Health innovator Dr Jack Kreindler is using technology to keep patients out of hospital – an approach which could save the UK billions of pounds.
Kreindler founded project Sentrian in the US in 2012 in the belief that prevention is always better than cure.
Through the use of cheap connected wearable devices Sentrian helps patients receive treatment before it reaches the stage where they need to go to hospital.
“The 5-10 per cent of adults and children with complex chronic disease are thought to account for about 70-75 per cent of all healthcare costs, but academics conservatively estimate that between a third and a half of their time in hospital can be avoided if we could pre-detect deterioration and treat them early at home – the key is knowing when to treat them,” Kreindler says.
At the moment this is being used in the US to help sufferers of chronic illnesses, although he hopes the UK will take this on board.
He feels there is £10bn a year net saving to be made by preventing all avoidable hospitalisation by creating ‘the missing gear between hospital and home’.
He gives the example of a chronic asthma sufferer, who uses an inhaler containing a sensor that measures how often they are using their device and at what times.
This information is relayed to the care providers who are then alerted to any abnormalities – for example the patient is using their inhaler more often – and can provide treatment before they require hospital care.
There are wireless blood pressure monitors and weighing scales that send messages to healthcare providers every time they are used, as well as monitors to measure glucose and oxygen levels.
“It gives you and your family the ability to constantly be informing the people that are supposed to be caring for you about any changes in your health,” he says.
Not all of the devices give conclusive answers, however, and Kreindler points to activity monitors that are fraught with contextual biases: “Is your activity going down because you’re happy and healthy, because you’re spending time at a relative’s house or have you forgotten to put it on?
“The things that we thought would be really good markers may not necessarily be translatable.
“There are over 300 different devices and for us the job is to make sure we don’t turn patients into ‘Christmas trees’ with devices dangling from every part of their body – they should enjoy the benefit of wearing or using just two or three.”
Other devices put less pressure on the patient to remember to use them. Plaster-sized patches can be worn on the chest to measure things like heart rate, breathing and even stress levels.
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Kreindler, who is also looking to fight cancer with technology through medical imaging, believes this US health management system would be effective in the UK.
“We’re seeing these case management organisations that take on 100,000 patients and have call centres that can reach out to patients who are looking like they’re not doing well, and can then take a decision on whether to send someone out to them, change their medication or to send them to hospital – all because of the information being logged by these devices.
“It becomes a proactive process because you can tweak that person’s care as they need it rather than letting it reach a situation where you’re having them crashing into hospital.”
The eventual hope is that sensors can be embedded into everyday objects, such as a smartphone, so health management does not become a hindrance to the patient.
“My view is that more of the things that are useful to us in our healthcare are going to find their way into things that we carry around and use all the time,” he says, adding that evidence from the US will ultimately assist the UK in whether it adopts such strategies.
The effect of this, he adds, could eliminate the current seven million avoidable hospital bed days. If one avoidable visit of a week costs around £10,000 he estimates there will be savings of £10bn a year – while all the data collected will lead to better understanding of conditions and a database that could even be shared with other countries.
“My aim is that if me and my family are to enjoy a really good healthcare service in the future we’re going to have to stop wasting money at a pace that is crushing our economy,” Kreindler adds.
“And if we’re proven wrong by this and it doesn’t deliver a return on investment, then we’ll have to invest far more heavily in other, longer term strategies for tackling the rising chronic disease crisis that we face.”