Wearable COPD Trial to Reduce Costs Associated with Unnecessary Hospital Admissions

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2Q 2019 | IN-5499

NHS Greater Glasgow and Clyde in Scotland will begin a 12-month trial in August 2019 to test the use of wearables in remotely monitoring patients with Chronic Obstructive Pulmonary Disease (COPD), one of a growing number of wearable trials for medical purposes. Mortality rates for COPD in the United Kingdom are the twelfth highest in the world, with Scotland in particular seeing a larger number of both hospital admissions and deaths. It is hoped that the trial will help reduce the frequency which with COPD patients are hospitalized; currently, an average of 10 COPD patients per day are admitted to NHS Greater Glasgow and Clyde’s emergency room alone and, without intervention, that number is expected to increase. These admissions are painful, stressful, and time consuming for patients, and cost the NHS around £6,000 each. The trial will include 400 patients and, after it is completed, the data will be evaluated to consider whether the model can be scaled and deployed across the rest of the NHS to help the 1.2 million people in the United Kingdom with COPD. If successful, it could also be used for other conditions, particularly diabetes.

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Wearable Trial Aims to Reduce COPD Related Patient Admissions

NEWS


NHS Greater Glasgow and Clyde in Scotland will begin a 12-month trial in August 2019 to test the use of wearables in remotely monitoring patients with Chronic Obstructive Pulmonary Disease (COPD), one of a growing number of wearable trials for medical purposes. Mortality rates for COPD in the United Kingdom are the twelfth highest in the world, with Scotland in particular seeing a larger number of both hospital admissions and deaths. It is hoped that the trial will help reduce the frequency which with COPD patients are hospitalized; currently, an average of 10 COPD patients per day are admitted to NHS Greater Glasgow and Clyde’s emergency room alone and, without intervention, that number is expected to increase. These admissions are painful, stressful, and time consuming for patients, and cost the NHS around £6,000 each. The trial will include 400 patients and, after it is completed, the data will be evaluated to consider whether the model can be scaled and deployed across the rest of the NHS to help the 1.2 million people in the United Kingdom with COPD. If successful, it could also be used for other conditions, particularly diabetes.

Throughout the trial, clinicians will gain access to patient-reported information and physiological data from wearables (including heart rate, steps, and sleep patterns) and breathing machines to allow treatment plans to be varied accordingly to ensure that the correct levels of antibiotics and steroids are immediately delivered. This will also prevent patients from taking unnecessary antibiotics and steroids in case they become ill. Machine learning risk stratification models will be derived to enhance the delivery of care for patients with COPD. Patients will also be able to communicate with clinicians via a cloud-based platform, and consultants will have the ability to change patients’ ventilation levels remotely through the Wi-Fi and Bluetooth based platform. This will help to improve patient care and reduce medical costs, although it is unknown by how much.

Machine Learning Platform Central to Wearable Trial

IMPACT


Wearable healthcare trials led by healthcare services with the aid of device vendors and platform providers are becoming increasingly popular, offering medical professionals a way to remotely monitor patients and allowing issues to be detected and treated sooner. This will reduce healthcare costs, because fewer patients will be admitted to hospital with worsening conditions that require treatment, and give medical professionals the ability to monitor a large number of patients simultaneously. These trials are undertaken by numerous different companies working together to ensure that all data is collected, securely stored, and analyzed to create effectual results. In the case of this COPD trial, NHS Greater Glasgow and Clyde will be working with KenSci, Microsoft Azure, Storm ID, and Fitbit.

KenSci, a Seattle, Washington-based platform company founded in 2015, offers an enterprise-grade, secure healthcare machine learning platform that allows healthcare organizations to build, deploy, and operationalize Artificial Intelligence (AI). Data from various sources, including wearables and medical devices, can be collected and analyzed via the platform, allowing medical professionals to manage patient care more efficiently. It is built on Microsoft’s Azure cloud platform, which provides machine learning that detects when there are changes in a patient’s health before they become an issue and ensures that all data is kept secure. Storm ID, a Microsoft partner, provides the support for the remote monitoring of the patients via its new digital-enabled care models.

NHS Greater Glasgow and Clyde serves a number of hospitals in Scotland that provide healthcare to over 1.2 million patients. Its respiratory team will be provided with data from patients to enhance the existing service model, improving the level of care for COPD patients. The wearables for the trial include a variety of fitness trackers and smartwatches from Fitbit with Bluetooth connectivity to make the platform accessible from smartphones or computers, with wearables from other vendors expected to be added in future if the trial is a success, allowing the technology to become available to a wider range of patients and medical professionals. The trial will be deemed a success if hospital admissions are reduced and medical professionals are able to remotely monitor their patients effectively.

Wearables Push into the Healthcare Market to Reduce Costs and Improve Patient Care

RECOMMENDATIONS


Wearables from major vendors, including Apple, Polar, and Garmin, are increasingly being used for medical trials, testing their ability to track various metrics and allowing medical professionals to remotely monitor patients. This approach is advantageous for wearable device vendors because it provides both proof that their devices can track healthcare vitals as they are used by medical professionals and publicity for the wearables themselves. It also allows healthcare services to be improved care and reduce time/costs and patients to have their vitals monitored more closely, potentially improving their overall level of health. While the use of wearables in the healthcare service appears to be beneficial, it is currently unknown exactly how much their use is able to reduce costs and save time.

To facilitate this move toward using wearables as medical devices (instead of larger medical devices that are abandoned by patients for being bulky and unaesthetic), vendors are offering a greater number of features that allow for use in medical situations while maintaining the functionality of a typical wearable device. Many of these features are standard in wearables, such as heart rate tracking, step tracking, and sleep monitoring, with an increasing number of vendors adding advanced features such as Electrocardiogram (ECG) monitors, blood pressure tracking, and fall detection. Vendors are adding these features to their devices because consumers are looking to get more from their wearables and becoming aware of the ability to continuously monitor a growing number of aspects of their health. The level of accuracy differs from device to device, but usually provides an adequate level of information for the average consumer, with wearables intended to be used for medical purposes often being put through testing in advance.

Wearable vendors looking to add these healthcare tracking features to their devices need to consider a number of aspects to ensure that the technology is successful. While many features can be added without major testing, if a company wants its device to be classified as a medical wearable, it will require medical clearance from organizations such as the Food and Drug administration (FDA) in the United States and Conformité Européen, or European Conformity (CE), in Europe. Medical approval ensures that inaccurate readings are kept to a minimum, allowing the device to be used more readily for medical purposes.

When adding these healthcare features to a wearable, whether with or without medical approval, vendors also need to consider how they will affect user experience and overall device performance. Battery life is a particularly important aspect, as adding these extra features may cause noticeable drain on the battery. A long battery life should be a fundamental requirement to ensure that a device can adequately provision these added healthcare tracking features without fear of it dying at a potentially crucial moment, leading to vital healthcare information being missed. Other aspects will also be affected, such as the costs of adding the features and the final price of the device. Making a device too expensive may limit its uptake, but this must be taken into consideration with the benefits it can provide to patients and healthcare systems.

The associated software and platforms also play a vital role in the use of wearables as medical devices, providing an area for patients and clinicians to have access to data from the devices. The software and platforms must function accurately, as any false or missed readings could cause healthcare issues to be missed or patients to be brought in for unnecessary treatment. If these issues were to occur continuously, the devices would be abandoned. Security is also vital, as sensitive information is often kept on the platforms which, if compromised, could be damaging for patients and healthcare services, again leading to the technology being abandoned, so providers of the software and platforms must ensure that they are accurate, reliable, and secure.