6-7 consortia 2005 NHS Connecting for Health set up to deliver Programme 2006 Some companies drop out 2007 Reconfigure 2008 Some contracts terminated 2009 More renegotiations and changes 2010 New government 2011 Change from replace all to connect all Meanwhile most GPs now have virtually paperless practice

Where next for EMRs?

• Interoperability

• GP-centred

Influenced by other trends

• Mobile

• Patient-led

• Sensors

• Big-data

Mobile

• 80% of UK to have smart phone by 2020

Patient-led and social media

Diabetes App Challenge apps developed BY young people with

diabetes FOR young people with diabetes

• UK wide competition for YPD (aged 16-25) & teammates to design and develop an ‘app’ (either website or Smartphone app)

• Apps to help others prepare for and set the agenda of clinic appointments

• 6 apps were created by 6 YPD and 8 teammates

• Tested by 83 YPD

‘Stakeholders online’ project

Experiments in getting service users and professionals online to discuss future e-health services

Sensors and alarms

There are all sorts of sensors and alarms already available which may reassure the carer about their family member.

Next is a clip from a commercial video from a company called Tunstall. I am just using their video to illustrate the types of devices already available.

Sensors and alarms

Telehealth

Telehealth research at Plymouth University

Professor Ifeachor, Dr Kamel Boulos, Dr Carroll and colleagues at the University are working with other European universities on the LiveWell project. This aims to develop a Web-based Training and Social Networking System for: • Parkinson’s disease patients: to

help them self-manage their condition, reduce the burden on their caregivers, and promote their well-being and social inclusion.

• Caregivers: to help them with

access to relevant information, training and greater support through an online community.

• Healthcare professionals: to enable them to remotely monitor patients’ participation in various activities and communicate with patients online, thus helping improve patients’ effective rehabilitation.

Wearable technology eg1 - eCAALYX project

• eCAALYX Enhanced Complete Ambient Assisted Living Experiment, EU-funded project for older people with multiple chronic conditions

• Android smartphone app receives input from smart garment with wireless health sensors and the GPS in phone

• Communicates over Internet with remote server accessible by healthcare professionals in charge of remote monitoring

Wearable technology eg2 – various off the shelf fitness

bands and watches

‘Big Data’

• Patient collected data (mobiles, sensors) – Out of interest do you record some health data (BP, BG,

weight…) on a regular basis? – PINK yes, GREEN no.

• Genomics • Data stored has doubled every 40 months since

1980s • Now increasing even more.. ‘big data’ is difficult to

work most desktop packages - instead may use parallel software running on tens or hundreds of servers.

Robotics research at Plymouth University

Plymouth University is a centre of excellence in robotics research.

Guido Bugmann robot football Tony Belpaeme: ALIZ-E teaching kids about diabetes

Angelo Cangelosi RobotDoc and Robot-ERA

Frank and the robot

Giraff telepresence robot being used by geriatrician to contact elderly patient in her own home

Five telepresence robots. From left: Giraff £4000, Double Robotics £2600, Vgo £5000, TILR £10,000, Qb £15,000

RP-VITA telepresence robot used by remote doctor to advise nurse at bedside in American hospital (left) and County Down (right) (cost £200,000)

Telepresence

Telepresence – virtual visitors

Giraff has been tried out in Italy, Spain, Sweden, Australia, and are now being tried in the Western Isles of Scotland.

Do you Skype (or Facetime) (say) once a month?

• Wave green for yes

• Wave pink for no

Problems of technology development

• Does it improve health, wellbeing, quality of life?

• How should we educate and implement?

• What about equity?

This is a rolling presentation taking 10 minutes in total. It will start at the

beginning again in

E-health inequalities Healthpoint: public access touch screen ‘kiosk’ with health information (Late 80s -early 90s)

NHS supply side e-health inequalities

• (2011) 94% of GP practices in Harrogate Vs 35% in Southend have a GP website. (Plymouth 78%)

• (2009) Kirkwall had 35 times the number of people using Living Life to the Full (per 100,000) than Wigan

E-health

inequalities: lack of

awareness

Pilot cluster

randomised

controlled trial

comparing Google

Ads with website

links to raise

awareness of online

CBT for depression

Simpler and cheaper ways of giving video contact with the family

If the person can be shown how to use a tablet computer they could Skype. We are working with and evaluating Plymouth SeniorNet

Simpler and cheaper ways of giving video contact with the family

‘Skype on Wheels’

We are developing a simple method, of making Skype available and easy to use for residents in care homes and patients in community hospitals.

Families would Skype and a care assistant or nurse would wheel the tablet computer to the resident or patient. They would not need any expertise in using computers, but would be able to see and speak to their family member.

Left: original vaguely human shaped device suggested to care homes and community hospitals (rejected) and (middle and right) two first prototypes designed by students of 3D

Prototypes adjustable for use at different heights, in bed, seated, armchair, different size people.

What do you think of the idea of having Skype on Wheels available in

care homes and community hospitals, so that families can ‘Skype’ in and see

their relative?

Seems like a good idea (wave pink)

Can’t see it working (wave green)

Conclusion 7 trends information technologies

• Electronic records, decision support

• Mobile

• Patient-led and social media

• Sensors, telehealth, telecare

• Wearable technology

• Big Data

• Robots

End of the conference today

Reminders

• Free interdisciplinary workshop Wed 12th Feb – please email ray.jones@plymouth.ac.uk

• One day conference: Health and Social Care Futures 2 Wed March 26th - £20 on estore.