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

最近的一项国王基金审查强调了国家卫生服务（NHS）是公共部门碳排放的重要贡献者。NHS占所有公共部门碳排放量的25%，约占英格兰总排放量的4%。这比从希思罗机场起飞的所有客机的年排放量还要大。目前的医疗保健模式效率极低，即使在同一系统内，医疗保健提供者的不同专业也彼此孤立;这导致了与常规护理相关的大量资源浪费。国王基金的报告呼吁投资新技术，以促进自我管理以及远程护理和远程医疗，以推动NHS走向可持续的未来。医学皇家学院学院在2015年发表了一份名为《锻炼是奇迹疗法》的报告，不仅宣传了活动本身作为一种疗法的好处，还强调了不活动的危险。那些在国际电联接受治疗的人或髋部骨折后的老年患者将出现最严重形式的“失调综合征”，这是他们住院的副作用和不活动的后果。这些患者需要密集的康复方案，以恢复他们以前的功能，并减少他们的机会正在进行的健康状况与失调。目前的医疗保健模式需要不同专业团队的亲自评估和持续的随访诊所预约。这导致不必要的旅行，预约之间的长时间等待，甚至来自不同部门的多个预约，这都是令人难以置信的资源效率低下。Cush Health旨在开发一个革命性的远程监控医疗平台，为患者和临床医生提供综合护理。我们的解决方案允许通过可穿戴设备进行远程监控，以便在患者需要时在社区提供评估和治疗。它将作为一个闭环系统，使临床多学科团队（MDT）能够真实的实时查看其患者群体的进展。他们将能够设定个人远程目标，而恶化的病人也会自动突出显示给相关的MDT成员进行审查。这减少了MDT的旅行和资源，并使患者康复进展无需等待随访预约。通过集成到已经在社区中广泛传播的技术（如智能手机和智能手表）中，该解决方案具有可扩展性，可以快速增长，以满足全国范围内的需求，从而在公共部门实现净零排放。

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.