From IT to independent living – how to make telehealth & telecare catalyse improved care

1. From IT to independent living – how to make telehealth & telecare catalyse improved care Charles Lowe Charles Lowe Consulting Ltd. charles.lowe@btinternet.com 07860 619424

2. DH definitions • Telecare – service user to responder: environmental monitoring • Telehealth – patient to clinician: vital signs monitoring • Telemedicine – clinician to clinician: seeking expert advice • eHealth – all the above

3. The differences

4. What works best

5. Why X

6. What’s the problem? 20-60 • Fewer professionals • More LTCs • Raised expectations 75+

7. Or to look at it another way Denmark All EU UK

8. Will remote monitoring work?

9. The vision – Mrs Smith, a COPD sufferer in 2018 4 The home hub collects and aggregates information from the connected applications such as the spirometer and home sensors Mrs Smith accesses her medical records and interactive health information through her home hub The home sensors detect Mrs Smith’s movements around the home and send an alarm to her family if there is not sufficient movement Mrs Smith wears an alarm in case she falls. If she needs assistance, she can sound the alarm to contact a member of her family The home sensors detect when Mrs Smith is sitting for too long a period of time. An alarm is sounded if she sits for too long a period in winter to encourage her to move around to keep warm Mrs Smith’s smart medication dispenser reminds her to take her medication by sounding an alarm. If Mrs Smith fails to take her medication, her family are notified If Mrs Smith has an infection, she can provide a sputum sample to be analysed by her home diagnostics kit. This detects the presence of bacteria and sends the results to her doctor from her home hub Mrs Smith provides regular spirometer readings to her nurse which are sent from her homehub Source: Fathom Partners, Health Technology Futures, Kings Fund event

10. Remote monitoring works…BUT:

11. …with the result that… inappropriate X

12. Depression

13. Dementia prevalence “Individuals with high mental stimulation had a 46 percent decreased risk of dementia” Michael Valenzuela, Univ. New South Wales http://www.msnbc.msn.com/id/11025839/ Source: Alzheimer’s Disease International www.alz.co.uk

15. Before process change

16. After

17. Time with Clinician in 3 months

18. Time when remote monitoring in 3 months

19. But there are lots of players involved

20. Is this your health service?

21. Or this?

22. How can technology help... Reduce admin, POCT, self service • Release time to care • Catch disasters early at home & away • Reduce anxiety • Anticipate medical exacerbations • Improve disease management • Promote self-care • Eliminate unwanted human contact • Turn rush into quality time • Help people to help each other • Informate Falls, seizures Resulting in: Improved outcomes Secondary -> primary care Lower costs Discoveries Oxygen sats, help at hand, GAD7 CHD, COPD Medication compliance, new linkages Expert patient, mental stimulation Esp for learning disabilities Part of working completely differently One way of providing human contact Discover new linkages

23. Challenges

24. Trials

25. Not what you expect? • Mobile phones • Cognac • Tanks • ARPAnet • Cars • Stereo sound • Gunpowder • Remote monitoring More patients Less travel Continuous vs episodic care 24x7x365 Autonomous Decision support Behaviour change Self-management Informating

26. Management Council SMG PCT Board GP Forum PEC CEC LMC Adult Services Board Programme Board Project Boards

27. Leadership

29. Thank You Charles Lowe Charles Lowe Consulting Ltd. charles.lowe@btinternet.com 07860 619424