FOCUS ZONE REPORT – There are already 17.5million people living with chronic conditions in the UK and the Department of Health suggest that by 2030, incidences of chronic disease in the over 65s will more than double.
Estimates show that over the next 50 years the number of people in the UK aged over 65 will rise from 9.3 million to 16.8 million. Healthcare expenditure in Europe is already running at 8.5 percent of GDP on average and rising faster than the economic growth itself. These figures highlight that there is a need to change the way healthcare is delivered and the way medical knowledge is managed and transferred to clinical practice. The huge volume of information that needs managing means that ICT is key to implementing these changes. In the UK, the provision of healthcare outside of the acute hospital sector is a major priority for the NHS. The health economic case for developing remote diagnostics is well documented. Patients with long-term conditions account for 50 per cent of GP consultations and 75 per cent of time spent in a hospital bed. This has significant human and economic costs. The UK’s increasingly ageing population and the people living with chronic conditions are placing growing pressure on the NHS and society and require new intelligent health strategies to address the future challenges. The challenges embrace new developments in technology, sustainability and healthcare. Certain projects have been created to showcase how these developments can work together to provide an answer. A good example of what can be achieved can be seen at a traditional Victorian terraced house located in the heart of the UK at West Bromwich in the West Midlands. The i-House has been refurbished to illustrate how sustainable, assisted living is already possible in real housing situations. The i-House was created with the aim of setting the standard for the rest of the UK. Medilink West Midlands brought together Midlands-based manufacturers, West Bromwich Building Society, Sandwell PCT, Urban Living, Ergonova, Black Country Housing and Advantage West Midlands to create the i-House, the home of smart technologies, part of the i-Health initiative which is run by MedilinkWM is funded by Advantage West Midlands. The initiative was set up to showcase the capabilities of West Midland industry to address the growing needs of an aging population. During 2008 the i-Health initiative completed two assisted living technology demonstrators. Against this backdrop, a YouGov survey was commissioned by i-Health in June 2007, which revealed that 87 per cent of people said they wanted to remain in their own home after retirement, with less than 1 per cent wanting to live in a care home. With this clear public backing for assisted living, the i-House showcases technology for monitoring and accessibility, as well as memory aids and safety devices that are vital to enable people to stay independent. The West Midlands is fast becoming a ‘centre of excellence’ through the ground-breaking efforts of MedilinkWM’s i-Health initiative, which focuses on promoting the role of partnership, best practice and modern technology to support independent living. i-Health enables designers, manufacturers and health specialists to work together to produce cost effective and user-friendly solutions to the looming crisis of the UK’s ageing population. From the outside the i-House looks like a normal terraced house but inside it has been adapted to allow easy access for all, as well as being cost and energy efficient. Taking a tour of the building highlights a number of ways in which patients of the future can benefit from Telehealth technology. The entrance to the i-House is at the side of the building, allowing level access into the back yard. The gate boasts a number of features, including keyless entry and a video intercom linked to the TV so residents can see and hear guests before opening the automatic gate. The path has been widened for easy access and an energy efficient air source heat pump is in the yard, replacing a traditional gas boiler and drastically reducing heating costs. The path leads to the conservatory, where there is level entry with a fingerprint reader to unlock and log entry and exit. The access device enables non-resident carers to monitor frequency and length of visits to the house, providing peace of mind. The conservatory leads to the kitchen, which includes eco-friendly one-touch taps that fill to pre-set levels and to comfortable temperatures as well as a rise and fall sink so wheelchair users and the rest of the family can use it easily. All domestic appliances are connected to a fingerprint reader, which activates the hob, oven, microwave and kettle individually, so occupants only have access to items they can manage safely. A flood detector is also fitted, which shuts off the water supply and alerts the occupant or carer. The main computer hub, the i-Cue system, is the main brain for the house. The system controls the heating, windows and entry systems, monitors activity in the house and provides voice messages that inform residents of updates to conditions. In the living room, cabling runs around the room underneath easy to access panelling and trunking, to allow users to add and move sockets and plugs around the room with ease. It is a classic ‘future proofing’ technique. This is combined with an infrared unit in the ceiling that responds to all remote control appliances including the TV, lighting and audio systems. The result is that a resident can control their entire environment with one remote control or mobile phone. The lounge leads on to the dining room, which features a range of telemedicine units that measure all vital signs including blood pressure and heart rate. The stairs are fitted with a stair lift which bends around corners and fits snugly against the wall, ensuring residents can still use the stairs despite limited space. In the first bedroom, the through floor lift provides easy access, while the room is fitted with a panic button, ‘future proof’ cable panelling and trunking, accessible wall lights and the window and the heating controls are linked, ensuring that energy is saved by closing the window automatically when the heating switches on. In the second bedroom, which houses an adjustable bed, a bi-fold door opens onto the en-suite, maximising access for wheelchair users. The i-House, which illustrates the potential for integrated building intelligence support care in the home, is configured to respond to the changing needs of residents and has been designed to support individuals with long term conditions and a wider range of disabilities. Another example of how Telehealth technology will be used by future generations is on show in the North Staffordshire based i-Flat demonstrator which illustrates the full range of ‘plug and play’ Telemedicine, Telecare, Environmental control and occupancy monitoring systems available. For example, the i-Flat features a Tunstall Lifeline Telecare system which links the flat directly to a call centre and features two systems for monitoring personal health by collecting essential health data including ECG, blood gas, lung function and body mass. The system can be used by the patient on a daily basis to collect data on his or her health. The information is sent via mobile phone or internet connection to a supporting clinician. The two systems typify the dual direction the market is heading in; one utilises wearable devices providing connectivity using mobile phones and the other is a dedicated home based unit using a standard broadband connection. At the i-House, new Near Field Communication technology allows a user to merely touch their phone against an electronic tag to initiate a task or receive information. A tag has been placed at the entrance of the i-House. When this tag is touched with a NFC mobile phone it sends information in real time to let someone know that a carer has arrived at the home. The technology from Birmingham-based Sero Solutions ensures timely visits are made to people in need by care workers and simultaneously makes a record of their visit. Tags have also been integrated into medicine bottles. This allows a user to touch a medicine bottle with their mobile phone, to generate a request for a repeat prescription, which is sent to their GP. Smart Pictures have been integrated in the i-House, where pictures of friends and family are tagged. Once a user touches the picture with their mobile phone, a ‘Call Me’ request is sent to the relative via SMS, or call centre agent. The Heart of Birmingham Teaching Primary Care Trust is also utilising telecommunications to assess the public’s awareness of their own health needs and requirements as well as investing in a self-help web portal. In the i-House the Halliday James i-Cue system provides the central control hub for the i-House and provides home security, occupancy monitoring, automatic fall detection, panic button response, keyless entry / appliance control, automated lighting and remote control of the house using web and SMS control. By engaging with the demonstrator this company has been able to test and evaluate the i-Cue system in a realistic setting and explore collaboration with other suppliers. The company behind i-Cue have also worked with TECHNIK2, an SME specialising in home automation. TECHNIK2 were able to develop a range of hardware solutions in collaboration with i-Cue. This has fast tracked a number of innovations including keyless entry using finger print readers and a highly innovative device enabling users to ‘Log in’ to the kitchen. The device limits access to kitchen appliances, in particular for users with dementia. Other companies have also benefited from collaboration. Sero Solutions, a Birmingham based RFID technology company visited the i-House in late 2008. They quickly realised a number a health related applications for their technology. Sero Solutions have developed a mobile phone based application for reading RFID tags. After visiting the i-House they were able to quickly set up a number of scenarios using the RFID tags positioned in the house to log the entry and exit of care staff, invoke SMS control of the house (via i-Cue) by touching the phone on tags containing commands, for example to open the door. They also realised they could use the technology to log when a person takes medication and even as a system to re order prescriptions. These collaborations are supported by feedback provided by end users engaged in on going evaluation of the technology. The SME’s involved in this project are able to quickly respond to the feedback provided by end users. This is a critical part of the project and helps to ensure products are ‘Fit for Purpose’ and can be operated easily by the end user. This is a major theme for the i-Health led Assisted Living Innovation Platform project (ALIP). This was funded by the TSB in 2008 and provides £532,000 worth of R and D funding to support user focussed product development. This is supported by an EPSRC grant to the academic partner (Coventry University) of £225,000 to support end user engagement and product evaluation. This programme will establish an industry focussed set of models for engaging users in the product development process. i-Health is also a partner on the Building Research Establishment (BRE) led Home Hub, this is in partnership with, amongst others Cisco, Osbornes, Microsoft, RIBA and NXT Semiconductors. MedilinkWM has been working with BRE on the application of a selection of technologies from the i-House within their own technology demonstrator on the BRE Innovation Park. Subject to funding this will be a very positive step for the West Midlands suppliers involved in the i-House. This will give greater visibility of the technology to the construction sector. Moving forward i-Health is working closely with the West Midlands Strategic health Authority. This involves strategic input onto the SHA plans for the roll out of Telehealth technologies across the region. An important step for the project and its industry collaborators the close relationship provides access to key people in health and social care procurement and an opportunity to showcase the capabilities of regional industry. i-Health is also actively involved in the Health Technologies KTN, activities include leading on the Assisted Living SIG and developing a UK Directory of Assisted Living organisations to facilitate quicker partner searching. The i-Health initiative aims to build on the success of its first phase by focusing on roll out opportunities and procurement, continuing to raise awareness and facilitating more industrial and knowledge base collaborations. The demonstrator model has proven to be successful, primarily by providing a base for industrial collaboration which is capable of fast tracking product development. The demonstrators help to ensure various industrial partners are well placed to compete in this emerging market. |
