A patient with more than one condition – diabetes AND kidney disease for example – with several life-changing symptoms, requires them to take lots of medication that might have multiple side effects. Such difficult health conditions can be challenging to live with and some people find it hard to deal with the pressure, especially when patients are discharged or in-between services.
Combined Healthcare realise that many long-term sick patients aren’t simply somebody with one condition – they tend to have a number of health areas that they would like to manage better. This can be a frustrating experience for the patient, as often the information is not readily available, and they might also have to deal with polypharmacy if they are being passed to different services. It’s equally as challenging for the clinician, as they lack the time and resource to give the patient the full care they require.
This is why the idea for BeAble was born. A post-discharge system that provides the clinician with a library of more specific illnesses and treatments that aren’t just pulled in from NHS Choices(our research has considered this to be too long-winded and not specific enough). The library also provides the clinician with ideas for therapeutic activities to encourage a more active and happy patient. The patient is then provided with personalised information and a tailored plan about how to manage their conditions post-discharge, to stop relapse-prevention.
Bitjam are building two parts to the BeAble system – a mobile app and web platform from which clinicians will be granted access.
BeAble will have a number of core features, including a library of specific information and intervention suggestions for clinicians, written in a way that patients will understand, as well as encouraging patient control as they will have the opportunity to be more active about their condition (behaviour activation). Patients will have their care plan accessible from their mobile phones which will have the ability to connect with other technologies such as Amazon Alexa and Google Fit, enhancing the user experience by linking with apps that are useful to their ongoing recovery.
At the heart of BeAble is the idea of supporting patients who might be between many services or post discharge with the need to provide relapse-prevention support, to ensure patients are receiving quality and accurate care.
Patients will work more closely with their clinician to decide on appropriate therapeutic activities, which will help to establish and strengthen a relationship between clinician and patient. Any questions that the patient might have can be written in the app and up for discussion during appointment times. This is known as “channel shift” and it’s shown to improve communication. Patients can message as and when they need to. Channel shift could be the beginning of a move away entirely from the traditional appointment times as the idea is to reduce the number of necessary appointments with accuracy.
Issues such as poly-pharmacy can be tackled using a service like BeAble, to decrease the chance of patient relapse-prevention. Poly-pharmacy is an increasingly common phenomenon that demands attention at clinical level as it can threaten rather than improve a patient’s wellbeing if it’s not managed effectively.
Technologies such as BeAble can ensure best practice in medication management and enhanced self care which are fundamental to independent living with multiple long term condition.
Technology for Social Good
At Bitjam we prefer to choose projects and work with clients in the public sector such as healthcare and education. It’s not only an area we’re more familiar and have more experience in as a collective set of skills, but fields that we have personal preference for as we are contributing towards improving societal communication. You can read more about our projects on our portfolio page here.
If you would like to talk about BeAble, more of our “social good” projects or if you have an idea for a communications project yourselves then you can also drop us an email to chat here.
What Is Interoperability in Healthcare
Interoperability is the extent to which systems and devices can exchange and interpret shared data. In healthcare, effective interoperability occurs when IT and software systems to exchange shared data to create information that can be used to assist clinicians and other medical professions with patient care.
Issues Healthcare Staff Are Currently Facing
“Staff suffer from increasing workload and stricter performance measures with less flexibility. This has caused psychological and physical stress…” Science Daily.com
It’s no secret that digitising healthcare IT systems has been a slow and frustrating process for all stakeholders involved, especially the end users who have the responsibility of delivering safe patient care in a secure manner. This adds further pressure to staff who are already suffering from increased workloads and limited resources.
“We physicians have the longest training time of any profession, yet we now spend roughly two-thirds of our workday as data-entry clerks, tending to digital paperwork and administrative burdens” – WSJ.com
How Is Data Currently Manifesting Itself in Healthcare?
- Notes entered into the EHR (electronic health record)
- Documents that have been scanned as image files or pdf documents
- Discrete data such as lab test results.
“The data arrives from many different sources and systems and in multiple formats. It has to be parsed into a format that everyone understands and has been trained to act upon in an appropriate manner” Alan Brookstone
- The Tech
Data presentation can negatively influence decision making if it is presented in an illogical or intuitive way
- Human Skills
The computer skills of all staff members and knowledge of their EHR has a significant impact on data interpretation. There are many reasons why some people are less digitally literate than others.
- Upgrades and Disruption
According to AmericanEHR one of the most frequent complaints of users is that their EHR does not have the necessary tools or capabilities to perform a certain function. Sometimes the staff are unaware that their EHR has the functionality as they haven’t been trained to use the product properly. In other cases their system may require an upgrade. Upgrades can be complex and entire servers may need to be shut down for maintenance. Consequently, upgrades are often delayed because of the disruption.
How Can We Succeed?
Lack of interoperability leads to poor outcomes, therefore the issue must be tackled to ensure quality control.
We believe merging simple-to-use, reliable technology and adequate human support and training will result in the ultimate success of any EHR implementation.
So a move towards cloud-based systems will have a definite advantage as the software is updated centrally by the vendor with limited need to update technology at the user end.
The most significant impact would become apparent with changes to government regulations. G Cloud is an initiative that assists with the procurement by public sector departments in the UK of cloud based commodity IT services. Traditionally, vendors have to be certified as compliant by the Department of Health which inhibits better products and slows down new system implementation. G Cloud is a way of shifting away from more primitive systems and offers a positive step towards improving the efficiency of EHR software and communication tools.
At Bitjam we pride ourselves on finding continuous ways to improve developer documentation, with cloud-based systems and use of more consistent data design at the forefront of what we do. Our mission is to use technology for social good, so if you have a digital healthcare problem that you’d like to solve, email us at [email protected] to find out more about our previous work.
It seems the UK isn’t the only country frustrated at the state of their healthcare system. American businesses have also voiced their concerns over the rapidly spiralling cost of medical treatment.
This has led to the allegiance of some of America’s biggest corporations, including Amazon, to team up to form their own independent healthcare company for employees, based on data that they’ve gathered themselves (perhaps world domination is next?!)
And if the venture indeed launches and becomes integrated within the company, how long will it be until Amazon rolls out the system to the wider consumer?
Virtual Healthcare Assistants?
Amazon is one of several large tech companies who’ve ventured in to the world of virtual assistants, with the launch of Amazon Alexa in November 2014.
The voice-responsive AI can be called upon to assist with all sorts of digital tasks such as prompting connected apps or ordering products online. Amazon have been able to learn the behaviours and preferences of the consumer, and have drawn data from these statistics that have led them to them confidently moving into the world of healthcare.
Given that many people already “self-diagnose” using websites such as WebMD to validate their symptoms, (you can also activate this site using a virtual assistant such as Alexa or Google Home), it wouldn’t be unthinkable to imagine a time where we seek medical advice from the comfort of our own homes.
Having access to fast, effective medical solutions solves healthcare system issues such as a lack of workforce and wait time, and potentially reduce the spread of disease.
Home health aides are testing the use of Amazon’s Echo platform to assist elderly patients. They are finding this system gives clients more access to family members and assistance to ensure they get their medication on time. Other tech companies are now rushing to capitalise on this opportunity and provide similar services.
But what about the challenges? It would be both illegal and morally wrong to sell prescription drugs next to toys and household products. AI could potentially obtain inaccurate data leading to misdiagnosis or ineffective advice. There’s also the loss of human interaction, resulting in an impersonal experience, a lack of empathy and trust, and potentially increased paranoia around sickness.
“What we’re seeing is going to be a whole new look at privacy. HIPAA regulations … [are] 20 years old — and they don’t even take into account the technology and the data processing capability that we have today. There have to be a lot of adjustments before this becomes part of routine practice.” – Dr Eric Topol Scripps Health.
What the Health Tech Experts Think
Here’s how some experts believe an Amazon healthcare system might be adopted:
“Amazon, for example, might see that a customer has bought cough drops every week for the last month, and went to the doctor for a cold six weeks before but never filled his prescription. Amazon, or an “Amazon-like company” could use that kind of insight to encourage consumers to go back to the doctor, or drop by a nearby clinic for a nurse practitioner to examine them. That could solve the problem of getting the wrong care.” – Gil Irwin PwC
“One day, we could tell Echo our ailments and have recommendations and potentially some drug recommendations, which they could fulfill if they also have doctors available in live chat on an Echo Show device,” – Wendell Potter Tarbell.
AI’s and virtual assistants have been adopted into the mainstream very successfully, so it will be interesting to see how the IoT filters throughout our homes and personal lives to the point of acceptable dependency, even when it comes to our own health. We’ve noticed ourselves at Bitjam that we’re being approached by an increasing amount of businesses and researchers, including NHS, with regards to IoT projects.
What Bitjam are Doing
We have experimented with Alexa building simple question and answer skills based on health information (the core feature of Alexa). We have begun to think ahead with new products we’re developing integrating data design features for a plug and play capability into Amazon Alexa at future dates. It’s better to make small changes in data design earlier on rather than an after-thought.
To get in touch about your own IoT project, contact Carl for a chat at [email protected] (you could even tell Alexa to email him for you!)