Posted on Tuesday 9 April 2013 by Ulster Business
Professor Jim McLaughlin demonstrates some of Intelesens's technology to University of Ulster chancellor Jimmy Nesbitt.
Among the 99 proposals made by John Compton to make the health services more resilient, sustainable and safe were a reduction in the number of acute facilities, more provision of patient services by GPs and more people being cared for at home.
Last month Health Minister Edwin Poots announced measures that will potentially see the loss of 180 hospital beds and a 50% cut in the number of residential care homes over the next five years. He again said that greater emphasis will be placed on providing care at home.
Since the Compton Report the concept of Connected Health has been gaining traction. A Memorandum of Understanding was signed between the Departments of Health and Enterprise to explore mutually beneficial technology that could improve care provision and have positive economic spin-offs.
Professor Jim McLaughlin from the University of Ulster's Engineering Research Institute, who has been at the forefront of research and development in the sector, believes it is a fast developing area with huge potential for good.
"Connected Health is the term used to describe a new model for healthcare delivery that uses technology to provide healthcare remotely. It is a rapidly evolving area of multi-disciplinary research spanning engineering, technology, healthcare, medical devices, academia and industry," he told Ulster Business.
"It is creating great interest among investors as healthcare providers in the public and private sectors and consumers alike increasingly recognise its potential as a way of improving health and wellbeing and supporting economic development."
Professor McLaughlin says that an ageing population, coupled with changes in disease prevalence, has led to shifts in health care demands and put the focus firmly on early intervention.
"Connected Health uses technology to provide healthcare remotely and allow patients more freedom to get on with their lives. The aim is to optimise the use of healthcare resources and provide increased, flexible opportunities for patients to engage with clinicians and to better self-manage their care. It is a 'win win' situation," he said.
"The use of technology allows carers to gather and transmit vital statistics such as pulse or breathing. The information could then be supported by analysis where warning signs of declining health could be detected. This could allow people to live more independently at home with support and preventative care provided when it is needed, freeing up hospital beds for other patients and making savings for the Health Service," he added.
A cross section of businesses from Northern Ireland have just completed a series of workshops on key areas for future research hosted by the Connected Health Innovation Centre (CHIC) at Ulster's Jordanstown campus. The most recent event had attendees from big name companies like GSK, 3M, BT and EMC, as well as hospital and Health Trust leaders.
"It is clear from the success of the business workshops that CHIC will have a major role to play in developing the overall Northern Ireland Connected Health Ecosystem. CHIC is working with care providers, IT system integrators, medical device developers and digital media providers who can collectively provide a strong commercial solution which seeks to addresses changes to the way health care is delivered," said Prof McLaughlin.
So, how far away are we from having accessible affordable technology that's integrated into the health service to enable more people to be treated at home?
"People panic about that question," says McLaughlin. "The negative answer would be that some of the barriers like security and inter-operability do require some really big cash injections, not what I would call the current budget injections.
"But as we are speaking there is all sorts of roll out happening. People are experiencing technology and not realising it. At my GP I can order my prescription on line. It is not fully connected but any time I go back it improves," he added.
While there is an undoubted challenges, for example the need to connect up all the electronic patient information that is already available into one homogenous system, progress is being made, says McLaughlin.
"The rollout of electronic patient record systems is happening – the government has chosen a New Zealand-based company to come in and roll the technology out in the next six months. So on your next visit to the GP they might have much more information about you available. The next stage from that is that you might have access to that information yourself which in future might help you self manage."
Belfast's Heron Road hosts a trio of companies which are leading the local charge in terms of connected health – Intelesens, Heartsine and Heartscape, now part of Verathon. Much of the IP and technology in these companies originates from the University of Ulster, which continues to work alongside each of them.
Intelesens has become an internationally recognised innovator in targeted vital signs monitoring, producing a range of market-changing wireless vital signs monitors for use both in hospital and at home.
The company has been providing medical devices to well-known OEMs since 2001 and will next month fully launch its Aingeal monitor into the hospital market.
Where other devices monitor heart rate, wifi-enabled Aingeal also monitors breathing and ECG (the electrical activity of the heart).
"We know for a fact that typically 60% of patients in hospital are not connected to a monitor. So there was a need for a cost effective and efficient technology for that 60%," said CEO Michael Caulfield.
While the hospital monitoring market is well defined, with big players such as Philips, GE, Toshiba and Bosch all involved, it is in the home monitoring market where Caulfield believes the biggest changes are taking place.
Intelesens last year received FDA and CEA approval for a new device named Zensor, which clips on to a replaceable three electrode patch and measures a patient's heart rate, respiration rate and motion, with alerts sent when ECG arrhythmias (palpitations) are detected. A new means of measuring pulsox – the haemoglobin levels in the blood – is expected to be added to the device by next year.
This built in intelligence to detect irregular heartbeats, record them and send them wirelessly to a remote database with Intelesens software on it, is what the company believes sets the product apart from its competition.
"Basically if you're wearing the device your data is on a server accessible by the clinician in real-time," explains Caulfield.
"Zensor is already FDA and CEA approved so all we've got to do is convince the clinicians it does what it says it does. We're running clinical trials now and have most of that data ready to go. We plan to sell thousands, tens of thousands of these."
Caulfield notes that if, for example, 1000 people that present with palpitations have the device put on them by their GP and 600 are found not to need to go to see a cardiac specialist, a huge saving in both financial and resource terms would be generated.
Intelesens estimates in the initial stages it will sell about 2,500 units of the Zensor mainly in Northern Ireland, the Republic and the UK, and while the number is small, it still means 100,000 patients will benefit from the technology by the end of 2013.
Statistics suggest that an astonishing 350 million citizens in the US and EU have at least one chronic disease that could be managed by remote monitoring – including diabetes, congestive heart failure, chronic obstructive pulmonary disease, asthma and bronchitis.
"We live in a connected world, there are seven billion mobile phones in the world. You put in typically 12 digits, and you can potentially connect to any one of those other phones," notes Michael Caulfield.
"The connectivity is there so why are we not using that network for healthcare. Why are we not using the cloud. The infrastructure is there, the technology doesn't have to be invented any more for us to take the device that sticks to your chest or your ribcage and for the data from that to get to the doctor."
The big challenge the CEO sees in the shift to a hi-tech, connected health model, is in managing the data created by devices like Zensor, which GPs do not have the resources or time to analyse on their own.
"What's evolving in the US is telehealth companies – private sector businesses who work out a business model that says, we'll put Intelesens software on our server, we'll gather the data from 500,000 patients, we'll employ staff to manage that data and ask GPs what exactly do you want if we've been monitoring a patient on your behalf for seven days?
"There might be a gazillion megabytes of data out there but the GP probably wants one report with the patient name, period of monitoring and salient data. So there's a business model challenge as well. We talk about innovation and we're innovating the technology, the hardware and software, but there needs to be innovation in how the business model runs," he explained.
"We're ready with the solution but we're subject to the change happening within the health service. We're not going to solve everything but we believe our technology can be a very key and innovative component of Transforming Your Care."