Anthropos chief executive Jim Patience and PPP Taking Care managing director Steve Gates discuss how pre-emptive technology is helping to prevent hospitalisations and reduce bed blocking

I’ve been in technology all my working life, which is a long time,” said Patience, who has run large consulting and system integration organisations, as well as his own consulting business, which he set up in 2020. Through his consultancy, he worked with healthcare organisations which allowed him to see the applications of remote monitoring technology in the sector.

Gates’ company, PPP Taking Care, created the first personalised alarm system to become Which? Approved, and has been offering their technology to the sector for some time, but Patience feels that there are opportunities to move forward and for technology to play a much larger role in the delivery of care and protection for older people.

“I think we are honest enough to say that, within the industry, a lot of the focus and activity around this older population has been on a response to an emergency or a fall,” said Gates. “Something has to have occurred before we take action.”

Health outcomes are affected massively by how quickly help is received after a fall. Much like the “golden hour” after a heart attack, every hour on the floor after a fall is said to lead to an extra day in the hospital.

“I think what’s unique about the work that we’re doing together is that we still provide that as part of the proposition, but we’re moving beyond it,” said Gates. “We are now starting to move into what we, in this industry, call ‘proactivity’, where we’re there if something goes wrong, but equally, we are tracking and learning when things are going right. We can see any changes in behaviour and through either the work that we do together or by feeding that information to the family, we can intervene before something goes wrong.”

According to Patience, in an industry focusing on prevention, the 24/7 emergency monitoring of a connected home type offer is unique in this market: “What we’re trying to do is to predict when something could or might happen, and to make the right intervention before it does happen.”

Gates explained the “cycle of frailty”, by which, once someone has fallen for the first time it’s more likely they will fall for a second, third and fourth time. “While you might have a minor injury on that first or second injury, you are more likely to break an ankle or wrist on the third fall, more likely to break a hip, your legs or your arm, so there’s a recognised health issue.

Patience has recently been through the cycle with his 90-year-old mother, who fell a few years ago breaking her hip: “She fell again in October last year and she broke her hip and her wrist and she has been in hospital for about five months, partly because of problems in the system. There are no beds available, no care at home, stuff like that. It’s been very traumatic for her and preventing that first? fall is what we’re trying to do. She’s home now and she’s as happy as Larry. Our technology gives us the reassurance that we have a view 24/7 of what’s happening in her home, what she’s doing, and how safe and secure she is.”

Anthropos believe that the hospital ward of the future will be in the home for some, with many virtual wards already being created in people’s homes. “The technology is no less relevant if that person’s home happens to be in a care home, but you don’t need as much of the technology to effectively monitor the area if the residence is more physically compact,” added Patience.

Prioritisation

“I think there’s a massive benefit here around prioritisation,” said Gates. “We’ve done some work with the Association of Directors of Adult Social Services (ADASS) and I remember one of their commissioners said that ‘if social care continues to believe that the answer to the problem is just throwing people at it, by 2031, every school leaver will be required to be employed in social care’. This technology allows you to prioritise those of highest need, who should therefore be receiving the most attention. Therefore, it allows those people who don’t need that same support and attention to continue to live their lives, while you focus your activities, be that your people and the support you offer, around those people who need it, and for whom it will make a really big difference.

“Through the effective use of technology to focus the resources in the care home, you may well need fewer workers, but they will be better targeted, and they will deliver better outcomes. I think that’s where technology-enabled care can move the whole sector forward quite dramatically.”

Patience explained how their system also provides an ‘actionable insight’ to caregivers, who can then decide if intervention might be needed. “For example, if we detect that there has been an increase in bathroom visits through the night, that could be an indicator that the client has a urinary tract infection, so the carer or relative can do something about that the next time they visit. There’s a dashboard that shows just the things that need to be looked at through their computers and there is also an app so family members can be kept informed as well. They can look at it and see what’s happening, but they don’t need to act upon it unless we’ve identified a change that needs an intervention by them. It’s only where something needs to be attended to that they get notified.”

While their technology requires very little new ‘learning’ on the caregivers’ behalf, Patience has seen resistance to technology in the field.

“I think it’s fair to say that the care sector is a relatively slow adopter of new technology. One thing Covid-19 has done, I believe, was raise the awareness of how technology can help in the delivery of care, so where we’ve found over the last couple of years slower adoption than we would have liked, I think the time is now. The whole sector is talking about technology and moving towards prediction and prevention.”

Anthropos and Taking Care’s system comprises unobtrusive devices: “It’s just an extra socket that you put your plug into. Part of the benefit is that once it’s professionally installed, you probably won’t even know that it’s there. I think that’s a really important point about overcoming some of those barriers to adoption. My mother is a great example here. She has the devices in her home, and she doesn’t even know that they’re there.”

Absolutely crucial

Looking at Sajid Javid’s recent push for all social care providers to adopt a digital record, Gates said he thinks it is “absolutely crucial”.

“We’ve talked about the integration of health and social care for a long while, but, when you delve beneath the surface, one of the really big gaps is that, without a standardised care record, social care can’t see your interactions with a health service. Let’s look at it in two stages. Firstly, before people arrive in the care home, they’ve often had multiple interactions with the health system which are recorded in incompatible formats, and are not used for any planning purposes by social care to estimate how many people are travelling through the NHS and likely to arrive at care homes. Secondly, once they’re part of that social care network, they will continue to have all sorts of interactions with health staff. If you can’t see that all together on the same record, you don’t get an all-around picture of the support that the person is accessing. The longer we have separate social care records, the harder it’s going to be joining them up.”

“Both Steve’s organisation and my own are sponsors of the tech-enabled Care Association and they are driving the agenda towards prediction and prevention,” added Patience. “For us to be able to do that, we need technology, we need good information, about the individual and that includes the health record. It’s not just about behaviour, it’s about the condition of their health or well-being. We need to have good data and intelligence about that so we can put the right care plan in place.”

Gates feels that when people talk about technology, they often focus on gadgets and gizmos: “In the future, that will be far less significant than how we use the data that is being gathered for the benefit of the customer, and how we move into the sphere of prevention. The technology is just the enabler, that’s not the clever bit. It’s going to be what we can do for the benefit of the residents in their own homes and in care homes in terms of managing their health proactively.”

Patience feels that the problems in the social care system are not unique to the UK, with the problem being even bigger, for example, in the USA: “There are a lot of smart people in the USA who will be looking at technology solutions. We talk quite a lot to people in other countries, and people are doing interesting things. They’re very similar in the direction of travel they’re taking, but we can always learn from other folks. We have a research and development capability in our organisation, which is continually looking at new developments that are happening, not just in the UK, but worldwide, so we use technology from all over the world.”

Concerning social care in other countries, Gates said that the main difference is in funding, with the Netherlands coming out as one of the beacons of innovation.

“I think the reason that it’s quite country-specific, is that all of the European countries and the states within the USA have a different approach as to how they fund social care, which therefore drives the delivery. That’s why I think it’s probably more country constrained because a lot of the funding for social care and care homes comes from the central state. That’s not the case with tech.”

Looking to the future, Anthropos is participating in a trial of its platform in the homes of 20 older people in Warwickshire, the first of its kind in the UK to bring together expertise from multiple private and public stakeholders, including two group practices of GP’s, a care commissioning organisation and a care provider.

“The trial will be split between people living in the community and others living in extra care,” said Patience.

“Our technology is being used to deliver intelligence so that we can provide better care and get better care outcomes. We’re looking at the benefits that can be accrued for all the stakeholders through the use of technology.

“All of the stakeholders share the goal of enabling older people to stay safe, well and independent for as long as possible. The trial aims to prove the role that connected care can play in achieving that goal.”

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