Why Building Connected Care Communities Will Change Health And Social Care For The Better

By Andrew Davies, CEO of RWG Mobile (www.rwgmobile.wales)

During the COVID-19 pandemic, to protect both carers and the cared for, healthcare re-evaluated one of its oldest principles: that compassionate, expert care is always best provided in-person, hands-on, in a dedicated care setting.

Whereas previously we experienced doctor visits face-to-face, and popping to your GP in their walk-in hours was only a matter of waking up early enough, now a digital triage process is something we are well versed at. A phone call to schedule a video appointment with the doctor or nurse practitioner, and only as a second resort an in-person meeting.

And despite understandable pressures to business as usual, the net benefit of the new ways of working is strong enough that they have become a part of the ‘next normal’.

So the question is, where can we go from here? Healthcare and social care collaborate very closely in the care of people with chronic illnesses, for example, they may need frequent monitoring of blood pressure or blood sugar, as well as ongoing support to live independently. Can those biometric measurements be taken without them needing to visit a clinic, or be visited by a clinician? And there is more than clinical support to consider. Frequent visits to a surgery, or visits from a nurse, might be resented by some yet provide much needed human contact for others. Loneliness can have devastating consequences. So context – and choice – are extremely important here.

To be clear, the challenge to creating new health or social services isn’t from sensor tech. Indeed, the pace of change in wearable sensors and smart technology feels profound. Home blood pressure monitors and pulse oximeters are reasonably common in the care of chronically ill people, allowing frequent measurement and a degree of remote monitoring. Single-lead home ECG devices that check for a regular sinus rhythm and atrial fibrillation in susceptible individuals have been around for a while too. Now there are also smart watches and consumer blood pressure monitors that reliably can do the same job. New sensors are coming to market that improve on old techniques – a good example is continuous glucose monitoring, replacing finger prick tests. And there’s a huge amount of research into finding non-invasive proxies for important biometrics – such as heart rate variability (HRV) as a working measure of physical stress.

The real challenge is inertia in processes and systems. The triage example we started with above is a workflow or process innovation – one that has successfully become embedded in our healthcare system – and that is where the real benefits lie for patients and carers alike. Technology can be as innovative as we want it to be, but it can’t drive innovation by itself. A new, smart blood pressure cuff is innovative – but if it is not a part of a process that integrates it and contextualises it – it is just another gadget. The actual healthcare innovation happens only when the workflow or process is updated with the help of tech: things like more frequent checking but less in-person visits, and integration of that enhanced information into a system of analysis, diagnosis, and intervention.

In addition to maintaining the health of their chronic patients, health- and social care aim to allow patients to be as independent as possible and live in their own homes longer. Local authority budgets are under exorbitant pressure, so it’s important to find ways of caring that don’t rely so heavily on in-person visits, and which allow innovative new care services to be delivered at very low marginal cost – prompting enormous innovation within the sector.

So what could a next normal look like, and how do we get there? If we reimagined service delivery? If we could harness all of digital’s potential? If we could augment – or optimise – irreplaceable in-person visits?

Healthcare and social care could benefit from a new kind of digital platform. An open innovation platform, embracing every kind of sensor technology. Generating insights – not just data – that power new workflows and interventions. And linking the cared-for, professional carers and kinship carers (family and friends) in conversation, with video at the forefront. The generic term is Health-Platform-as-a-Service (HPaaS). We call ours iCare.

By working through some care scenarios, we can start to understand how HPaaS powers real service innovation. Starting simple, imagine that a vulnerable person has a fall at home. A sensor will detect the fall, and the platform can automate action. A first step might be to initiate a video call with a carer, popping up a familiar face on a regular TV set. The next might be to scramble some physical help, or a paramedic.

Then, we might look for a cause for the fall. For example low blood sugar? Or abnormal blood pressure causing dizziness? If that person was being remotely monitored for those biometrics, then that data is available for analysis.

Now think beyond reacting to crises – to anticipating and preventing them. We can use movement sensors and location awareness, patterns of use for lighting and heating, and supplementary information from wearables. We can incorporate live pop-up quizzes about mood, or medication. All of this information can be analysed to create a detailed ‘wellness’ portrait of the cared-for individual. Are people varying from their established routines? Are they more, or less, sedentary? Are they too warm, or too cold? Are they taking their pills?

AI can make sure that trends are spotted and highlighted, prompting a video call from a professional carer or family member. Does the individual look well? How do they sound? How well are they moving? Checking in and preempting problems.

With Health-Platform-as-a-Service everyone has a ‘seat at the table’. The patient (the cared for) sits at one side, the clinician (professional carer) on another, and friends and family (kinship carers) on a third. They’re all having an informed conversation, where technology acts as a facilitator. The patient’s biometrics inform the conversation between the cared for and clinician. The analysing and graphing of that information makes it understandable and actionable to the kinship carers too.

HPaaS can revolutionise the way care is delivered. The platform can analyse lakes of data, delivering instant snapshots for immediate action, and uncover long term trends near-invisible to short human attention spans. So that everyone that cares – professionals, families, and friends – can reach out, get involved, and make a proactive intervention.