A Technological Revolution in Elderly Health

Irish medical times

Ireland

August 17-24, 2007

Fintan Deere reports that the up-and-coming technological solutions to some of our most pressing healthcare problems – especially where the elderly are concerned – will pleasantly surprise us all
A glimpse of the future contribution of technology to healthcare was unveiled by microchip giant Intel recently at a presentation in its Irish Innovation Centre in Leixlip, Co Kildare.

Speakers at the ‘Insights into the Digital Healthcare Horizon’ meeting included Mr Eric Dishman, General Manager of Intel’s Health Research and Innovation Group and Mr David Prendergast and Mr Simon Roberts from the company’s ethnographic research department.

Since 1999, Intel scientists have been studying the healthcare needs of elderly people with a view to designing technology-based responses to the health problems of the steadily-ageing populations of most countries, especially in Europe and the US. The company is focusing on personal healthcare technology against the backdrop of frightening demographic trends.

Anthropological analysis

Enhanced longevity will double the number of people in the world aged over 60 to more than 1.2 billion by 2025. Older people face chronic illnesses; healthcare budgets face the same crisis as pensions budgets and public and private health sectors will creak at the seams. Intel says technology will not offer a panacea for healthcare issues for a more elderly population but it can play a valuable two-fold role.

The first is the enhancement of technology use in hospital, pharmacy and doctors’ surgery settings. The second is in personal technology that will interact directly with elderly people, enabling their well-being to be monitored at home.

Intel’s research — being conducted partly in Ireland — is multi-disciplinary and involves health professionals, technology designers and ethnographers, who are compiling a detailed anthropological analysis of the lifestyle of elderly people. The research has focused on the needs of people facing typical old-age health problems, such as Parkinson’s disease and Alzheimer’s.

Shimmers

Already, prototype devices called ‘shimmers’ have been developed which are designed to be carried on the person and track key indicators about the owner’s state of health. Another device being modelled would measure the steadiness of people’s gait discreetly from under the carpet and give advance warning of increased risk of the patient falling.

Intel intends that this information will feed into the patient’s professional medical carers, giving a better chance of early disease detection and better monitoring of a patient’s ongoing stability or decline.

This in turn would allow more focused professional intervention, minimise routine trips to doctors and hospitals and allow more people to live longer and more safely at home. And in turn, this would relieve the workload on the health service and keep the cost of caring for a greying population under control.

Mr Herbert Weber, Director of Marketing Digital Home, Intel Europe, Middle East and Africa, said the firm’s premise is that the world needs “a different formula” if it is to simultaneously cope with an ageing population, reduce the cost of healthcare and improve access to it.

“The underlying genetic problem is that people are living longer. We have been focused on health technology research for seven years and now have two dedicated business units for the sector,” he said.

“The first is for the traditional health sector, it is about better computers, servers, databases and IT infrastructure in hospital and for doctors and pharmacies – areas we all know very well” said Mr Weber. “Our other focus is on personal health systems. looking at what could be done in the home.”

Chronic diseases

The right technology, Weber says, can help ensure people do not need to go to an institution or hospital at all, or not stay there as long if they have to go.

“Older people have chronic diseases, they are not dying but on the best day they are sick. Eighty per cent of the spend on healthcare is on chronic disease rather than acute care but most of the infrastructure in hospitals and clinics is for acute care and attending to emergencies,” he said.

“Today’s health infrastructure cannot cope with today’s problem – an older population and a larger number of chronic disease patients.”

Mr Weber said the research conducted by Intel is looking in particular at common ailments of the elderly. “We want to find out how do we find the right technology for people with Parkinson’s disease or Alzheimer’s? How do you detect it, can technology detect it faster?” he explained.

“Earlier detection would reduce the cost of treatment and bring a cost benefit to the healthcare industry, but also a quality of life benefit to the patient, to you and me. Our focus is on independent living in old age, how you make people more independent,” he said.

Early warnings

Weber says technology can do what there simply are not enough people in the healthcare system to do by any means, such as early warnings of the risk of a fall in the home.

“Falls are a primary source of death in the home – break a hip and you are finished. We want to reduce the number of falls. They don’t occur like a lightning bolt, there are symptoms before.

"We want to invent the technology that can predict that someone is likely to fall years as well as hours and minutes beforehand. Indicators like when you get up or go to bed, how much you sleep, how much you drink, or do you eat regularly, all influence well-being”, he said.

“If technology can track basic bio-medicine signals — electro-cardiogramme, lung volume, blood sugar levels — there are not that many indicators to be tracked — a physician can read from that data that a problem is developing. He can then intervene and call the patient to his office for a diagnosis.”

Direct interface

Mr Weber said such a scenario would reduce the frequency of direct interface between GP and patient.

“For an elderly person, even going to the doctor’s surgery once a week is a problem, because they are not that mobile any more. Secondly, in 99 per cent of the cases it is for no good reason, so a large number of trips are made which are not really needed. Technology could replace these with a virtual visit; the doctor will get data and maybe talk to the patient on a videophone.

"We are still trying to perfect what will eventually be useful in the home and how it would need to link up to in the health provider. It will help indicate who is in trouble and save time and money because if you want to administer the same diagnosis every single time to all patients you drown the system,” he said.

If the same number of physicians and nurses are deployed to focus on the people whom the technology has detected as being imminently prone to a serious problem then the health system will be able to deal with the problem of more older people, according to Mr Weber.

Harnessing technology

Harnessing technology solutions in this way could greatly reduce the burden on healthcare industry, Mr Weber said.

“It is extremely expensive if you wait until somebody has a heart attack and uses an emergency ambulance, an emergency room and has an operation. If you can reduce emergency cases by a fraction you will save the health sector of the world a lot of money,” Mr Weber said. There is also a potential social dimension to such technology, said Mr Weber.

“It is not only about medicine, about diagnosis and treatment it is also about social contact. It can help how relatives can stay in touch with elderly parents and are involved in their care but can‘t connect physically on a frequent basis.”

User friendly

The technology is the easy part, he says and the hard bit will be fine-tuning it to a way that is user-friendly and acceptable.

“The real question is how to make it all useful so our researchers are trying to find out how people interact with technology and what are the real needs.”

To this end, Intel’s researchers studied 800 elderly people in 20 countries in their own homes.

“They looked at real houses, real life environments, followed the people and even lived in their homes and made very detailed notes on every single action, including what they ate and when they got up,” Mr Weber explained.

“They even went to the doctor and the shopping mall with them. They did this for a month, to understand that person and that environment.

“When you put all of this information together, you start to get patterns and an insight into how to make the technology relevant.”

Field work

This field work has been conducted in Europe and will be done next in Asia. Mr Weber accepted that, apart from the issue of marrying the potential solutions created by technology researchers to the needs of healthcare professionals and of elderly people themselves, questions about privacy and data protection must be resolved.

But Intel’s ambition of providing technology-based health answers for an ageing population is not a distant hope, he insisted.

“We are still researching but I think the timescale to translate into real products will be three to five years and the market is ready for it. I’m 52 and I think it will be around before I retire,” he said.

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