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Being able to respond in a fast, efficient and cost-effective manner to the healthcare needs of the UK’s growing elderly population is a major source of pressure for the NHS today.
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Individuals in this group are more likely to suffer from chronic medical conditions that require lengthy courses of medication and frequent hospital check-ups, so the clinicians overseeing their care can keep close tabs on their progress.
All this, of course, comes at a cost. According to figures released in October 2015, NHS trusts chalked up a funding gap of £485m during the first quarter of 2015/16.
Their governing body, The NHS Trust Development Authority, partly attributed this overspend to the challenges trusts face when working out how to deliver ongoing care to “medically fit” patients once they’ve been discharged from hospital.
It is a conundrum Dutch technology giant Philips is trying to solve with its Healthcare Informatics, Solutions and Services (HISS) division. Its aim is to equip patients with the tools and technologies they need to self-manage and monitor their healthcare at home.
This approach can significantly cut the number of visits patients make to hospitals and GP practices, HISS CEO Jeroen Tas tells Computer Weekly, and – in turn – reduce some of the burden on the health service.
“We know everything about monitoring people in an intensive care unit setting, and we have 250 million patients hooked up to our devices each year,” he says.
“What we’re looking to do now is bring this capability into people’s homes. So, for example, if you’re an elderly person with multiple chronic diseases, what kind of devices can we give you to help with that?”
Some of the tools in this category include interactive weighing scales, blood pressure monitoring cuffs or ones that keep tabs on when patients take their medication, says Tas.
Warming to this theme, he outlines devices that can track changes in a person’s gait, which could pinpoint patients at risk of a fall or stroke in the home.
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Regardless of the device used, all would feed information back to healthcare providers– either for record-keeping purposes or to alert them that some degree of intervention may be needed ahead of time – resulting in higher levels of patient care.
“What we’re looking at is if we can create a very easy environment where these devices help people control their condition, but at the same time allow us to keep monitoring them,” he says.
“If we stream this data from the devices, we can ask questions, understand the context, and interpret its meaning in real-time, and take action.
“That action might be a daughter calling up, saying, ‘Mum, you need to take your medication, because I can see you’re not,’ or sending a therapist to someone’s home to help them.”
Using cloud to deliver clinical care
Delivering on this vision requires the ability to collect, store, analyse and cross-reference the data Philips receives from these devices on a large scale and in real-time, adds Tas. Without cloud, this would have proved impossible.
The firm has set its sights on connecting hundreds of millions of devices to its health monitoring platform, and will need to efficiently process the large volumes and varieties of data these will give rise to.
“We need a whole lot of computing power and that has to be elastic because, if we’re starting this and it’s successful, it will need to deal with petabytes of data each month. That’s what we’re designing it for,” he says.
“We’re looking for hundreds of millions of devices that will ultimately be connected. We already have seven million devices streaming data, but how are we going to deal with 100m? That will require a completely different infrastructure.”
Using a cloud-based infrastructure makes sense from a resiliency and availability point of view, says Tas. That is why the company is looking to Amazon Web Services (AWS) to support its sizeable ambitions.
“It has to be able to scale, but it also needs to be mission-critical because, if someone is wearing a device and they fall, you have to be able to help – or otherwise that person may die,” Tas says.
“We could never set up an infrastructure like AWS. Our strength is we understand the clinical world. We understand how to create good propositions for customers. We’re not going to waste our capital and talent on core infrastructure. We want to use it to craft digital solutions for healthcare.”
Using the cloud allows Philips to strip out the cost and resource barriers that often prevent companies from expanding their operations overseas. In Philips’ case, this would make the UK pilot projects it has recently embarked on much harder to do, says Tas.
An example of this is The Supported Self Care Champion Project Philips launched in conjunction with Cheshire and Wirral Partnership NHS Foundation Trust and NHS West Cheshire Clinical Commissioning Group in August 2015.
Its aim is to help nearly 1,000 people suffering with long-term medical conditions live more independently, by providing them with technology-enabled, self-care services over the course of 12 months. The project will help Philips shape how to delivers similar offerings on a nationwide basis in future.
“We run a global business and, if you need to deploy on-premise, you need to have all these people in place before you can do so,” he says. “Now we just deploy in the cloud with a small team that manages it.”
Hybrid vs. public cloud
Whether or not the HISS division of Philips will go on to join the roll call of AWS customers that have gone “all-in” on its cloud platform is difficult to say at this moment, as it is currently responsible for managing around 26,000 servers housed within thousands of its customers’ on-premise datacentres.
“These servers manage clinical data and images and some of that we still have to do because we may be supporting real-life images for someone operating on a patient, for example. Or we may have someone rushed into A&E, where they need to pull up that data and make a really quick diagnosis,” said Tas.
“For that, we can look at these datacentres and servers as edge devices in the cloud, where we can cache data and deal with latency or run some of the processing close to where we need it. But a lot of it can be run in the cloud,” he says.
For what Philips is trying to achieve right now, the hybrid approach works. Having cloud resources on tap paves the way for the organisation to essentially crowd source a diagnosis, rather than rely on the sole knowledge of a single clinician, resulting in a faster and more accurate diagnosis.
“We can go back to the cloud and say, ‘give us cases that look similar to this one,’ and we can interpret it combine this image with the medical record of the patient, their biopsies and data from relevant literature, and deliver faster patient care,” Tas says.
“Some people say 'no' to healthcare in the cloud, but I say the opposite – the benefits are just too overwhelming.”