Quarkside

24/01/2014

Care Bill: LAs should prepare now

Filed under: Health,Innovation,Social Care,Technology,Wellbeing — lenand @ 12:25 pm
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The Care Bill will need massive ICT change within Local Authorities (LAs) by 2016.  The Department of Health (DH) have issued, for discussion, a guidance note on social care information and technology (DH Care Bill Guidance).  Priority actions are:

  1. Roadmap: Plan with suppliers to satisfy a new charging regime by 2015.  Back office systems will need updating.  LAs will also have to provide information and advice to citizens – especially signposting citizens to care services.
  2. Self-Funders:  Consider on-line assessment for self‐funders within wider changes in information and systems.
  3. Better Care Fund:  Use the NHS Number as the primary identifier to comply with Integrated Digital Care Records Guidance.  There is capital fund open to NHS providers applying for resources to support the development of Integrated Digital Care Records, including with adult social care.  The second round will open shortly and LAs are strongly encouraged to work with NHS providers to make a compelling proposal.
  4. Open APIs:   Think about embracing open APIs when procuring, renewing or refreshing its IT systems.
  5. Technology Enablement:  Work with DH and national partners, to develop technology that drives improved outcomes, citizen experience and efficiency.

LAs should take this opportunity to consider joining forces to support a social enterprise that provides a national infrastructure with Open APIs into citizen controlled Personal Data Stores, keyed on the NHS number.  Co-production is the best opportunity in decades to provide interoperability between health and social care records, including self-funders recording expenditure against their Personal Care Budgets.  A social enterprise, such as Kemuri, could provide such an infrastructure, with suitable funding.

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Funding a Social Enterprise

Filed under: Health,Innovation,Risk,Social Care,Wellbeing — lenand @ 8:43 am
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Ideas are free.  Concepts are beguiling and an excuse for inaction.  Improving the wellbeing of an ageing population seems to be a noble social enterprise.  People don’t want intrusive monitoring – but digital technology can help.  Kemuri has taken the first steps in providing a passive wellbeing monitoring service that will cost less than £1000 in the first year and less than £500 in subsequent years.  One year in a residential care home costs at least 10 times this amount, or more likely, 20 or 30 times.

The technology for Kemuri’s simple well-being monitor uses the Internet of Things.  It may be a buzz word, but when Google invests £2 billion on such products, it is not just hype.  Adrian McEwan’s book on the Designing the Internet of Things has helped to identify the action needed for a start up.  The chapter on a Business Model Canvas provides a nine point process for showing what must come next. The benefits are clear, the costs are containable, so how can funds be raised to deliver at scale by 2016, when the impact of the Care Bill becomes clear to the general public?

The proposition is that funding should be forthcoming if there are sufficient provisional orders.  Provisional orders would be financially risk-free for care commissioners.  If the products and services do not meet pre-determined conditions, then the order need not be fulfilled.  The financial risk is taken by the funders.  The big question is the size of the market at the price point selected.

In the UK, here are approximately 2.5 million people aged over 75 living alone in own homes, sheltered housing or care homes.  Any one of these is a potential beneficiary of passive wellbeing monitoring.  2,500 provisional orders would be just 0.1% of the potential market.  2,500 provisional orders represents a turnover of £2.5 million.   Is this attractive to Angel funders or Venture Capitalists?  Time will tell.

24/11/2013

Ageing: Put the Social back into Care

Filed under: Innovation,Social Care,Wellbeing — lenand @ 12:28 pm
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At last, some recognition from people who understand the need to put the Social back into Care.  The “SmokingChimney” prototype won a £2000 prize for the Kent Connects challenge “How can we make it easier for people to help each other?

It was not led by Technology – but a real life story from one of the attendees who joined the team.  He was so impressed that he wants the first version off the production line.  He created the strapline and enthusiastically gave the winning presentation.  It is an example of how designers should listen to people who want something very simple – the refinements can wait.

Have a look at the SmokingChimney slide pack to see the simplicity of the prototype.

13/07/2013

MLF supports open standards: Open Care EcoSystem?

Filed under: Innovation,Outcomes,Standards — lenand @ 7:29 am
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Martha Lane Fox understands the case for open standards; from her speech in the lords:

“I am not talking about expensive and costly top down nhs IT projects but instead about better use of data, open standards, more agile development and a more digitally minded culture in our healthcare sector….

 … the Department of Health (DH) believes that at least three million people with long term conditions and/or social care needs could benefit from the use of telehealth and telecare services. Implemented effectively as part of a whole system redesign of care, telehealth and telecare can alleviate pressure on long term NHS costs and improve people’s quality of life through better self-care in the home setting.

The NHS can potentially save so much money, they should consider giving financial support to organisations working on preventative care.  Here’s Quarkside’s idea.

Elderly people living independently could have their homes fitted with activity sensors and wear health monitors eg blood pressure.  Data is collected continuously, via the Internet, and analysed to create an individual’s unique, normal, behaviour pattern.  Deviation from normal patterns, displayed to family members or carers, alerts them of potential health problems and they can provide valuable data for GPs or hospitals.

Early medical intervention could improve outcomes for people with chronic conditions, eg diabetes, loss of cognition eg Alzheimer’s and recently discharged from hospitals.  Each could be worth £billions.

An ecosystem of open standards makes sense.  We need standards for::

  • Home activity sensors, eg smart meters
  • Health monitors, eg heart rate
  • Safety alarms, eg carbon monoxide levels
  • Time series data for all types of home and health monitors
  • Display of analytical information for individuals, families, carers and health professionals
  • Information governance of digital identities and data sharing

Standards like this, developed coherently in the public sector, would encourage innovative SMEs to enter the market and vastly improve health outcomes.  It could be a world leading industry, helping the UK economy.  This open ecosystem should be supported by multiple stakeholders.  It crosses the boundaries of Government departments of Business, Innovation & Skills, Health, Education, Communities & Local Government, Work & Pensions  and Local Authorities with responsibility for Social Care.

Any Government and Trust funding for the development of an Open Care EcoSystem will help the transformation from a reactive public health service to a preventative health culture in private citizens.

Is ten years too ambitious?

14/06/2013

Get all the URLs into a room!

Filed under: Innovation,Policy — lenand @ 6:39 am
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The Internet of Things may eventually enter the vocabulary of Members of Parliament (MPs).  But as Dr Julian Huppert, MP, pointed out, the eyes of MPs glaze over at the mention of digital technology.  He was not joking when he said that in the debate about child protection, there was a call to get all the URLs into a room for a meeting.

The use of acronyms adds to the confusion when they could have alternative meanings.  When discussing the protection of IP addresses, an MP can be forgiven for thinking it is about the protection of Intellectual Property addresses.

The point was well made at the beginning of yesterday’s meeting of the Digital Policy Alliance (the DPA, not to be confused with the Data Protection Act).  If digital technology terminology is to permeate policy, then DPA publications must be clear and have value to MPs in their constituencies.  This enabled the meeting to massage the message into five topics on the Internet of Things (IOT), not to be confused with the Internet:

  • Business
  • People
  • Government
  • Privacy
  • Infrastructure

03/06/2013

Predictive Monitoring: Heart Attack and Stroke?

Filed under: Innovation,Risk — lenand @ 6:12 am
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Machine learning via neural networks produces impressive results.  The Blood Glucose prediction hackathon used three data streams: historical blood glucose, insulin dosage and carbohydrate consumption.  This explains approximately 50% of the prediction.

Blood Glucose Predictive Power

Blood Glucose Predictive Power

Adding three more streams would increase this to 85%; other nutrition, activity and other lifestyle factors.  All these could be simply collected from mobile devices and used in other health prediction applications. It shows the value of monitoring data streams for multiple purposes.  This data could also be analysed alongside logs of blood pressure and heart rhythms.

Just think of the value to people who are at risk of heart attack or stroke.   Real-time predictions of heart rate and blood pressure could set alarms that would moderate a person’s behaviour.  An impertinent machine telling you to Stop driving!, sit down! or have a rest! may upset your plans – but it is better than risking your own or another life.

Machine learning is not rule based – it calculates the rules.

29/05/2013

Predictive Healthcare: Innovative growth in USA

Filed under: Innovation,Technology — lenand @ 10:31 pm
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McKinsey have analysed the applications of big data technology in US healthcare and show that direct intervention and predictive power is increasing:

Big Data in Healthcare

Big Data in Healthcare

 

If early successes are brought to scale, we estimate that big-data applications could eventually strip more than $300 billion in costs from the nation’s health-care system and improve transparency to drive better patient outcomes. Such applications might help avoid costly readmissions, enhance the understanding of chronic diseases, and ensure that patients are treated in the care setting that best meets their needs.”

This should encourage UK and EU investment in smart software to help in diagnosis and treatment to improve health outcomes.  There’s big money for those innovators that provide scalable machine learning and prediction.  The Internet of Things is capable of generating more data than can be analysed easily by traditional techniques.  Singapore is doing it.

IOT: Where do you start?

Filed under: Innovation — lenand @ 7:16 am
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The Internet of Things now has so many players.  Companies trying to rise to the top in horizontal and vertical markets.  This Techcrunch article attempts to make sense of them.  Emerging industry has so many innovative start-ups, all seeking to become market leaders.  However, don’t be surprised if the oligopolies win in the end – by internal investment or purchase of smaller companies.

Where does anybody start if they want to develop an idea through proof of concept to a sustainable business?IOTMap

Apologies if this image blows the size of your browser screen.  It works OK on Opera with ‘fit to width’.  Otherwise look up the original Techcrunch article.

26/05/2013

Ageing: Digital Half-Life Policy

Filed under: Innovation,People,Policy,Technology — lenand @ 7:53 am
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Digital technology will impact everybody in the second half of their lives.  The age from 50 to 100, for the vast majority of people, will be a decline of most faculties until death do them claim.  Now is the time to think of the technology implications and develop a policy for public debate.

Here’s a table that shows the decreasing personal digital needs of people over 50 and the increasing needs of their family, friends and service agencies.  There’s an shift from being active and independent to moribund and entirely dependent and others. There a wide range of intermediate states of health and vigour, and digital needs should be individually tailored for the best outcomes.

Digital half life - Needs

Digital half life – Needs

The active, social person with no major health problems has lots of choice with the faculties to manage digital technology with ease.  For many this can last into their nineties.  However, the vast majority steadily need more external support. They wish to live independently, and this becomes easier and more economical if they accept external monitoring services. Currently these are expensive, using old technology in the home.  There are gaps in the market for home monitoring services – some idea is given in the table below:

Digital half life - Gaps

Digital half life – Gaps

The Internet of Things will lead the revolution.  Low cost home networked sensors are critical to the way forward.  It also needs good communications to data centres and analytical software as part of an affordable infrastructure.  Automatic sensing of changes to normal behaviour are necessary, in addition to the commonplace detector alarms.  With intelligent investment, the UK could develop a World leading technology industry.

18/05/2013

Prepare to grow old

Filed under: Innovation,People,Technology — lenand @ 7:54 am
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Quarkside does not need to do research when there are already good resources. For example, a review of the Telecare market produced by the Aktive project.  The UK claims to be leading the world and the Technology Strategy Board is pumping funds into ageing related projects.

The message is that people should consider installing technology in the whilst they are fit and active. This will have to be self-funded, because statutory health and care agencies bodies will not pay until there is a crisis. By monitoring normal daily activity, advanced software can detect changes that point to action that could prevent a crisis.  Potential savings are enormous.  Being able to live in your own house for one year extra is worth £30,000 to £50,000.

The minor problem for the elderly, or major opportunity for entrepreneurs, is that nobody is supplying a low cost home activity monitoring service.  DIY is not an option.

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