Homeward Bound

Technology has transformed the care of patients in hospital. But can it also help to keep them out of it? Scientists around the world are now exploring how futuristic medical devices can allow chronically ill patients to be cared for in their own homes.

HOSPITALS were once places where recovery and survival depended more upon the level of care sick patients received from staff, rather than ground-breaking treatments. But in the last half-century or so, medical technology has revolutionised the diagnosis and management of almost every major disorder.

From MRI scanners that detect illness hidden deep inside the body, to keyhole surgery that leaves virtually no scars, modern medicine has transformed the in-hospital experience.

Now science faces potentially an even greater challenge – to try and keep chronically ill patients OUT of hospital.

The ageing of populations in developed nations means more people are living longer but with chronic illnesses that need proper management to avoid life-threatening flare ups.

In countries like the UK, these exacerbations can add to winter bed-blocking that means hospitals struggle to find room for critically ill patients because wards are packed with those suffering poorly-managed chronic conditions.

So what are the technology giants doing to shape future medical care?

Much of the innovation centres around fine-tuning devices, systems and programs that will manage chronic illnesses round-the-clock. The central theme is using technology to predict potential problems so that the patient, carer or doctor can take pre-emptive action. Patients benefit because better management means fewer risks to health. Hospitals benefit because fewer beds are taken up with patients suffering complications that are largely preventable.

Verily, formerly Google Life Sciences, is at the forefront of this change. It says its aim is to develop smaller, more compatible devices that are capable of capturing vital medical data from patients so they can be cared for more effectively. The company says: ‘We are building devices and tools that are smaller, more powerful and more convenient than ever before. Smaller devices fit more easily into daily life so they can monitor conditions more consistently and proactively signal when something is amiss. Information exists in every aspect of our bodies — from our genes to our sleep patterns. Software engineers, analytics experts and user experience designers at Verily are developing platforms, products, and algorithms that can analyse complex health information.’

Its flagship product is a contact lens with an embedded glucose sensor.

The hope is the lens will make it easier for millions of people with insulin-dependent diabetes to monitor themselves continuously by measuring the glucose in their tears – rather than having to carry out painful blood checks several times a day.

Poor glucose control can lead to hospital admission through hypoglycaemia – a dangerous drop in blood sugar levels, or hyperglycaemia, where levels are too high.

And in multiple sclerosis, the company is exploring the potential for wearable sensors to provide valuable clinical information on patients’ wellbeing. One is a health-tracking wristband that can measure pulse, heart rhythm and skin temperature. At the moment, it’s mainly intended for use in clinical trials – to measure how volunteers respond to drugs – but could evolve into part of a disease management program.

Meanwhile, Phillips Healthcare is developing packages that help doctors with the remote management of chronically ill patients in their own homes, or in care.

The eCare Coordinator is a package that provides doctors with a daily review of each of their patients, including vital data on blood pressure and weight. This allows them to prioritise patients and adjust care plans or intervene as needed.

A separate program – the eCareCompanion – is for patients and allows them to answer questions about their health and enter measurements to stay connected with their care teams. Using a tablet device, patients can connect with gadgets such as home weighing scales, oximeters, blood pressure meters and even medicine dispensers, to give doctors in their surgeries a complete insight to their health. The application even reminds patents when to take their medications.

Earlier this year, the head of NHS England, Simon Stevens, told the World Economic Forum that technology in the community would shape the future of health care. He said: ‘Over the next decade, major health gains won’t just come from a few ‘miracle cures’, but also from combining diverse breakthroughs in fields such as biosensors, medtech and drug discovery, mobile communications, and artificial intelligence computing.’

By Pat Hagan

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