Vox Pop: 'Parents can comfort their children - without getting tangled in wires'

Healthcare, wearables

Wearable technology is now entering what Internet of Healthy Things author Joseph Kvedar has called the ‘me too’ phase of its development. On the healthcare side of things, this is perhaps reflected in a second wave of what some are calling ‘medical-grade  wearables’ coming into being. We asked Dr Heather Duncan, Consultant at Birmingham Children’s Hospital (BCH) and Anaesthetist Dr David Williams of Morriston Hospital, Swansea, how wearables are revolutionising the life of the patient and healthcare professional alike.

(BJ-HC/ Vox pop) Wearable wireless technologies could revolutionise the lives of children with life-threatening conditions, by allowing them to be picked up and comforted by parents and care providers and enabling more of them to be cared for safely at home, says Dr Heather Duncan, consultant for the Paediatric Intensive Care Unit at Birmingham Children’s Hospital (BCH) - and leader of its ground-breaking Real-Time Adaptive & Predictive Indicator of Deterioration (RAPID) project.

Could you tell use about the Real-Time Adaptive & Predictive Indicator of Deterioration (RAPID) project that you’re heading up at BCH?

We’re using wearable wireless technology to identify and predict deterioration in children earlier, so that we can avoid life-threatening events. The technology uses biotelemetry and wireless sensors to collect real-time data on vital signs such as heart rate, breathing rate and oxygen levels. This data is then analysed to predict when a child’s condition may be deteriorating, providing an early warning system that can be acted on immediately.

What is it about the technology that makes you think that it will “change the way we care for patients in hospital forever”?

First, it has the capacity to transform care, enabling children to be wirelessly monitored – and that’s really important for children. It means that parents can pick them up and comfort them and they’re not getting tangled in wires all the time. Patients can also be moved more easily from place to place – from bed to trolley, for instance and from there onto the theatre trolley - making healthcare workers’ lives so much easier too.

The second thing is how it is transforming our perspective on things. In healthcare, it’s usual for us to think of things as ‘normal’ and ‘abnormal’ – either the heart rate is ‘high’ or the heart rate is ‘low’, for example. This technology is enabling us to identify what is normal for a particular individual too. In our first study, a few years ago, the process of getting to know the patient in this way took 30 to 40 minutes - but now we can do it in five minutes. So we get a sense of the patient’s specific ‘normal’ and we get to see the patterns - which can be a lot more reliable than an early warning system which aggregates ‘higher’ or ‘lower’ thresholds – within minutes and that makes for a very powerful tool!

What particularly excites you about the potential of wearable technology/ wireless sensors to help in the care of children with life-threatening conditions?

I think there are a great number of children who could be and would prefer to be at home, but for whom the monitoring has been an issue - particularly for parents of children at risk of sudden death from epilepsy, or children who are technology dependent, for example.

This new wireless technology we’re using is much more usable and more reliable. It’s also better at reducing false alarms and so, once we’ve tested it rigorously in hospital of course, we are hoping to develop it for home use. In this way, the data can be monitored on a dashboard by the responsible healthcare worker – and children can be monitored from the comfort of their own homes!

Are there any risks involved in its use with this group and if so, how might they be overcome?

There are no risks that we are aware of. We use a specific bandwidth for our wireless data transfer, for example and so the data is secure. The wearables are also very low power, so there’s no physical risk to the patient either.

The big thing with new wireless technologies is giving adequate coverage. With the children now being enabled to be so mobile - which is good both for them and their recovery - you don’t want to miss situations. So we’re building a buffering capacity into the devices so that we still capture the data when a child goes out of range - and when they come back in range it downloads.

Bearing in mind that our readers are primarily healthcare IT leaders, is there anything you think important to get across to them?

I think the message is that, for us, the future is wireless – and healthcare IT strategists need to think about how they can enable us to work in this way. This kind of technology essentially allows us to have fewer expensive monitors and at the same time to monitor a lot of patients, generating a lot of data. Thinking about how to manage that large amount of data to ensure that it supports best patient care is really what they need to be thinking about from our perspective.

Dr Heather Duncan was born and completed undergraduate education in South Africa and qualified in Paediatrics and Paediatric Intensive Care in the UK, following a Fellowship in Critical Care at Hospital for Sick Children in 2003. She is a full-time Paediatric Intensive Care Consultant and Paediatric Intensive Care Associate Clinical Director (clinical lead) at Birmingham Children’s Hospital, one of the largest Paediatric Intensive Care units in the UK. She has broad research interests in clinical service development, quality improvement, risk reduction, innovation in health care and cost effectiveness, although her main focus has been developing Paediatric Early Warning to reduce cardiac arrest. Her current collaboration with McLaren Applied Technologies, Isansys Lifecare, Aston and Birmingham Universities is developing adaptive models for patient-specific early warning.