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Future Solutions In Progress


Theme 3: Monitoring of Chronic Illness in the Home and Remote Settings

 

Theme 3 Projects:

 

Immediate point of care molecular diagnostics for lung inflammation/infection in critical care
Limbs Alive – Monitoring of Upper Limb Rehabilitation and Recovery after Stroke Through Gaming
Principal Investigator:  Professor Janet Eyre
Organisation: University of Newcastle upon Tyne
Start Date 2nd January 2012
End Date: 31st December 2014

View Abstract

Stroke frequently damages the area of the brain controlling movement; as a consequence there are thousands of people with weakness down one side of their body. This has a major impact on their lives because everyday activities require two hands. The brain can relearn control of the weak arm, but this needs frequent therapy over many months. There are not enough therapists to provide this on a one-to-one basis and fewer than 20% of patients regain independence after a stroke.

Professor Janet Eyre and her team have developed a library of video-games to be played at home, which provide highly motivating therapy for relearning arm and hand movements. The aim of the project is to analyse information about patients’ performance of arm and hand movements during the video games in order to provide feedback to the patient and their therapist via the internet. This will enable effective rehabilitation of arm and hand movements to be delivered at home at times and places to suit patients, whilst still maintaining expert supervision from a therapist.

The need for hospital visits will be greatly reduced, patients will have the opportunity to undertake more frequent therapy sessions, therapists will be able to supervise more patients and patients should regain greater independence.

Real-time detection of the onset of secondary brain injury in the intensive care unit
Totally automated blood pressure monitoring at home to improve care of patients with Heart Failure or Pulmonary Hypertension
Principal Investigator:  Professor Chris McLeod
Organisation: Imperial College London
Start Date 1st September 2012
End Date: 7th May 2015

View Abstract

Many older people suffer from the long-term disabling illnesses of heart failure and/or pulmonary hypertension. The symptoms are shortage of breath and severely restricted walking range. Without medication, patients get progressively worse until the disease kills them. With medication – a combination of three types - the symptoms can be successfully alleviated. Both over-medication and under-medication can be medically dangerous and costly, either a waste of drugs, side effects or the patient requiring re-hospitalisation.

The vital measurement for controlling medication is pulmonary artery pressure (PAP) which currently can only be measured by catheterisation, involving a hospital procedure and some risk. Professor Chris McLeod and colleagues at Imperial College London have developed a tiny pressure sensor with which they propose to measure PAP. Once the device is placed securely within the artery, measurements can be made at any time by interrogating the sensor by radio from a pocket-sized reader. The reader will be permanently and wirelessly linked to the hospital. Professor Tarassenko's research group at Oxford University will apply its extensive technical and clinical experience of real-time monitoring of patients in hospital and of the use of mobile-phone based telehealth to improve the management of chronic disease. Close control of the medication will be possible, leading to improved patient condition, slower progression of the disease and reduced re-hospitalisation. Measurement quality is guaranteed and measurements during normal activity will be better than current catheter-based measurements in a clinic or hospital bed. The patient will know that they have 24/7 care.

Immediate point of care molecular diagnostics for lung inflammation/infection in critical care
Open-architecture telehealth platform for COPD
Principal Investigator:  Professor Lionel Tarassenko
Organisation: University of Oxford
Start Date 1st June 2012
End Date: 31st March 2015

View Abstract

TCOPD affects 210 million people globally, with 50% of costs (unplanned hospital admissions) that could be avoided with more responsive models of care. 30% of COPD patients in the NHS are re-admitted to hospital once within the year. Within 10 years, COPD will become the third leading cause of death. Even if everyone stopped smoking today, the effect on COPD statistics would not be seen for up to 20 years.

A research group headed by Prof Tarassenko at University of Oxford proposes to develop an easy-to-use system for patients to monitor their condition, based on mobile communications technology (hence the name of mHealth). The project will make use of the latest generation of smartphones and tablets to enable COPD sufferers to complete patient diaries, respond early to worsening symptoms, and receive support from a respiratory nurse who has access to all of their data. This will lead to improved self-management and a higher quality of life for these patients, with a reduction in the number of severe exacerbations which they experience and which require an unplanned and costly hospital admission.

A key goal of their approach is to bring the costs of telehealth technology by at least an order of magnitude to enable it to be adopted on a much larger scale than at present.