Technology advances in neurology healthcare
We live in a technological era and seldom a moment goes by when we are not using some sort of device or app, browsing the internet or relating across social media. Healthcare has long seemed behind in using these advances in technology to improve their services, but this is beginning to change.
From the mainstream health apps and devices like FitBit, to specialised devices for people living with long-term or life-changing conditions, the range of available software and hardware is expanding exponentially. Technology is now providing smarter, simpler and more life-appropriate means of monitoring and managing health, nutrition, movement, fitness and birth control.With long-term neurological conditions like Parkinson’s and multiple sclerosis (MS) which span so many facets of physical, emotional and mental health, and which affect all elements of life, the opportunities to use technology beneficially are numerous. Australian-produced Parkinson’s Kinetigraph tracks the movement and gait of people with Parkinson’s through a wrist device. Recording their movements, the data can be examined by their consultant to see how their condition is progressing, or monitor how they respond to changes in medication.The app EpSMon helps people with epilepsy to monitor their health and keep track of their level of risk from seizures. Sudden Unexpected Death in Epilepsy (SUDEP) is associated with certain risk factors such as routinely getting poor sleep or being exposing to personally known seizure triggers. The app helps people check their own epilepsy against these risks, prompting them to visit a healthcare practitioner if certain risks seem high.Assistive technologies in and around the home have also become more sophisticated. For those living with dementia, for example, motion sensors by the front door might prompt them to lock it whilst a system of placing picture ‘tiles’ on key items around the home like keys or medication can be linked to a smartphone app. The individual can check their app to see where the phone last ‘saw’ the tile, helping the individual locate the item easily.Communication aids are another tool which have become far more versatile with the improvement of technology. The app ‘Talking mats’ helps children and adults alike with communication difficulties. It enables them to express their views about leisure activities - not just opening up a discussion but likely prompting more activities to be considered or taken up.
Just the beginning
There is still a long way to go, however, and far greater possibilities exist through technology to improve the lives of those with a long-term neurological condition. The MS Society recently produced a report with the Nuffield Trust looking at how technology is being used to improve care for people with MS. Outlining the ways people can manage their MS through devices and apps, the report goes further, highlighting how much more can be done, from expanding options for people with MS to self-manage their condition to more widespread digital change like the rollout of digital care plans to improve accessibility and coordination of services. The Society has created an action plan, setting out short, medium and long term goals across four key areas that will further advance the ways that technology can change the lives of people with MS.More prolific use of individual apps for self-monitoring seems a plausible thing to implement quickly, but what about the benefits we know can be brought about by widespread change? Shared electronic records, for example, is something that clinicians and patients alike have called for in recent years to improve services and communication, to aid multidisciplinary care and assist in more holistic management. The challenges of shared records across community and hospital teams, let along across health and social care, however, is well known anecdotally.The Kings Fund produced a report in June this year examining exactly this: the benefits and barriers to widespread digital change in health and social care. ‘The use of digital technology in health and social care can improve quality, efficiency and patient experience as well as supporting more integrated care and improving the health of a population,’ opens the report’s overview. Meanwhile, the organisation’s interactive map is encouraging, demonstrating multiple sites, not just in the UK, that have made significant headway in implementing new technologies to improve patient outcomes.The report notes the many challenges that large-scale change, especially in adopting unknown technology, must undoubtedly bring about, and systematically looks at a number of these in turn.
It starts with small steps
Both the Kings Fund and the MS Society reports, published within weeks of each other, end with positivity, setting out the path needed to see digital change become a reality. From the MS Society action plan and its concise, actionable goals such as ‘In partnership with NHS bodies, look to pilot a service model, underpinned by technology, to help coordinate MS care’ to the Kings Fund’s clearly outlined learning from case sites pioneering change, steps in the right direction start small. ‘Digital change will gain momentum and legitimacy by being locally led’: the Kings Fund states, issuing a challenge to all involved in patient care. It starts small and it starts with us.The path is a long one, with a substantial amount of work needed to effect real and lasting change. However, in the same way that we as a society have graduated slowly from using a dial up computer in a cafe once a week, to carrying a constant wifi connection in our pockets at all times, if we continue to seek solutions and create opportunities for change, surely our healthcare service, and the lives of the patients it serves, will look vastly different in a decade’s time.