Wear next?

Wearables are the latest techno-craze but are they right for the telecare market right now?

Apple Watch, Samsung Gear, FitBit, Jawbone and a whole host of others have become the latest in a line of rapidly advancing technologies captivating the consumer market. Sales figures and forecasts are still in the making but Gartner estimates range from 60.4m units to 102.5m units (if you include all sports watches and monitors) over 2015 with 20% growth over the next few years.

And the spread of technology is encroaching on many new frontiers including Telehealth and Telecare.  With an ageing population (1 in 5 of us will live to 100) and increases in multiple long-term conditions (by 2018 3 million will have multiple morbidities) it is evident that being able to monitor vital signs and provide medical information to a carer or GP is of real benefit. This is known as Telehealth. A common definition of which is:

Telehealth is the remote exchange of data between a patient at home and their clinician(s) to assist in diagnosis and monitoring typically used to support patients with long term conditions.

Mobile Telecare Services (MTS) is different and can be defined as:

Services used to transmit location and alert messages (i.e. request for assistance) between User and monitoring centre or responder, both inside and outside of the home.

[Note: mobile telecare services are different to traditional telecare panic alarms (pendant and base-unit aka ‘button and box’) as it offers safety and independence wherever they are, not just in a house]

In my conversations with telecare providers I am often asked about ‘wearable’ technology. So why can’t a watch be used in a Mobile Telecare Service?

Well, as many things are, it comes down to size!

Let’s explore what an effective mobile telecare service needs as a minimum…

Panic-alarm – this needs to do two things; to transmit a mobile alert (normally in the form of data i.e. SMS or GPRS) and be able to communicate two-way voice between the user and the monitoring centre/responder to assess the nature of the incident and reduce false alarms, unnecessary distress, and ambulance callouts.  Therefore any watch needs to have a SIM card for alert transmission, and high quality microphone and speaker for communication (many speakers and microphones simply are not fit for purpose for most vulnerable people).

Falls-detection – most fall-sensors use either changes in orientation, or changes in acceleration/impact. The very nature of a telecare watch being worn on a users’ wrist means that it will change orientation, accelerate and decelerate on a moment by moment basis as a wrist moves around – this is not effective and leads to false alarms. At least not without sophisticated algorithms managed by the software platform to accurately interpret a real fall.

Locating the whereabouts of someone – wherever someone is distressed, injured of lost, a rapid accurate response needs to be provided. Traditional button and box telecare is only as good as the link between the pendant and the base unit (normally radio-frequency), in most cases less than 50 metres (in clear space). Once someone breaks that link, for example when in the garden or leaving the home, the traditional telecare unit is rendered useless. To monitor someone’s whereabouts it needs global positioning system (GPS) to register with orbiting satellites outside of the home. A ‘GPS fix’ should be done on a regular basis, not just in an emergency.

Battery life – So let’s recap so far, we need to power a SIM card for calls, fall-sensor, panic-button, speaker, microphone, global positioning system and presumably a screen to see what’s happening – all powered by a device that fits neatly on your wrist and in a way that a vulnerable person can actually use it!

Assuming this is possible, it will still need recharging. How do you do this with a watch? Two ways; firstly take it off (which defeats one of the main benefits of ‘wearing’ it) or secondly attach the watch (which you are wearing) to a mains plug or recharging unit. Like you, most people we speak to would also prefer not to be ‘tagged’ and wish to take off the watch for bathing or bedtime. Ultimately, the simple answer is that battery technology isn’t currently able to sufficiently meet the needs of a watch-based mobile telecare service.

And finally,

Wear-ability – the ability for someone to sensibly wear the watch and perform adequate functions of MTS (as indicated above).  We should consider the comfort factor here as well as possible sensory impairment. Accepting that if we could fit all of the above components and battery into something that could be worn (it would be quite large and heavy!) how easy will it be to wear a watch this big with buttoned shirt-cuffs or elasticated jacket cuffs?

So in summary.

We have no doubt that more suppliers (and some existing ones who should know better) will enter the market with new watches and gizmos to dazzle us and some service users may prefer to wear something on their wrist instead of around their neck. There is no doubt there is a burgeoning market for telehealth wearables, specific to delivering medical data remotely to clinical and professional advisors, reducing trips to the GP or community nurse visits.

Within telecare, wearable watch technology struggles on each of the key factors highlighted above and is not yet adequate to cater for the ‘for everyone, everywhere’ nature of a mobile telecare service.

The result?  Many wearable devices simply don’t currently provide accurate and reliable telecare.

At Oysta, the overriding priority is the performance of the service so that users are truly safer when independent – it simply must work.  In our device choices we continuously balance technical performance, simplicity of use, and ability to carry or wear devices in a way that ensures the services works well.

Remember: Counting steps is pointless when someone has fallen to the floor!