eHomeCare: Sustainable Tele-Home monitoring for healthy independent living of vulnerable groups.

COVID-19 has increased social isolation amongst the elderly, particularly within ethnic minority and deprived communities, and providing good care in this situation is challenging. Individuals prefer living in their own homes and independence improves life satisfaction and happiness, which in turn reduces pressures and costs in health and social care. Healthy ageing is a UK government priority, with targets of 5 more years of independent living by 2035\. Sustainability and carbon reduction in healthcare is a key part of the Government clean growth strategy, with the NHS responsible for 1/3 of public sector carbon emissions; 24% of this is related to buildings and 18% related to transport that can be significantly reduced by remote consultations.

Frailty involves multiple body-systems losing their built-in reserves, affecting 10% of people aged over 65yrs and 50% of over 85yr-olds, has increased prevalence in minority groups, and is the key condition leading to loss of independence. The British Geriatric Society recommends gait speed and timed get up-and-go test (TUG) as the most accurate objective tests for frailty, but patients are typically diagnosed by subjective clinician opinion. Reduced gait-speed and TUG performance correlates with all-cause mortality, hospital admission, falls, negative outcomes from surgery/ medical treatment and nursing-home residence. Exercise and physiotherapy interventions have strong evidence in reducing and reversing frailty and increasing disability-free life years.

eHomeCare uses novel indoor positioning and 3-dimensional pose analysis techniques to provide continuous assessment and trend analysis of gait speed, TUG time, truncal instability, daily distance walked, falls, and fall location. This information is used to accurately grade frailty and to guide an integrated remote physiotherapy application which gives real-time feedback on performance and personalised adjustment to the subsequent exercise programmes. The frailty data will also be shared with patients, families, clinicians, and carers allowing improved self-care and timely interventions to reduce and potentially reverse frailty, reduce falls frequency and enable better care planning.

Our vision is to lead smart telecare for seniors to promote healthy, independent living whilst helping to decarbonise the NHS by reducing hospital admissions and enabling remote outpatient care, with associated decrease in NHS carbon emissions from GP/hospital transport and clinical building space requirements.