Recent years have seen an explosion in the field of health apps, wearable devices and sensors monitoring many aspects of health and fitness. These range in their capabilities from simply counting steps and calories to tracking indicators including blood pressure, alcoholic units, recovery from surgery or glucose levels in the blood.
With an ageing population and the rise in multiple chronic conditions, demands on the health and social care system are increasing. Improving prevention and empowering patients to manage their own health can be successful strategies to eventually reduce financial pressures and improve patient outcomes.
With some caution and appropriate patient safety checks, sensors and devices connected through the Internet of Things (IoT) can be great tools to deliver enhanced prevention, early diagnosis and the self-management of chronic conditions.
But how far can sensors and wearables really take us in delivering such goals?
Examples of pilots successfully using sensors and devices to support patient care are multiplying across the country. Some local councils are piloting the use of ambient sensors attached to home appliances to support older people stay independent for longer, by monitoring activity and alerting carers or social care professionals when necessary.
In Surrey, a partnership between the NHS, academia, and third and private sector, has gone one step further by creating an IoT technology system that monitors the health of people with dementia who live at home. Here, a network of digital devices collects physiological and environmental data, while a machine learning algorithm analyses possible changes in health and behaviour, and alerts health and social care professionals when risks arise. The first trial showed improvements in the physical and mental health of patients and carers, and the system will soon be piloted in other areas of the country.
Elsewhere in England connected devices have been used to support patients with chronic conditions—such as diabetes, chronic obstructive pulmonary disease (COPD) or heart failure—to monitor their vital signs at home. Values such as blood pressure, oxygen levels or body weight are collected and monitored remotely by health professionals, who can provide support and train patients to manage their conditions. The pilot in Liverpool resulted in patient-reported improved general health, and fewer GP visits and hospital admissions.
If rolled out, the use of some of these devices has the potential to deliver significant savings in terms of reduced doctor’s appointments, medical interventions and hospital admissions. But the real change will be in the next generation of ‘intelligent’ devices. These can not only monitor health parameters, but are also able to react accordingly. Smart insulin is one of the best examples, given its possible revolutionary effect on the lives of an increasing number of diabetic patients. Although research is still in its infancy, glucose responsive insulin devices could—if successful—be able to detect glucose fluctuations in the blood and automatically administer the right amount of insulin, sparing patients’ hypo- and hyperglycaemia, but also daily injections.
Yet, where the greatest gains are to be had is perhaps in the ability to connect the data gathered by all these technologies and share it across the healthcare system. This could help create an real-time clinical profile of each individual, but also build large anonymised datasets that can be used for population health management.
So, going back to the question of how far monitoring devices can take us. Well, it seems the answer is that sensors and wearables can take us quite far, and the proof of concept is already out there, with potentially enormous benefits for the health of individuals and the sustainability of the healthcare system. What will be far more complex to achieve is their safe and affordable roll-out.