There’s a dilemma for people who need residential care and for their families and loved ones.
On one hand it is important for their morale, dignity and rehabilitation that they should enjoy as great a degree of independence as possible.
Yet, those who are living with brain or spinal conditions are, by definition, vulnerable.
For their own safety and for the peace of mind of their families and carers, they require monitoring to a greater or lesser extent.
Monitoring, however, is something which undermines, or even negates, independence.
Fortunately, modern technology is allowing the development of systems which enable remote monitoring, allowing a person to live on their own but which alerts a carer, relative or any other nominated body when anything arises that might indicate a problem.
One such system is VEMS (pictured), developed by husband and wife team Martin and Antonia Bradford.
Initially their target market was the elderly, but it soon became apparent that VEMS was a valuable tool in the care of all vulnerable people.
Antonia, who has a master’s degree in computer science and Martin, an electronics engineer, developed VEMS over two years ago through a combination of their professional experience, a hobby and family circumstance.
Antonia explains: “The whole thing started when we built a little monitor for our boat to check that the electricity was working and there were no leaks and so on.
“The thing was working beautifully then suddenly my mother-in-law had a fall, then I said to my husband, ‘what we need is a boat monitor but for your mother’.
“So we started developing it and within a few weeks we had a very early prototype in her house.’’
Last year Martin’s mother had a stroke, but, fortunately, VEMS alerted them that something was wrong.
“We don’t know whether our early response saved her life or not, but the point is that we knew straight away that there was something amiss even though we were not close by,’’ says Antonia.
“We managed to get someone to get help to her and she recovered very well.’’
VEMS monitors movement, temperature and humidity; data which is captured by a monitor and relayed to a cloud-based server where an engine builds a statistical model of the customer’s behaviour.
Antonia says: “The system generates readings and if it thinks that a number is significantly different to what it is expecting, it starts to raise concerns. It builds the level of concern and when it gets to a certain point it sends a notification to the mobiles of the nominated people.’’
A carer can log into the system at any time to check on the wellbeing of any of their customers.
“You put the sensor unit in the room, you connect it to the home WIFI and then you forget about it. You just live normally. It’s very simple to use, with all the complexity up in the cloud.
“We wanted to make sure that it was accessible to people of all abilities and most importantly for all pockets.”
Currently they are looking for 30 volunteers to trial VEMS.
Antonia says: “The participants will have the service free of charge for three months and if they decide to stay with the service they can keep the sensor with our compliments, but if they’re not happy, they return the sensor and we will cancel the subscription. It would cost them nothing.’’
For more information, visit www.vixenelectronics.co.uk
Using technology to help preserve independence
With the creation of the Luscii remote monitoring platform, people with ongoing care needs can avoid the necessity for regular medical appointments, while clinicians can ensure they’re being looked after from afar. NR Times speaks to its founder Professor Daan Dohmen about Luscii’s role in the future of healthcare
From his early experience of working part-time in a nursing home came a realisation that patients could and should play a more active role in their care and health.
“For me, that was a really important step in my vision to use technology to help regain people’s independence,” says Professor Dr Daan Dohmen.
“The nursing home had all good intentions but took away the independence of people living there – they put them in the shower, they did everything.
“There was one day that I took an 82-year-old lady from the nursing home to a grocery store one block away. We weren’t supposed to do that as there was a store in the nursing home, but I said ‘Let’s go together’ and took her there in a wheelchair.
“She said to me ‘Daan, this was the nicest thing to happen to me in ten years’ – and that made me think even more about how we can use technology to provide freedom to people who may not have that.”
And from that realisation has grown Luscii, a platform which enables home monitoring for patients, allowing clinicians to keep check from afar without the need for them to come in to hospital.
Founded in the Netherlands, it is now used in seven countries across Europe and Africa, including in the NHS, Luscii – named in tribute to Florence Nightingale, derived from the Latin ‘luscinia’ – is enabling a new digital approach to healthcare.
Powered by its Clinical Engine, the use of AI supports and alerts healthcare providers when intervention may be needed, and contact can be made immediately via message or video connection.
Clinicians can monitor patients remotely via a dashboard, using Luscii’s concept of virtual wards to correlate data and alerts for multiple patients, and then responding with intervention whenever required.
“For managers of Trusts and CCGs, they understand this can help increase capacity and help with waiting lists, but it is even more important from the patients’ perspective in unlocking the power for them to use the tools independently,” says Daan.
“And for doctors and nurses, who we call our ‘medical developers’, they can build their own digital pathway with e-learning modules and algorithms for their patients.”
With the launch of Luscii in a pre-COVID-19 era, in 2018, the events of the past year have seen the platform take on an even more fundamental role in healthcare.
“COVID really pushed the concept of digital,” says Daan.
“We’d seen a lot of doctors and nurses who were quite anxious about digital health, thinking is it clinically relevant, will it lead to ‘cold care’? Often if a patient said they wanted to try digital apps, the doctor would say ‘That’s nice, but I don’t think it’s for you’.
“The past year has forced clinicians to try digital means, and suddenly they are finding out that this can be beneficial in certain situations.
“Through our virtual wards, we were able to support the early discharge and triage of COVID patients – sometimes it was 11 days earlier when patients could go home.”
And its response to COVID, which saw it develop the Corona Check app – which enabled hundreds of thousands of people to submit health data daily from their homes, allowing healthcare providers to determine who may have COVID-19 and who needed most immediate care – has been acknowledged with the Prix Galien Excellence COVID-19 MedTech Award.
“We got out the digital Lego box and built a COVID app – we now have 20million registrations on that platform,” he says.
Born out of his previous business FocusCura, a healthtech which uses smart tools to promote the autonomy of vulnerable people, Luscii continues to grow, particularly in light of the new-found digital adoption within healthcare.
Now in seven countries – five of which came in during COVID – with its native Netherlands and the UK being some of the earlier adopters. Currently, it is used in more than half of all Dutch hospitals and was pioneered in the NHS by the All Together Better alliance in Sunderland, supporting elderly patients with chronic illnesses at home.
And it was among elderly people, inspired by his experience of the nursing home, that Luscii’s potential was initially realised.
“A lot of elderly people with chronic diseases had to go to hospital all the time, they often had to arrange for a family member to take them there, then they would get to hospital only for ten minutes later to be back outside as they were fine and able to leave. The rest of the week they’d be too tired to do anything,” says Daan.
“We came up with the idea of how to support people with chronic illnesses to have remote check-ups. This was at a time when iPads had just launched and video calls were happening. But what started as a project got bigger and bigger so we had to split off independently.”
And from its origins in supporting elderly people, the roll-out is now including a much wider area of healthcare, as its role in COVID has helped to demonstrate.
“Once we have virtual wards, people can understand how they could be used in other areas,” says Daan,
“It’s a personal dream of mine that doctors create these programmes and share between them. Through collaboration, it becomes bigger than a product – it is a movement.”
Going forward, with the potential for digital healthcare continuing to be realised, the ongoing international roll-out is set to continue for Luscii.
“We are now in seven countries worldwide, four of which we haven’t been to physically, the roll-out has all been done virtually,” says Daan.
“We have shown we can scale quickly so we can support more patients in more areas.”
Rehab tech business wins further recognition for innovation
Rehabilitation technology developed by Fourier Intelligence has won yet more recognition for its globally-significant innovation.
The ExoMotus M4, a lower limb exoskeleton, was awarded the Shanghai Design 100+ accolade.
The exoskeleton, a gait and body weight system, is the first and only product of its kind on the market with its own body weight supporting system.
The ExoMotus M4 will be launched into the Chinese market at the Shanghai GReAT 2021 annual summit at the end of July, and is expected to be unveiled in the international market in early 2022.
The latest recognition comes only shortly after Fourier Intelligence won four awards at the China International Medical Equipment (CMEF) Spring Expo, with two being given to its newly-revamped ArmMotusTM M2 Pro device.
The Shanghai Design 100+ awards recognise and promote the influence of designers in Shanghai, and covers innovation from over 30 industries.
Over 2.45million public online votes were cast in determining the winners, which were also determined through industry voices and key expert votes.
The ExoMotus M4 lower limb rehabilitation robot was acknowledged for its ergonomic and user-friendly design, which can achieve gait functional training and multiple mode evaluations.
The gait mechanical leg can provide the user with precise sensory input in the early stage of rehabilitation through repetitive walking and inhibit the formation of an abnormal gait pattern or learned non-use.
Early gait training on the ground enhances plantar activation and biofeedback, and dynamic balance and symmetrical weight-bearing assessments can be performed before and after training, which provides a quantitative reference for measuring the outcome and progress of gait training with this futuristic assistive technology.
In addition to having multiple training modes and adjustable parameters, having the additional balance assessment and training modules are the three main characteristics of this lower limb rehabilitation robot that is designed to empower gait training. Through this feature, users can have personalised rehabilitation training.
Fourier Intelligence is recognised globally for its innovative and intelligent solutions that are based on independent research and development of core rehabilitation robot technology, providing medical institutions and patients with the world’s leading comprehensive advanced rehabilitation solutions.
At present, the company has strategic partnerships with nearly 20 universities and research institutes around the world to jointly develop progressive rehabilitation technologies and promote the application of rehabilitation robotics at the international level.
Some of these partner institutions include the Shirley Ryan Ability Lab in Chicago, KITE Research Institute at the Toronto Rehabilitation Institute – University Health Network, ETH Zürich in Switzerland, National Healthcare Group in Singapore, and the University of Melbourne.
Fourier Intelligence has over 1,000 installations in hospitals and institutions with a global presence in more than 50 countries and regions around the world.
‘Eye tracking technologies are vital life links for ALS patients’
Eye tracking technology is proving to be a lifeline for people living with ALS, delivering vital communication assistance which helps to break isolation. Here, leading healthtech influencer and ambassador for health innovation Gil Bashe discusses the power of such intervention
The moment the flood of ice-cold water poured over my head, there was shock and silence; seconds afterward, my senses returned. I blurted out: “That’s cold!” Family nearby laughed, the moment passed, and the video of my ALS Ice Bucket Challenge was shared online. Mission accomplished, or so one might think.
My state of frozen speechlessness was over in a moment, but for people diagnosed with ALS (amyotrophic lateral sclerosis also known as Lou Gehrig’s disease), that state doesn’t just last for a moment. It’s an ongoing, harsh and frightening reality that makes life more difficult and can actually shorten it.
LOSS OF SPEECH SIGNALS LOSS OF CONNECTION
Verbal and physical communication connects us. It is essential to life. But impaired speech (dysarthria) is among the first symptoms evident with ALS. As the disease advances, degradation of the nerves that control lip, jaw, tongue and vocal cord movement causes reduction in muscle stimulation. Unused muscles grow weaker and weaker, to the point where 80 to 95 per cent of people with ALS cannot fulfill their communication needs using their voices alone. In time, most become silent, unable to speak at all, and it’s this loss that isolates ALS patients perhaps more than any other aspect of the disease.
New clinical research points to promising investigational therapies that may slow the progress of ALS. This is important, but patients struggling now lack the luxury of time. While they wait, there are other innovations that can make their lives better and ease their isolation, especially health tech that assists essential communication. But these technologies only work if patients can get access to them.
EYE-TRACKING TECHNOLOGY OFFERS PEOPLE WITH ALS THE ABILITY TO COMMUNICATE
Advancements in precision eye-tracking can enable many with ALS to tap into lifestyle-assistive technology options. As leg, arm and lip muscles become weaker, eye-tracking tech enables users with ALS and other neurodegenerative conditions to engage in daily tasks, including wheelchair operation, home automation and augmentative and alternative communication (AAC) with family, friends and health providers.
One thing to keep in mind: for ALS patients, preserving communication is an essential part of care. If patients can’t communicate with those around them – especially family, caregivers and doctors – they are lost. The ability to communicate and be understood improves and may lengthen life. Austin Nieto recounted how obtaining an AAC device broke through his father Augie’s crippling isolation.
“With my dad’s mind unaffected, he basically became locked in his body, unable to communicate his thoughts, feelings, and basic needs,” shared Nieto. “My father was given a life expectancy of two to three years at the time of his diagnosis, and we are blessed that this year will be his sixteenth year with us since that day. I honestly believe this is a result of his EyeTech eye-tracking communication device.”
Today’s AAC technology is easy to navigate, and the clinical “magic” is driven by the marriage of medicine and software. EyeTech technology uses machine learning and artificial intelligence to translate a user’s gaze into action, enhancing conversation and ability. While the technology’s control panel is a familiar, user-friendly tablet, its operating system draws from constant human interaction, cloud-based secure data and camera calibration. The more a user makes it part of their real-world situations, the faster the technology adapts to provide an intuitive and natural connection between users and those around them. EyeTech founder and chief science officer Robert Chappell says:
“Eye-tracking is uniquely capable of enriching lives and delivering a higher quality of life to people needing to access AAC technologies. Focusing on how the technology can be a facilitator of connection and not an arduous barrier for people with neurologic conditions is what is making innovators drive toward new software and software updates geared to advance the AAC and medical fields – it’s all about accessibility for people in need – accessible of use and reimbursement.”
ALS DIAGNOSIS SHOULD TRIGGER RAPID PAYER APPROVALS FOR SUPPORTIVE CARE
Accessibility is the rub. The urgent need to support or restore communication makes getting authorization for AAC devices among the most frustrating challenges people with ALS and their families face. Payers too often treat requests for communication technology as secondary to care. This is wrong: with ALS, communication IS care.
The process is far from straightforward. People with ALS must first be evaluated by a speech language pathologist or other health professional to validate need based on cognition, speech quality and access ability. Then, device requests are sent to an AAC device manufacturer who must navigate the Medicare, Medicaid or private payer maze for reimbursement. Finally, the person with ALS must train to use the technology that will break their isolation and allow them to communicate again. Then they wait for approval to gain access. As their minutes and days tick away, they live in disease-imposed silence.
Service organizations like the Paralyzed Veterans of America (PVA) help U.S. veterans, who are twice as likely to develop ALS, navigate the Byzantine approval process. Others have to find their own path forward. Medicare often covers 80 per cent of device costs every five years, but ALS patients without supplemental Medicaid or private insurance need to pay out-of-pocket for copays. The average cost of a speech-generating device is $15,000, so people already devastated by ALS and the potential of being trapped in a silent world face the additional hurdles of income loss and mounting medical debt.
COMMUNICATION IS A LIFE LINK
For most with ALS, this is an unnecessary hardship, imposed by a system that appears to lack the humanity required to meet their most basic needs. Communication for people with ALS isn’t just a “nice- to-have” – it is an essential life link. While caregivers, providers and AAC innovators struggle through the approval and payment process and its roadblocks, people with ALS and other neurological conditions watch precious days, often weeks, slip by.
Eye-tracking AAC technologies are proven; they support and sustain lives. There is little doubt of their ability to break the isolation of ALS patients and support those who live with other disabilities and neurological diseases like Parkinson’s and Alzheimer’s. The health system is fragmented with people with health urgencies needing to navigate its complexities. The technology works and makes a life-sustaining impact. What will it take for the payer and approval system to heed the patient’s urgent call to action?
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