Can smart care help to tackle rising demand on services?

27 Mar 2015, 1:36 pm

#LocalDigital Live is a series of studio-based discussion programmes streamed live online that invites the audience to add their opinions and questions to the debate. Watch the recorded debate.

LocalDigital Live studio panel guests

There is a growing urgency to use technology in new solutions for health and social care.

The trend towards an ageing population means that demand for the relevant services will continue to rise, but there is less money to meet the demand and no sign that this will change. Existing service models are creaking under the pressure, and local authorities and healthcare organisations have to do things differently.

A group of experts came together at a recent Local Digital debate to grapple with some of the issues and shed some light on the approaches that could provide the solutions. Chair Helen Olsen, head of communications for the Local Digital Campaign, said this has become timely following Chancellor George Osborne’s comments in the Budget about the potential for the Internet of Things.

All agreed that the promise is looking more achievable with a big growth in the availability of connected devices that can monitor a person’s activities or vital signs and transmit a stream of relevant data to the organisations, or family members, providing support.

Debbie Johnson, ICT business development leader for Kent County Council, said it had been testing such devices for some years in its telehealth pilots. In the early days they were too expensive to use widely, but the economics are now changing and they show a real potential to deliver savings.

There has also been a significant change with the arrival of more small scale consumer devices. There was some resistance to placing earlier, larger models in homes, but the proliferation of smartphones and growing familiarity with devices such as the Fitbit and wi-fi bathroom scales is making people more comfortable with small monitors and sensors.

Johnson also highlighted one of the potential benefits from the technology.

“Our Whole System Demonstrator project was focused on people who had serious health conditions and were already in the system,” she said. “Now what we’re trying to do is to support people with lower levels of need, so they don’t reach the system and don’t require a large investment from the state to maintain their good health.

“By exploiting that opportunity to get that feedback and help them manage their health, and when they do need help they have friends and families who can step in. We’re hoping to maintain independence much longer by starting lower down the scale of need.”

Andrew Chitty, managing director of Digital Life Sciences, pointed to other benefits in talking about a project to digitise access to GPs in Birmingham. When given the option of a telephone or Skype consultation about 70% of patients chose it, and for 70% of those it was successfully resolved, in a shorter time than needed for a face-to-face. This increased the capacity of the GPs by 15% and gave them more time to spend dealing with patients with more serious conditions.

“We’re also seeing data on people not going to A&E for things that could be handled by a GP,” he said. “The key is using everyday technology to manage demand and effectively increase the capacity of the workforce. It’s smarter working.”

Further benefits are also available through the use of cloud services to store and process information from the devices.

According to Paul Thomson, lead architect for health at Microsoft Consulting, it is now accepted that it provides a secure environment for sharing sensitive data, and acts an agency to bring together the consumer with professional care.

“We can see the potential for the two worlds to become closer and for information to flow between them more freely,” he said.
Chitty also highlighted the potential for a new relationship between authorities, people who are currently using digital services they pay for, and the providers of those services.

“If the local authority could work in partnership with providers of digital services to that market, then they would get huge forward planning insights and contribute from their expertise to the planning of that market,” he said. “It’s the potential for a mixed economy model which is very exciting.”

Taking advantage of all this is far from straightforward and is going to need new models of service delivery, not just the application of the technology to what organisations are already doing.

“It’s around putting together a package of sensors and services around people as part of a service of care,” Chitty said. “Not just putting them in the home for their own sake.”

There are several issues to address in doing this. Among those that came up in the discussion were:

  • A need for standards in the use of devices and the data they generate. A starting point would be the recognition that people are the owners of their data and provide the right integration point for its exchange;
  • Different groups of people are going to respond to different factors in taking up the technology;
  • People have to be enabled to use the devices;
  • Despite the potential for great insights from big data, it has not yet been properly harnessed as the public sector currently lacks the skills and capability;
  • Healthcare data currently does not place enough focus on outcomes
  • Organisations need more digital skills.

“We haven’t arrived, it’s a journey we’ve just started,” Johnson said. The other panellists shared the view, and Thompson said there is a lot of scope to learn from other industries that have been able to move more quickly in adoption of the technologies.

It is a big challenge that will lead to some agonising from all sides of health and social care, but Johnson provided the local government perspective that doing nothing is not an acceptable option.

“We have to address rising demand and less money,” she said. “Unless our services are going to drop in quality, which nobody wants, we have to do things differently. The size of the prize is enormous, about being able to maintain quality services. And you can increase capacity if you utilise the technology.”