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Mountains of health data: what's next?

17 August 2017

How time flies! Okay, enough clichés. This blog is a chance for me to update you on my PhD research – and a lot has been going on. For instance, alongside more than one hundred companies showing their interest in the Nightingale project, I have been to the European eHealth Week in Malta and have also collected mountains of health data.

It's off-season in health care, but that's actually good news for me, as it gives me time to do all those other, just as important things that a PhD candidate will be ultimately judged on. Things like writing academic articles. Even activities for the Nightingale grant that I told you about earlier this year have been put on hold. In other words: The European Commission is starting to review our preparatory work.

I've certainly been very busy over the past months, focusing all my energy on preparations for a huge eHealth tendering process. As part of this, we're calling on European industrial players to develop smart, wireless technology for monitoring high-risk patients when they're in the hospital and at home. "We" in this case means the "Nightingale" consortium, which brings together the UMC Utrecht, University College London Hospitals, University Hospitals Leuven, Uniklinik RWTH Aachen, and Karolinska University Hospital in Stockholm.

Overwhelming interest from across Europe

Our actions have really got the ball rolling across Europe. It's amazing to see so much interest – and it really is a lot of interest – from companies across Europe. For instance, the sessions we organized in Brussels and Munich attracted more than 100 people from various companies, from small start-ups to huge, million-dollar businesses."From small start-ups to huge, million-dollar businesses"

The sessions' primary aim was to shed more light on our challenge and answer questions from industrial players in the most transparent way possible. Having budding start-ups and million-dollar businesses sitting at the same table gave the sessions an interesting dynamic all right. While one prefers to hold their cards close to their chest, the other is passionately "selling" their own innovative ideas.

However, a select group also voiced some other considerations. Do you really want to continue monitoring patients at home? Is it not better to use "smart monitoring" back in the hospital first? No. There was a reason the consortium was awarded this EU subsidy – because we want to be able to monitor patients at home in the near future.

Pioneers in health innovation

In any case, we are being pioneers in health innovation. This was very clear at the European eHealth Week in Malta, which I attended with Karianne Lindenhovius (our project manager at Nightingale). Although we witnessed the progress Europe has made in terms of eHealth, we didn't see any truly innovative eHealth concepts from my perspective. What we did notice, however, was the uniqueness of our appeal to European industry: to develop a solution that enables patient monitoring in hospital and at home.

All these developments and ideas are informed by our experiences of wireless monitoring technology in hospitals involving high-risk patients with wearables. At the moment, I'm working with Eline KleinJan, an graduate student in Technical Medicine, to research the reliability of various wireless sensors. This research often focuses on - often - very ill patients in Medium Care, and we monitor the measurements in the nursing ward.

Initial feedback from nursing staff

We're learning so much from feedback. Although we do see the potential of wireless monitoring, the information we hear from the users – patients and nursing staff – is what's really helping us move forward. "The information we hear from the users – patients and nursing staff – is what's really helping us move forward"

While nurses don't have to act upon the new technology yet, staff members have said that they would like to see more regular measurements of patients' vital functions carried out. This would offer a solution to a current problem: If a nurse thinks that the patient's health is deteriorating, they need to mobilize the measuring equipment, disturb the patient, and have to perform checks on the patient's medical record, most often by hand.

This is an extremely time-consuming process, at a time when nurses are coming under an increasing amount of pressure. You could imagine they'd welcome wireless technology that records all vital functions.

However, alongside positive responses, we should be aware of the fact that the launch of an innovation comes with its risks. For instance, a nurse recently told me that he was scared critically ill patients could be discharged more quickly from Intensive Care and transferred to the ward – "because patients on the ward are being monitored now, too." These are the typical "unintented" risks that we need to address as soon as possible.

Mountains of health data

Telemonitoring produces a mountain of data all right. I'm not exaggerating when I say that each patient has had their heartbeat or respiration measured at least 100,000 times using various sensors. But how usable is this data? Do we really need so much continuous data to monitor patients? "Telemonitoring produces a mountain of data all right"

Seeing the data on a computer will show us a "rapidly increasing heartbeat," but nothing else as yet. I've already written about this in this blog.We can only interpret the data once we know how the nurse acted at that point in time, and when we know how the patient is feeling.

Although the data itself can prompt an examination of the patient, we're aware that we need more than just data to perform telemonitoring on patients. We need contextual information that enables us to assess the situation.

"Soft signs" can help us here. These signs include: a patient who is becoming increasingly short of breath, a patient who stays longer in bed, or a patient who is looking paler and paler. And who is better qualified to tell us this than the patient themselves, or their carers?

Soft signs for smart telemonitoring

We'll soon have the tools to recognize patient deteriotion earlier, on the ward or at home. But I think we'll have to starting using 'smart monitoring' to achieve this. In my eyes, "smart" means adding "soft signs" of the patient itself."In my eyes, 'smart' means 'soft signs' of the patient itself."

What next?

Let's start analyzing those mountains of data. This will take a while, considering that the study is still ongoing. In the meantime, I'm thinking of how we can add "soft signs" to the telemonitoring data. If you would like to keep up to date with all the latest news on Nightingale, please visit https://www.nightingale-h2020.eu/project-news.

Now you're totally up to date with my PhD research! If you have any questions about the study, feel free to contact me on Twitter or LinkedIn!