Putting technology at the forefront of care
The ageing population is the single and most significant driver for changing health and care needs in our society, according to Age UK’s 2017 report ‘Health and Care of Older People in England 2017.’ While the government has pledged to fund the health service with an additional £20 billion, in an era of phenomenal technology innovation, it is essential to question how best that investment should be spent.
As we enter a new technology-driven world, new and exciting opportunities are becoming available to improve the NHS and maximise the quality of care for those who may be infirm or living with conditions such as Alzheimer’s or Dementia. From apps that minimise admin overload for carers to the role of Augmented Intelligence (AI) in monitoring individuals, we are now at a turning point in the healthcare sector, a time when technology truly offers the chance to transform the way in which care is delivered.
Helen Dempster, Chief Visionary Officer, Karantis360 examines why the effective and intelligent use of technology across the whole social care ecosystem will key to enabling more of those who suffer from Alzheimer's and dementia to stay in their homes for longer and with a better level of care.
Combating the care crisis
According to the Alzheimer’s Research UK, there are currently 850,000 people living with dementia in the UK. And the challenge associated with supporting and funding the care for those with dementia continues to escalate, with this number expected to grow rapidly over the next several decades. As the population ages, they will need greater care and support, especially as statistics show a person's risk of developing dementia rises from one in 14 over the age of 60, to one in six over the age of 80.
The current care services are under strain, with an estimated nine million people caring for their loved ones, many with increasingly complex needs - and this number will only continue to climb. As this rises there will be greater financial and mental stress put on the often geographically distant family members, and heightened workloads for carers.
Most people want to avoid being admitted into a care home: according to Age UK, 97% of the population would like to receive care in their own home. But the funding gap in social care - predicted by the Local Government Association to reach £3.5bn by 2025 – is creating a devastating knock on effect on the NHS, with thousands of elderly patients stuck in hospitals when they are well enough to be at home because there is no support network in place to help look after them. With the cost of delayed discharges now at almost £290mn per year, the chief executive of the health service, Simon Stevens, recently reported that the equivalent of 36 hospitals were suffering because of a lack of social care.
As Matt Hancock has highlighted, “Tech transformation is coming” to the NHS. But how can we utilise this technology to help the cherished ageing generation without needing to admit them into a care facility? It is not just a case of doing the same things faster. Given the scale of the problem, technology must be leveraged to fundamentally reconsider how the entire social care ecosystem operates.
One of the most fundamental roles that technology must play in the future is to enable carers to undertake their primary function: care. This means minimising the admin burden and releasing carers to spend more time with patients. With one million people in the UK predicted to have dementia by 2025, carers are under huge pressure to meet escalating care needs, and yet are compelled to spend upwards of 20 minutes in a 30 minute patient visit filling in manual forms. And it is clear that this administrative work is having a negative impact on how they interact with their patients, with only 32% of carers stating that they have as much social contact as they’d like.
In addition to the sheer waste of essential, one to one patient time, this paper-based information is also simply not stored in a way that enables easy sharing with stakeholders, from other carers to health providers and family members.
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The advanced social ecosystem
The implementation of digital solutions enables carers to improve the quality and personal aspect of care. Having a non-intrusive system of IoT based sensors ensures the delivery of 24/7 care, tracking habitual behaviour and spotting changes in real time to allow for intervention when it is most needed.
This real-time information will not only alleviate the pressure on carers and families alike, but will provide a platform for the end to end digitisation of healthcare. Co-ordinating the ecosystem of local authorities, healthcare providers, NHS Trusts, GPs, registered nurses and care homes, will assure the social care model will be more transparent for family members.
And that means organisations have a chance to rethink the way in which care is delivered, better matching this service to specific patient needs. Living with dementia and Alzheimer’s can have a big emotional, social, psychological and practical impact on a person; their social environment is central to their life, regardless of age or mental ability. Therefore, carers need to consider how a patient’s support could be tailored to their individual needs.
Would a patient be better served by shorter daily sessions plus continuous monitoring? Or would an emergency response service be more appropriate - leveraging alerts passed out to a care agency or managed service that is monitoring IoT dashboards to send to emergency response doctors? With a 24x7 system that monitors and picks up abnormal behaviour, the care ecosystem has a chance to operate in a very different, proactive and most importantly personal manner that caters to the needs of every patient.
Combating communication challenges
The adoption of easy-to-use apps will enable carers to further support their patients with a tailored service. Having systems such as this in place are proven to reduce the administrative time spent by up to 75%. An app combining a simple user interface with voice recognition, not only assists with minimising the admin burden, but also makes it easier for carers to record more personal patient information - such as a patient's mood, important dates including birthdays or the anniversary of a spouse’s death. This system of information sharing can be particularly important for those clients with dementia and Alzheimer’s, as family members can alert carers to any specific events that may have happened on a certain date to help explain unusual behaviours and vice versa.
In addition, this technology ensures the carer’s report is automatically shared not only with the local authorities and/or care agency but with the individual’s family members, addressing one of the huge causes of stress for those tasked with overseeing the care of a loved one. In this way, the traditional challenges of information sharing between agencies can be overcome and ensure the most up to date medical and personal facts are always available to those who need them.
An era of change?
As the number of those with dementia grows, carers need to adapt to the constantly changing situations. Technology is now advanced, user friendly and cost effective enough to make a real difference. People want to stay in their own homes and it is widely believed they are healthier and happier in that familiar environment. Innovative technological solutions enable carers to have the information to support a more personalised care experience - and a minimised admin requirement; while family members have the relief of immediate information on the loved one’s current state of health and mind.
And this technology makes financial sense; for local authorities, enabling even just a handful of individuals to remain safely and happily at home, rather than in a care facility, justifies the investment in new technology; while for the NHS, the ability to address bed blocking will unleash vast resources. And what is truly exciting is that this is just the start; with a greater level of information the social care model can only become more transparent. From IoT sensors to applications on a mobile device, technology has the opportunity to predict potential problems, to better understand patient activity and to create a personalised service that is suited to each client’s individual needs.
Introducing Dosis - the AI powered dosing platform
Cloud-based platform Dosis uses AI to help patients and clinicians tailor their medication plans. Shivrat Chhabra, CEO and co-founder, tells us how it works.
When and why was Dosis founded?
Divya, my co-founder and I founded Dosis in 2017 with the purpose of creating a personalised dosing platform. We see personalisation in so many aspects of our lives, but not in the amount of medication we receive. We came across some research at the University of Louisville that personalised the dosing of a class of drugs called ESAs that are used to treat chronic anaemia. We thought, if commercialised, this could greatly benefit the healthcare industry by introducing precision medicine to drug dosing.
The research also showed that by taking this personalised approach, less drugs were needed to achieve the same or better outcomes. That meant that patients were exposed to less medication, so there was a lower likelihood of side effects. It also meant that the cost of care was reduced.
What is the Strategic Anemia Advisor?
Dosis’s flagship product, Strategic Anemia Advisor (SAA), personalises the dosing of Erythropoiesis Stimulating Agents (ESAs). ESAs are a class of drugs used to treat chronic anaemia, a common complication of chronic kidney disease.
SAA takes into account a patient’s previous ESA doses and lab levels, determines the patient’s unique response to the drug and outputs an ESA dose recommendation to keep the patient within a specified therapeutic target range. Healthcare providers use SAA as a clinical decision support tool.
What else is Dosis working on?
In the near term, we are working on releasing a personalised dosing module for IV iron, another drug that’s used in tandem with ESAs to treat chronic anaemia. We’re also working on personalising the dosing for the three drugs used to treat Mineral Bone Disorder. We’re very excited to expand our platform to these new drugs.
What are Dosis' strategic goals for the next 2-3 years?
We strongly believe that personalised dosing will be the standard of care within the next decade, and we’re honored to be a part of making that future a reality. In the next few years, we see Dosis entering partnerships with other companies that operate within value-based care environments, where tools like ours that help reduce cost while maintaining or improving outcomes are extremely useful.
What do you think AI's greatest benefits to healthcare are?
If designed well, AI in healthcare allows for a practical and usable way to deploy solutions that would not be feasible otherwise. For example, it’s possible for someone to manually solve the mathematical equations necessary to personalise drug dosing, but it is just not practical. AI in healthcare offers an exciting path forward for implementing solutions that for so long have appeared impractical or impossible.