For many years the health service has been encouraged to embrace the digital age and drive operational efficiencies and improved patient outcomes through the adoption of innovative technologies and solutions.
But this is happening in a piecemeal fashion across the country and one major challenge is linking these systems together so they provide full coverage across the disparate acute, community, primary, emergency, and social care sectors.
In particular, the synergy between health and social care systems is largely lacking, and this has a direct impact on speed of discharge and the overall patient experience.
Alex Nash, head of assistive technology at the Access Health, Support and Care (HSC), explains: “Historically, health and care operate separately, and products have been designed independently and quite often are not interoperable.
Joined-up care
“But COVID has absolutely led to a big mind change, with people realising that these systems need to be joined up and that creates a big opportunity to do things right.”
Following recent acquisitions of Servelec, Alcuris, and Elemental, Access HSC has developed a portfolio of joined-up health and social care solutions, from prescribing systems to care management software.
COVID has absolutely led to a big mind change, with people realising that these systems need to be joined up and that creates a big opportunity to do things right
These include the Access Home Hub, which runs on a SIM card, so does not rely on WiFi connectivity.
The hub plugs into a standard socket within a person’s home and links to a plethora of third-party sensors and devices, each providing vital data on an individual’s health and wellbeing. These can include environmental sensors, smart plugs, and remote monitoring technologies.
Nash said: “It’s about bridging the gap.
“We can use these systems to speed up hospital discharge by, for example, providing home monitoring which will recognise if someone is becoming unwell and will, over time, get to know the individual and be able to provide pro-active and preventative care.
“For example, sensors can recognise an increase in bathroom use, which may suggest a urinary tract infection, which can often result in a lengthy hospital stay for older people.
“By highlighting this early, medication can be prescribed, which may help to reduce the need for inpatient treatment.”
These systems are a step up from the traditional lifeline buzzers, which link individuals to a call centre if they need help.
Nash said: “A family member or carer can use the app to see when a person is getting out of bed, using the bathroom, or opening the front door, for example.
“And the system gets to know that person’s unique behaviour and looks for any anomalies.”
Solutions, such as the Access Home Hub, offer support to help individuals live independently for longer
Remote support
While these types of solutions are increasingly being used to support elderly people to live more independently, the Access HSC is also working with the NHS and local authorities to help other vulnerable individuals, including young people with learning disabilities.
Nash said: “In Southend, the system was used in the home of a young person and their parent could see if they were eating healthily as the data reported on how often the fridge and freezer were opened. They could also see if he was on his computer all day and the smart plug showed when he was online.
We can use these systems to speed up hospital discharge by, for example, providing home monitoring which will recognise if someone is becoming unwell and will, over time, get to know the individual and be able to provide pro-active and preventative care
“Not only did this help the parent to remotely check on his wellbeing, but it avoided arguments and animosity as the parent was not constantly nagging their son.
“The potential for these solutions is great and we are seeing increased traction across health and social care, with a scheme in Scotland and the upcoming rollout of more than 1,000 units on Jersey.”
The bigger picture
But key to the future success of these technologies will be a more-joined-up approach to funding.
Access HSC’s quality risk and compliance lead, Martin Lowthian, told BBH: “For me the big thing is the way the two sectors are funded.
“There has been a lot of talk over the years about joining up health and social care, but no government has worked out how to develop a consistent budget.
“It’s about seeing the bigger picture. If someone is admitted to A&E then it is costing the NHS around £700 a day. But, if these people can be better supported in their own home, or in a care home, then a package of care or care home bed could cost 10-25% of that, which creates material savings and more capacity in the NHS.
“I would love England to learn from Scotland, where budgets are combined and instead look at it as a total package of care.”
The key to the future success of supportive technology will be a more-joined-up approach to funding, according to Martin Lowthian of Access HSC
Understanding needs
Offering advice to local authorities and NHS trusts looking to implement these technologies, he added: “To begin with we as technology suppliers must find out what the absolute must-haves are for the client – not just the nice to haves, but the expected outcomes, then it’s about being robust in our review.
“Where it often goes wrong is where a software provider or the people who are commissioning it have not put the necessary evaluation processes in place.
“It’s crucial to make sure the people who are implementing it are engaged and it’s about making sure they understand exactly what their role is (inputs), what they are getting and that they are not making assumptions.
These solutions do so much more than just support people and keep them out of hospital. They create a wealth of data on which commissioners can base their funding decisions
“The best conversations are when you understand what the client needs and you can demonstrate how you can provide that, or not as the case may be.”
Nash concludes: “The new integrated care systems will hopefully take this digital approach and run with it.
“These solutions do so much more than just support people and keep them out of hospital. They create a wealth of data on which commissioners can base their funding decisions.
“And, going into winter, and with the cost of living crisis, these technologies will be able to help gauge the impact and alert relevant support services.
“The beauty of this technology is that we are constantly adding new things and can link to lots of relevant services.”