Proving the Business Case for the Internet of Things

Microsoft helps UK consortium tackle epilepsy

Steve Rogerson
September 27, 2016
A way to improve the quality of life and care for people who are living with epilepsy has been developed by a private-public consortium in the UK and combines Microsoft technologies, wearables, shared care records, machine learning and data analysis tools.
Called the Epilepsy Care Alliance (ECA) and co-funded by Innovate UK, consortium members are the University of Kent, Poole Hospital NHS Foundation Trust, Shearwater Systems and Graphnet Health. It works with Graphnet’s CareCentric shared record software, and Graphnet is marketing the product.
Called MyCareCentric Epilepsy, it collects information from wearables, smartphones and portals and integrates it with a patient’s clinical record. The enhanced record is shared in real time with patients and clinical teams in a network of expert care.
“Wearable technologies have massive potential to transform the way healthcare is delivered,” said Christos Efstratiou, head of the University of Kent research team. “Coupled with advanced activity tracking algorithms, we are able to now monitor patients on a day to day basis. This will allow clinicians to better assess the effectiveness of medications, and enhance personalised care.”
By providing timely expert guidance and support, the software aims to overcome many of the difficulties that people with epilepsy commonly face, including loss of independence and isolation.
At the same time, it means clinicians can see patient-contributed information in real time, and in easily digested formats. This is important because the diagnosis and treatment of epilepsy is recognised as being extremely challenging and reliant on the availability of accurate, complete patient information and specialist knowledge at the point of care.
The aim is that MyCareCentric Epilepsy should help support new models of care that are more responsive to the needs of the individual. At the same time, the new clinical pathways, coupled with real-time pre-emptive interventions, could help reduce the costs of care and improve the treatment of the condition.
The system is being piloted by Poole Hospital NHS Foundation Trust, one of the partner organisations developing the product.
“We are creating a network of expert care for the individual which has potential to bring meaningful and significant quality of life benefits,” said Rupert Page, consultant neurologist at Poole Hospital and clinical lead for the Dorset Epilepsy Service. “These benefits to the patient can be achieved at the same time as benefits to the local health economy through reduced outpatient appointments, ambulance calls or emergency department visits and by cutting unnecessary hospital admissions and medication costs.”
MyCareCentric Epilepsy works by bringing together all patient information held by the GP, by the acute trust and by any other parts of the care community into a single record so it can be shared throughout the community. This is achieved using Graphnet’s CareCentric shared record system.
Full healthcare data and lifestyle capture via wearable devices – in this case the Microsoft Band – can be added as can data from other connectable health monitors and smartphones. The app captures data such as sleep patterns, exercise, heart rate, temperature and galvanic skin response.
The system is being further developed to enable family and friends to supply information to enrich the life-logging dataset. With explicit consent, this could include video and audio recordings of seizures to assist diagnosis and management. Experts then use these data to build up a picture of that individual’s seizures, potential indicators or predisposing factors.
Clinicians can be presented with the information in a single dashboard view, accessible via the web or mobile applications, so they can review and decide on the most appropriate next steps. Clinicians and patients can interact directly and in real time, with benefits for patient care and support as well as efficiency. This is done through the patient portal.
Seizures can be detected using machine learning, in this case using the Microsoft Azure platform. Seizures are tracked and monitored. The pattern and frequency of events is visible to the clinical team in real time. Analysis of these data using machine learning could help individuals identify increased risk of seizures.
Alerts notify medical staff, and in the future friends and family, when a seizure has occurred and professional advice can be given directly back to the patient. Clinical teams can be notified when one of their patients presents for an unscheduled admission, providing prompt advice and guidance that could reduce length of stay, improve outcomes or avoid an unnecessary admission.
“This project is all about delivering better care for patients,” said Page. “It enables us to focus resources on those patients who need support as close as possible to their time and point of need. “The novel visualisation tools mean we can see the most clinically relevant information at a glance, releasing more time to care.”
By integrating wearables, monitoring and notification technology with secure communication to clinical systems, expert advice and support can be provided on a timely basis to the patient.
“The high level of direct engagement helps clinicians obtain a more holistic view of how epilepsy affects an individual, as well as a better understanding of the nature of their seizures and impact of treatment,” said Page, who added that by bridging a care and communications divide, MyCareCentric Epilepsy supported the design of new models of care for the patient.
“The ability to respond rapidly to changes in seizure frequency and potential medication side-effects means patients may become seizure-free sooner and with fewer visits to the hospital or GP surgery,” said Page. “For example, the automatic notification of patients with epilepsy being admitted to the hospital, either with seizures or unrelated problems, has allowed our epilepsy care teams to proactively advise the admitting team. In a number of cases, this has significantly reduced the length of stay for those patients as well as provided an opportunity to improve their seizure control.”
Patient Sean Hamilton explained that he wanted to sign up for MyCareCentric Epilepsy as soon as he heard about it.
“The one key thing for me is about being able to have a safety net and a support system so I can actually regain my independence,” he said. “What tends to happen now, particularly if I am out on my own, is that I end up back in an ambulance or in A&E. I hope to get better control of my seizures and ideally to get the life back that I used to have.”
Ian Denley, director of Graphnet and its associate company Shearwater Systems, added: “A shared care record system like CareCentric is the basic building block of information sharing. We are now moving into the really radical and exciting phase of building on this shared information and changing the whole nature of care provision. In this case, we combine intense patient engagement with different ways of working among the community nursing staff and the hospital staff, and in a way which will ultimately help patients look after themselves.”
Denley added that this was the first in a whole series of apps providing new models of care for the treatment of long-term conditions that Graphnet will be bringing to market.
The Epilepsy Care Alliance has used a number of Microsoft applications including Microsoft Band and Azure. Suzy Foster, Microsoft’s health and life sciences director, said: “This pioneering project has the potential to redefine the delivery of epilepsy care. It is so exciting to see how the latest developments in technology are being used to improve individuals’ treatment and quality of life. We are looking forward to the next phase, where our partners use their technology and market presence to roll out applications for other conditions and disease groups.”