|Homepage / Publications & Opinion / Articles, Lectures, Preprints & Reprints (post 2002)
How sensors will become home helpers
4 Nov 2009, Danny Bradbury, SmartHealthcare.com
Suppliers are working on fitting patients' homes with monitoring devices, allowing them to stay there for longer
It's like a scene from Big Brother. An elderly woman, who hasn't seen another living soul in days, shuffles across the room and sits in front of the television. An hour or two later, she goes to make a cup of tea, but forgets why she got up. She does this three times in a row before deciding to take a nap.
Sensors littered around the house have been monitoring everything, including her footfalls, the water pipes, the bed, and the TV. A software-based expert system compares today's activity with baseline trends garnered from daily monitoring. It alerts a home care physician to the fact that the patient appears to be walking more slowly than normal, and retracing her steps repeatedly. The pressure sensor in the bed shows that she's sleeping at unusual times. Early signs of dementia are appearing. Clearly, it's time for a human being to give her a call.
Such scenarios may not be as far fetched as one might think. As countries around the world consider major reforms to their healthcare systems, companies are hoping to use technology as a means of cutting down on costs.
An ageing population, combined with the need to reduce costs by introducing efficiencies, is making such systems more attractive, say their advocates, especially as the technology required to implement them matures.
"The national average salary for a skilled nurse is $76,000 (£47,000)," says Brian Bischoff, chief executive of Healthsense, a US-based company already selling sensor networks to help patients transfer back into home care and reduce the strain on primary care facilities. "We're enjoying the macro savings from these technologies. The ability to detect that someone needs assistance and keep that safety net there for them, that's what allows people to transition down a level of care."
At a time when primary health care providers are under strain from an ageing population suffering from more chronic diseases, anything that can help to lighten the load is bound to appeal. Companies like Intel – which formed its own healthcare division as part of a major restructure – have been eyeing this opportunity with interest, lending it more credence.
Healthsense sells a system called eNeighbor, which uses sensors to monitor the behaviour of patients at home. The system can automatically detect a need for assistance without residents activating a call device, the company says, and can monitor for specific individual issues, such as wandering, or forgetting to take medication. The systems communicate using WiFi wireless networks, explains Bischoff.
Sensors and sensibility
Not everyone is convinced of sensors' utility, however. "This is pretty much a waste of time and money," argues Peter Cochrane, former head of research at BT from 1993-99, and founder of Cochrane Associates. "All you need is an iPhone or BlackBerry. The sensors built in tell you exactly what people are doing. They also have all the processing and memory to manage the lives of the old and infirm."
"People don't sleep or shower with their BlackBerries. When you're in your home, it's a different environment, and this is why it's effective. People don't have to take it with them," protests Bischoff.
Could a phone measure your respiration rate, temperature, and carbon dioxide output? James McLaughlin, director of the Nanotechnology and Advanced Materials Institute at the University of Ulster, says that point of care monitoring systems will increasingly provide more intensive day-to-day analysis of patient conditions in the home.
"The last 10 years have seen the development of body-worn vital sign measurement systems," he, says, adding that these will be commercially available within two years. "You would directly monitor ECG, temperature, respiration rate, CO2, all in the chest area, and the smart programs in there would assess your ECG arrhythmia. Only then would we bother the physicians."
The future holds lots of promise for sensor-based monitoring systems, McLaughlin says. Sensors may listen to you sleep in bed, and monitor your heart rate from across the room, he predicts. Accelerometers may be embedded in home devices to see how well they are being handled. Telephones could measure the mistakes made when dialling numbers, while sensors embedded in floors could measure movement across surfaces and detect signs of stumbling on one foot or falling.
However, other more intrusive monitoring must be made more acceptable for the home. Measuring blood and urine, for example, is still a challenge.
Nevertheless, sensors could be the answer to some of the work load challenges facing primary care, and could help drive down the cost of home-based support. But there is one human element that all of these experts seem to have forgotten: won't these remotely monitored people get just a little lonely?