Selfcare and connected health: How populations can use technology to support long term condition management

If you look online for health apps or products designed to monitor your health, you will find an array of items developed to help you better understand your body’s heartrate, sleep patterns, breathing and more. The range of items available to consumers, is indicative of the way that health is making its way into people’s everyday lives. In the same way that the mobile phone connects people with each other, wearables, apps and digital products connect people with their own health and well-being.

Philips’ Connected Care model prescribes exactly this. A way in which people can actively manage their health, whilst being supported by technology and data, both of which can be utilised by clinicians and patients for the ongoing management of care.

Philips is dedicated to helping people manage the conditions they have to live with. This is evident through the company’s work alongside the Liverpool Clinical Commissioning Group (CCG). The two organisations implemented support for self-care through the use of tele-monitoring equipment, a clinical hub and the acquisition of data for patients living with chronic conditions such as COPD, diabetes and heart failure.

Results from the study, which included 1808 patients, showed that 90% of patients felt more in control of their condition and emergency admissions and secondary care costs were reduced by 22%.

To understand more about Philips’ outlook towards health and how the company is collaborating with clinical partners and patients on connected health innovation, we spoke to Lucien Engelen and Jeroen Tas. Lucien is the director of REshape Innovation Centre, a programme of the Radboud University Medical Centre focusing on applying emerging technologies in healthcare alongside the inclusion of patients in the innovation process. Jeroen is the executive vice president for Philips and responsible for the Connected Care and Health Informatics Businesses.

Earlier in the day the pair had spoken in length about data and the potential for creating patient-based solutions for managing chronic diseases. They are both enthusiastic, friendly and deeply insightful into the way that healthcare services are positioned and marketed to the public.

Asking about Philips’ vision for Connected Care Jeroen responded by saying: “Philips is looking at population health management; enabling carers to provide continuous, proactive care and supporting consumers and patients to manage their own health and live longer and healthier lives. The focus is on managing chronic disease primarily outside of the hospital. Trying to keep people out of the hospital is at odds with how people purely look at how hospitals and healthcare works. How can we better understand the population we serve? How can we create cohorts for segments for people with similar needs and how can we best address those needs? How can we create the programmes and execute the programmes that use connected technologies?

He answers himself and talks about the need for two types of technology, wearables and technology to turn large datasets into meaningful and actionable information. Wearables can collate the health information of a user, which can then be integrated with other patient information such as EMR data to give it context and more meaning and then be interpreted so services can proactively engage patients.

“Engaging patients to take their medication on time, to stick to the goals you set for them. So, we are making the home a viable care setting that is connected to the hospital via telehealth that enables continuous monitoring and helps care teams to intervene at early stage of health deterioration through predictive analytics, our personal emergency alert system with its predictive analytics engine behind it is an example of this. I think that’s the start of a true elderly care service”.

The true elderly care service Jeroen speaks about uses Philips’ GoSafe pendant, a wearable device to aid elderly people who are at risk of falling. The device detects falls and can automatically send out an emergency signal for those who take a tumble and need assistance. It can also be backed up by CareSage, a powerful analytics engine that plots the patient’s medical information with post-admission patient behaviour at home over time, spots subtle changes, and can predict a serious health deterioration up to thirty days in advance.

The pendant is just one example of the way technology can and is existing within the atmosphere of our everyday lives. Its potential is amazing, something which Lucien and Jeroen recognise.

Of particular interest is the emergence of devices such as the pendant which help connect patients with actionable data about themselves which was otherwise only in the hands of clinicians. Lucien responds to this and speaks about why there has been a disconnect between the patients access to data.

“Healthcare traditionally has been a business where the knowledge has been based on data that the clinicians created inside of the hospitals or the clinics, combined with all the knowledge they’ve had through training. Up until the last four or five years its only been possible to open up that data, prior to that IT systems were not able to read it, because it was stuck somewhere else. So now we’re at a place with standardisation of IT systems starting to come in place. Patients want to be more engaged than ever knowing they can get all their data, it’s strange that healthcare is the last branch where you don’t own your own data.”

He continues: “People aren’t scared of technology; they want to be empowered and have choices. There’s a power shift between patients and clinicians. The role will shift. The patient will be on an equal level playing field to the clinician on having access to the data.”

It makes sense. With the amount of wearable technology, apps and devices out there which can continuously manage health aspects such as sleep patterns, body temperature, heart rate and activity, it’s easy to see how much data can be accrued.

Are healthcare institutions going to take advantage of the vast wealth of technology around them? If they don’t the industry would remain stagnant, overburdened and severely underequipped in terms of workforce/staff. It’s all down to patient engagement Jeroen tells me.

“The healthcare systems need to recognise that with today’s technologies they can engage better with their patients because that will allow them to provide healthcare and get better outcomes. I think that’s where we see in a couple of years the equation will start to shift.”

Companies are beginning to see the opportunity in health. The old model of waiting to see a GP is changing Lucien tells me.

“Up until lately the system was adverse in trying not to make patients dependent on the professional and that is changing. Other companies such as Apple are also stepping into health, now all of a sudden I’ve got choice, such as a great flashy app, that gives me the opportunity for 24/7 healthcare. The other option is my GP, where I’ve got to call three times, where I can get a slot in the next two weeks, you have to take a day off from your job”.

Together Lucien and Jeroen have a wealth of knowledge about the industry. Their opinions are far ranging and the pair constantly evolve upon their ideas about healthcare and technology. But whilst their familiarity with available technologies is vast, I wonder if the everyday person is so knowledgeable about what’s available.

Lucien answers me by describing the outcomes of an e-health  questionnaire in the Netherlands.

“I think it’s a great question. In the Netherlands for the third year in a row we’re running an e-health monitor that’s done with patients and professionals that asks how many times have you had a video consultation with your clinician or GP etc. For the third year in a row patients are saying they’d really love to use these systems if they knew it was possible. The physician say patients don’t ask me for it so they don’t need it. So, some way we have to break through that barrier and we at least think that we just have to do it. We don’t have all the answers just jumping in we could talk for ages, for years even! To see what possible barriers come into our path, and to be honest the problems we have encountered were completely different to the ones we thought of originally. So, we think that the best thing is to engage with these things and to just step on it. Find the patients and professionals that want to use it and they will be the best ambassadors.”

All the systems that Lucien and Jeroen mention have the potential to change the way people think about healthcare, particularly its hospital based services and the option for selfcare that is presented through so many apps, fitness trackers and devices. It seems that when the adoption rate for these technologies increases, people will begin to think more about how healthcare can be blended into their everyday lives.

One area of health that could and is benefitting from technology is diabetes. Philips and the Radboud University Medical Centre are developing an app, designed to help patients living with chronic conditions such as diabetes type 1.

The app consists of a mobile patient app combined with an online community and has been designed to collect data from multiple sources and encourages supported decision making for people living with chronic conditions.

The collaborative project is one that is particularly close to Jeroen’s heart, whose daughter was diagnosed with diabetes when she was a teenager.

“We saw that you need to connect these devices to capture and measure health data as well as regular data such as what do you eat” Jeroen says. “Then we want to put it in the context of what I call the sweet spot, the numbers should be presented in such a way that you can work with them to improve your personal health, which will be different for different people. We then run an algorithm that helps people with these decisions. The way that we structure this is we capture info from devices, we keep a history, we find what the right optimal balance is for you, what goals you should set yourself. At the same time, we said you need to be able to connect to your care team. So, you need some form of coordination between your caregivers, so that info can be shared with these care givers and the other way around.”

Prior to this it’s always been done in separate apps or in a notebook. Lucien tells me. The app that Lucien and Jeroen are talking about here aims to consolidate information, collected from wearable devices that track your fitness and health levels. There’s something else the pair consider as well, the need for people living with conditions such as diabetes, to be able to connect with their family and loved one.

Jeroen talks about his daughter’s diagnosis, and how some of her friends’ parents wouldn’t take her on trips because of the added complication of looking after a child with diabetes. Now through this app that wouldn’t be an issue Jeroen says.

“If we had this app then, we could remotely see what you’re taking, how you’re testing, when are you taking the insulin and we could remotely see how you’re doing. So, the care team is not just a professional care team, it’s also friends and family” Jeroen says.

Apps such as the one that Lucien and Jeroen have presented have the potential to connect healthcare professionals, healthcare volunteers and friends and family to continuously enable a level of care that can’t been seen outside of the hospital.

“I think my daughter has a sense of control” Jeroen says.

But it’s not just his daughter he mentions.

“There’s half a billion people with diabetes, heart failure and I always say just look at these numbers, if we can just help it a little bit, we can make an impact.”

Given the potential and emergence of technologies that Lucien and Jeroen are working on, as well as a multitude of other companies, it’s easy to imagine a future where we see this impact realised.




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