As one of the leading providers of software and mobile solutions to organisations that deliver health & care in the home, you would expect us to evangelise about how technology innovation will revolutionise the sector. There is a risk we will disappoint you: big benefits can be delivered by adopting existing technologies – mostly relating to mobile, some service/process innovation and robust execution. Inside the new connected world, the fundamental role of the care worker or the nurse is not going to change (this type of robot is far, far away); however technology can support care delivery, reduce admin and take monitoring and quality control to a whole new level. Compare the amazing sophistication of ordering a pair of shoes online with the delivery of health or care to patient or vulnerable individuals at home: You probably picked the shoes based on online reviews and chose a delivery slot that worked for you; instead of calling the service provider you simply checked online if the delivery was progressing to schedule.
Not very exciting but very powerful: Service/process innovation
There are lots of exciting announcements coming out of Silicon Valley (and some from the Silicon Roundabout, just around the corner from us): internet of things, big data, quantum computing, DNA sequencing, wearable technologies, etc.
This is all very intersting, but we need to keep in mind that delivery of health and care in the home is currently a largely paper-based affair. The opportunity for home healthcare in the next five years is to harness the power digitalised information and mobile connectivity – as has been done in most industries, hospitality and logistics are good examples – to optimise care delivery and introduce simple service or process innovations.
Smartphone at the heart of it all
There is little doubt that the mobile or smartphone will be at the heart of care delivered in the home for the foreseeable future. It can provide seamless communication between stakeholders, access to health records in the field, cost-effective data capture and full audit trail.
With smart phone penetration approaching 95% and improving network speed, new incremental technologies (often just apps) linked to the smartphone are emerging. The smartphone can provide assistance in capturing everything from time and attendance to vital signs.
Ubiquitous smartphones can also facilitate new processes and business models. Given the number of part-timers and transitory workforce, we expect homecare providers to benefit from staff bringing their own phones (so called BYOD) and connecting to the employer via an app.
NFC usage exploding
As the world is eagerly awaiting Apple’s announcement on the iPhone 6, it appears that even Apple has finally accepted that NFC (near field communication) will be an important feature of smartphones. NCF or RFID (radio-frequency identification) allows wireless communication between devices of all types over a very short distance (a few centimetres). NFC first became famous with the introduction of Oyster Card on the London Underground. It removed the need for a ticket, allowing the user to store a small amount of money on a card and pay by swiping in and out through the gates. Although NCF technology adoption has taken longer than initial enthusiasts predicted, many large banks have now introduced the technology for making small payments on cards and similar functionality is emerging on smartphones.
For delivery of health and care in the home, NFC provides an excellent way of proving attendance or delivery with care workers able to swipe in and out in seconds (as a substitute for paper time sheets or landline telephone solutions). There are a number of exciting other use cases for NFC, ranging from tracking of medication and equipment in the home, through to the idea that NFC cards can hold medical data and be easily read by care providers from different agencies. In Cambridge, for example, a pilot is run for old and frail people to carry their medical information on NFC-enabled bus passes. This approach may circumvent some of the tricky consent and information governance issues associated with giving care providers cart blanch access to online information.
Smart scheduling + algorithmic route optimisation
Although scheduling visits by nurses and care workers is more complex than scheduling the delivery of a pair of shoes, the sector in the UK has been slow to embrace route optimisation. In homecare this is probably because care workers are typically not paid for travel time as opposed to Sweden, where route optimisation is seen as vital to reduce the cost of care delivery.
Over time, we expect providers to deliver solutions that not only improve optimisation but fundamentally better match demand and supply. As care delivered in the home becomes increasingly complex (and sensors help with daily monitoring), the service will need to be configured to respond more quickly to urgent care requests. Another scenario which will drive variable demand is the increasing use of personal budgets or straight private pay. We already hear sons and daughters demanding apps from which to book care visits into slots where the informal care givers are not available.
Voice recognition = easy data entry in the field
Whilst the smartphone can easily deliver information to staff in the field, the capture of care notes and observations on smartphones or tablets can be impractical. Voice recognition (just like NFC) has been long in the coming but with an arms race between Apple, Google and other technology-enabler, voice recognition is becoming very good indeed. In the next few years, voice recognition will become the preferred method for capturing unstructured text.
Sensors: The challenge is service & process not technology
The Internet of things is one of the new revolutions on the horizon. Tiny sensors with extensive capabilities, long battery life and standard communication protocols (not yet there) will eventually have a huge impact on home healthcare. However, sensors have been around for a long time and although now smaller and less costly, the problem to date has been incorporating the sensor into the service delivery. A telehealth or telecare monitor provider, contracted separately from a provider of homecare, is not in a position to extract all the value out of such technologies. It is only when joined-up, serious progress can be made.
In the next few years, providers of health and care in the home will increasingly use sensors (to detect ‘simple’ but important issues like wet beds, dehydrated individuals, falls, etc). Sensors are also likely to play a significant role in improving medication usage monitoring. Sensors can also be used for logistical operations such as automatically opening the door for the care worker with a ‘key’ on his or her mobile.
Biometric for verification
Information governance, including making sure information is only accessed by appropriate users, is a real challenge in the sector. In the future, biometric authentication, instead of (or in combination with) smartcard or passwords represent a chance to make assess both easier and better controlled. This is a space technology is developing fast. For example, Barclays Bank has introduced finger vein authentication for the transfer of large amounts of money for corporate customers.
Robots: long, long time
Despite the unstoppable march of industrial robots (and some lawnmowers and hoovers), we do not believe that in the foreseeable future robots will be able to compete with a compassionate care worker equipped with a high-performing smartphone as his or her assistant.