The H2H Study: Sustainable Hospital-to-Home digitally enabled exercise pathways to improve older adult’s post-operative outcomes

A recent Kings fund review highlighted how the National Health Service (NHS) is a significant contributor to public sector carbon emissions. The NHS accounts for 25 per cent of all public sector carbon emissions, or around 4 per cent of total emissions in England. This is greater than the annual emissions from all passenger aircraft departing from Heathrow airport. Current healthcare models are enormously inefficient with different specialties of healthcare providers siloed away from each other even within the same system; accounting for the vast waste of resources associated with routine care. The Kings fund report called for investment in new technologies to facilitate self-management as well as telecare and telehealth to drive the NHS to a sustainable future. The Academy of Medical Royal Colleges published a report in 2015 called Exercise the Miracle Cure, not only promoting the benefit of activity as a therapy in its own right, but also emphasising the dangers of inactivity. Those treated in ITU or elderly patients post-hip fracture will have the most severe form of "deconditioning syndrome", a side effect of their hospital admission and a consequence of inactivity. These patients require intensive rehabilitation regimes to regain their previous function and reduce their chance of ongoing health conditions associated with deconditioning. Current healthcare models require in person assessments from different speciality teams and continual follow-up clinic appointments. This leads to unnecessary travel, long waits between appointments and even multiple appointments from different departments which is all incredibly resource inefficient. Cush Health aims to develop a revolutionary remote monitoring healthcare platform for integrated care for patients and clinicians. Our solution allows remote monitoring through wearable devices to deliver assessment and treatment in the community when patients need it. It will function as a closed-loop system, whereby the clinical multi-disciplinary team(MDT) can review their patient population's progress in real time. They will be able to set individuals remote targets while deteriorating patients also be automatically highlighted to the relevant MDT members for review. This reduces travel and resources of the MDT and enables patient rehabilitation progression without waiting for follow-up appointments. By integrating into technology already widely disseminated in the community such as smartphones and smartwatches, this solution is scalable and can grow quickly to meet demand nationally leading the way towards net-zero in the public sector.