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The Health and Social Care Information Centre (HSCIC) has created a telehealth prototype called MediPi created on a Raspberry Pi, with the aim to pilot the kit next financial year.
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Both software and hardware are open source. The MediPi project aims to address one of the reasons why telehealth uptake in the NHS remains relatively slow: Affordability.
The Whole Systems Demonstrator (WSD) programme – which the Department of Health set up to find evidence supporting the use of telehealth – released its report in 2013, saying that telehealth was not cost-effective.
The research found that adding conventional telehealth measures to usual care would cost £92,000 per quality-adjusted life year and was unlikely to ever be cost-effective.
Although most agree remote monitoring of patients with long-term conditions is beneficial – for the patients and the health service – the WSD programme cast doubt on its affordability.
However, the HSCIC may have come up with an answer to that. The MediPi system uses a Raspberry Pi, a 7in touchscreen tablet and a set of equipment such as a blood pressure cuff, a finger oximeter and some diagnostic scales, all off-the shelf products coming in at a total of £250.
As easy as Pi
Richard Robinson, a technical integration specialist at HSCIC, came up with the idea after his wife went to find volunteers to participate in a telehealth pilot study. The kit she brought home – which included a 3G enabled tablet, Bluetooth enabled devices and a home hub – Robinson thought sounded expensive. He decided to look into how much cheaper he could do it himself.
“The cost for telehealth is crazy when you think about it,” he says. “Devices like Raspberry Pis are being churned out at £32, so I thought I could definitely do it cheaper.”
Robinson developed the prototype, which has a simple interface using a tile dashboard for easy interaction. Each tile represents a device, such as the blood pressure cuff, and also has a quick "yes" or "no" questionnaire for patients to fill out.
An NHS trust is slated to pilot the MediPi system in the next financial year.
The HSCIC declined to identify the NHS trust, but the pilot scheme such is likely to work with heart failure patients. Around 900,000 people in the UK suffer heart failure every year, and 30% to 40% of patients die in the first year of diagnosis; monitoring weight, heart rate, blood pressure and oxygen levels is key to improving quality of life and preventing hospital attendance.
Each device can connect to the touchscreen tablet with a USB cable, however Robinson says the way the software has been put together makes it easy to add a wireless interface device.
“We’e taken a very simple approach where we take all the data from the device and send it over raw,” he says.
“Each of the bits of the data can be encrypted separately so they can only be seen by the recipient they're intended for.
“Currently we're sending it using an NHS Spine message, but while MediPi can use Spine messaging, it's also able to use other sorts of messaging. We envisage a secure network we can send the messaging across.”
The software is built on JavaFX, making it platform agnostic. Since there’s no requirement to run on a Raspberry Pi, “it could be deployed on anything”, Robinson says – but he adds that he chose Raspberry Pi partly because of the financial reasons – partly and because it’s a British brand.
“That's lower down on the priority list, but I think it's quite important that it has been manufactured and designed in Britain,” he says.
Damian Murphy, technical integration manager at HSCIC, points out that the organisation only provides the capability; how it’s used is completely determined by the patient and health trust using it.
The HSCIC is simply trying to facilitate the use of telehealth through a cost-effective method and doesn’t plan on becoming a telehealth supplier.
“There has been a degree of market failure on the grounds that telehealth is not affordable. What we have here is rapidly approaching being a fully worked-out demonstration of how you can get around some of the things that make it unaffordable,” he says.
“There's no actual proposal for the HSCIC to go into the hardware manufacturing of this, but rather facilitating others.”
However, the HSCIC is talking to universities to work out how to make it as efficient as possible from a production viewpoint.