This post was co-authored by Stuart Bailey, Product Director, Capita Healthcare Decisions
This blog is part of a series in collaboration with our partners and customers leveraging the newly announced Azure Health Data Services. Azure Health Data Services, a platform as a service (PaaS) offering designed exclusively to support Protected Health Information (PHI) in the cloud is a new way of working with unified data—providing care teams with a platform to support both transactional and analytical workloads from the same data store and enabling cloud computing to transform how we develop and deliver AI across the healthcare ecosystem.
As pressures on the National Health Service (NHS) in the United Kingdom continue to grow, so does the need for safe and effective home health care. Head Home is a remote patient monitoring (RPM) solution that looks to streamline current at-home care for patients and their health and care professionals.
The NHS is currently experiencing the most severe pressures it has in its 70-year history, with an already strained system being stretched beyond its limits by the impact of the COVID-19 pandemic.1 In hospitals, the number of general and acute beds available has been declining since 20102, and it has been estimated that up to 15 percent of beds are being used by people waiting for care3. Finding innovative ways to relieve these pressures remain critical in supporting the NHS’ recovery.
To find solutions to this challenge, a key area to address is facilitating more efficient patient discharge and at-home care. Patient surveys have long shown that most older people prefer to receive care at home, and recent research by the University of Oxford has found that this may improve patient outcomes and satisfaction, while simultaneously helping to reduce hospital pressures.4 This approach is known as “hospital-at-home” and its use has been accelerated by the pandemic. Hospital-at-home aims to allow health and care professionals to provide remote monitoring and communication for patients from their own homes, whilst helping healthcare facilities to free up vital resources. However, while wearable devices such as temperature monitors, pulse monitors, blood pressure monitors, and even heart monitors are readily available, solutions that enable them to be monitored remotely are less common and the hospital-a-home approach is currently reliant on expensive, hard to maintain devices and bespoke manufacturer software.
This is largely due to data still being stored on-premises in a siloed healthcare industry, and a lack of interoperability among these on-premises systems. Disparate datasets are collected from a variety of wearables without a unified solution to manage them, making it difficult for providers to access patient data collected from wearable devices at home in a timely fashion. This results in delays in patient monitoring and formulating treatment plans when patients are out of the hospital, making monitoring and treating patients remotely unachievable.
To help solve this problem, Microsoft released Azure Health Data Services, a suite of purpose-built technologies for protected health information (PHI) in the cloud built on the global open standards Fast Healthcare Interoperability Resources (FHIR)® and Digital Imaging Communications in Medicine (DICOM). This solution enables providers to unify and manage data on a trusted cloud, making it possible to standardize diverse data streams such as clinical, imaging, device, and unstructured data using FHIR, DICOM, and MedTech services. Data collected from various wearables and in different formats can be ingested and persisted in Azure Health Data Services, allowing data to be managed in one place, and therefore reducing the need for numerous manufacturers’ software. It enables providers to view the standardized data in context with other clinical datasets, supporting the goal of moving from reactive care to proactive care while reducing cost, empowering a more effective and personalized approach to at-home care.
Expanding healthcare support with Azure Health Data Services
Aiming to enable the hospital-at-home approach to better support patients and help to relieve existing pressures on the NHS, Capita Healthcare Decisions leverages Microsoft Azure Health Data Services which enables healthcare professionals and patients to manage patient data in the cloud. Head Home by Capita is a remote patient monitoring (RPM) solution that enables the health indicators of patients to be monitored by health and care professionals from within their own homes. Through Head Home, personalized health indicator thresholds can be set, ensuring that if there is a change in the condition of a patient, then their care team is notified over the preferred interface by the provider (SMS, push notification). This allows health and care professionals to react in an appropriate and timely manner, whilst reassuring patients that, should their wellbeing change, they will be cared for. Head Home can currently support the monitoring of blood oxygen level, heart rate, body temperature, respiratory rate, blood pressure, and single-lead ECG, ensuring a range of key health indicators can be effectively monitored in a hospital-at-home.
In addition to the indicator monitoring and warning system, Head Home enables patients to talk to a personal assistant via voice interface to communicate with their care team, ensuring a greater connection for patients receiving care at home. This type of communication between a patient and their health and care professionals has been shown to be critical for recovery, helping to develop trust and transparency during the care process. This verbal communication is being recorded in the Head Home dashboard, alongside notes from patient appointments and check-ins, helping to improve clinical documentation and efficiency.
The hospital-at-home model sees the provision of faster access to appropriate and targeted care in people’s homes and introduces the right digital infrastructure to deliver the system benefits, as well as helping to tackle the elective care backlog. With Head Home, Capita Healthcare Decisions has pioneered a digital solution to enable clinicians to support patient recovery at home by providing a better-connected real-time monitoring solution whilst reducing the need for healthcare delivery resources.
As existing providers of clinical decision support software, Capita Healthcare Decisions utilizes the Azure Health Data Services to persist health data in the cloud. This enables rapid exchange of data backed by a PaaS offering on a trusted cloud. In addition, Azure Health Data Services allows Capita Healthcare Decisions to ingest the patient data from wearables providers (HealthKit and Google Fit) and device aggregators for persistence and analysis, enabling new opportunities to gain new insights in research and improve patient care. By integrating this with a variety of Internet of Medical Things (IoMT) devices and making use of personal assistant voice interfaces, Capita Healthcare Decisions aims to deliver an accessible and easy-to-use service that can provide the monitoring required to keep patients safe during their care at home. By using the FHIR standard, Capita Healthcare Decisions is leveraging the power of an open-source standard that will evolve with the science of healthcare and enable interoperability with data flows in existing healthcare systems. The interfaces that sit between the monitoring devices themselves and Capita Healthcare Decisions’ intuitive monitoring platform enables these readily available, relatively low-cost devices to be easily deployed at scale. By providing these complementary functions, Head Home is helping to deliver a more viable hospital-at-home environment.
At a time when NHS resources are being stretched to new levels, innovative technology platforms such as Head Home offer a much-needed solution. Leveraging Microsoft Azure Health Data Services, Capital Healthcare Decisions offers an agile way to monitor the health of patients remotely, ensuring that at-home care can be delivered safely and effectively, all with the associated potential to improve outcomes, patient satisfaction, and reduce healthcare delivery costs.
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®FHIR is a registered trademark of Health Level Seven International, registered in the U.S. Trademark Office and is used with their permission.
1An NHS under pressure. (2021). The British Medical Association Is the Trade Union and Professional Body for Doctors in the UK.
2The number of hospital beds. (2021, November 5). The King’s Fund.
3NHS: Up to 15 percent of hospital beds used by people waiting for care. Pollock, B. I. (2021, November 18). BBC News.
4Study finds that caring for older people at home can be just as good—or even better—than hospital care. The University of Oxford. (n.d.). www.ox.ac.uk.