The IoT in Healthcare – care in the home, part 2

How can the IoT improve the lives of people being cared for at home?

In this second part of two I continue to discuss how the lives of people being cared for in their own home can be significantly improved by the appropriate use of IoT and Cloud technology.

Medication reviews

As I mentioned in my previous blog it is common to be prescribed medication and be left on that medication for years without review. This is a very important aspect of the person in care’s long term state. As I mentioned in my previous blog this may only require a simple strategy where a record of the person’s medication is held on line with an agreed update recording any new symptoms.

Medicine and medical supplies ordering

When the person in care has a complex medication regime it can be fairly challenging to stay on top of the medication supplies. My daughter’s medication requires daily manual monitoring and results in notes posted on fridge doors and two or three trips to the chemist to collect all of the medications on the order. Sometimes one or more of the medications is unobtainable and on one or two occasions we have had to call over 20 chemists to find stock. My daughter has an adverse reaction to some of the coatings used on tablets so this further complicates matters as we have to locate specific brands with no colouring in their tablet coating.

The whole process is so inefficient and prone to error requiring a wheel to be reinvented every time a prescription is raised. Also, there appears to be no formal way of specifying a particular brand to overcome the allergy issue. We are sometimes faced with a stand-off with the pharmacist to ensure we have the correct brand.

As I mentioned in my earlier blog medicines are relatively easy to predict in the most part, other than some minor adjustments due to spillages or mis-measurements. Supplies such as bed pads, gloves, wipes and other disposables are a little less predictable but not impossible to manage. Having an automated order facility would remove some of the challenges associated with checking stock, requesting the prescription and receiving notification that the order is complete and awaiting collection. There have been one or two attempts to move this process online but although it spares us the phone call to the surgery it has done nothing to resolve the bulk of the issues.

Having this information in the Cloud with all of the specific information regarding allergies to coating would spare us a lot of work. It would also prevent mistakes when emergency doctors are called as all of the medication records would be available for healthcare professionals to see. And, as I mentioned in the previous blog, it is also feasible that any additional medications required to overcome an infection or new condition could be entered to check for contraindications to reduce the risk to the patient.

Patterns of behaviour

The ability to monitor and record patterns of behaviour can contribute significantly to a comprehensive proactive healthcare management system. Simply relying on the person in care to raise an alarm may fall short of identifying underlying and developing health problems. Most of us are creatures of habit so deviation from our normal pattern of behaviour could be an early indication of a developing health issue.

Using a range of bed and floor pressure sensors and door sensors combined with appliance sensors on the kettle, fridge, microwave, cupboards, TV, etc. a baseline pattern of behaviour can be determined for future reference. Thresholds can be set to alert healthcare professionals or family for early intervention. This would have certainly helped in my Mum’s situation when she spent the night on the floor with her alarm tag beyond reach.

Anxiety monitoring

Anxiety can be an indication of so many underlying conditions. Some people can suffer with anxiety and not actually know why they are suffering. However, the results are very real and often debilitating. If stress and anxiety can be monitored (using heart and skin sensors for example) it has far greater chance of being managed. This is just as much a problem for people being cared for at home as it is in hospital or care homes. In my experience, anxiety can be more of a problem for people being cared for at home because there is less going on to cause a distraction to take the persons mind off of their problems and their anxiety. Once my daughter gets caught in that visious circle it is extremely upsetting and debilitating.

Anxiety intervention

I realise everyone is an individual but I saw some relaxation technologies at The Autism Show in Excel recently and I wondered if this technology could be triggered automatically by anxiety monitors. The environment can play a big part in managing anxiety, especially for people with Autism. Keeping noise to a minimum, playing favourite music or nature sounds, maintaining a cool temperature and creating a calming mood with effective lighting can help significantly to restore calm.

Triggers from anxiety monitoring can be used to set up the environment in a way that the person in care finds calming. The lighting technology is already available in retail as some shops are attaching coded tags to their clothes to set the mood of the lighting in changing rooms. If the customer enters the changing room with swimwear the lighting will represent sunshine. If they enter the changing room with night wear the lighting will be more subdued. This technology could be put to good use to help reduce anxiety controlled from the Cloud via anxiety monitoring sensors.

Environmental controls and alarms

By incorporating heating and lighting controls people with limited mobility would be able to maintain their environment via remote control or mobile app. This could be particularly useful for people confined to their beds. Smoke, fire, carbon monoxide and other alarms could also be fed into system to provide emergency alerts to monitoring centres and family. I equipped a number of sockets in my daughter’s bedroom with wireless remote control switches to enable her to switch fans and lights on and off to maintain her own environment. As mentioned above, there is potential for this to be automated providing early intervention to reduce anxiety.

Geo-tracking

Geo-tracking may be useful for people with more mobility who may be prone to disorientation.

Summary

The Cloud alone may not be the most appropriate solution here as there are still so many homes through the country with poor or no broadband connectivity. But that is another issue and it is beyond the scope of this blog. Assuming a reasonable broadband service is available the possibilities for automated advanced care services enabling people to live in their own homes are limited only by imagination and budget.

Based on my own experience I am sure comprehensive health monitoring with triggered interventions would have a significant positive impact on healthcare. Going back to the late 1960s I remember my doctor calling in to see my grandparents without being asked. Nowadays it is near impossible to get a doctor to make a home visit. Even in extreme circumstances we are expected to get ourselves into hospital when our surgeries are closed. Doctors no longer have the time or resource to just drop in on their patients to see how they are. But it is feasible that with their patients being closely monitored they could schedule a visit or even a phone call if their patient drifts too far away from the baseline mentioned above. These preventative or early intervention visits could have a significant return on investment by keeping people out of hospitals.

Useful links…

Dail Mail – Dementia Care Lottery Exposed
Andrew Gunn – Inexcusable, a lack of digital innovation in healthcare provision