Healthcare Wearables for Independent Living

大约四分之一的人患有多种长期疾病（MLTCs），在65岁以上的人群中，这一比例高达三分之二。据估计，这一群体的治疗费用占卫生保健支出的70%。这些人的健康状况较差，生活质量较差，死亡风险较高。这一群体面临的主要挑战包括保持他们在家中的独立性，避免进一步发展可能威胁其健康并进一步损害其生活质量的疾病，以及尽量减少这一群体的高额医疗保健负担，这些负担可能因不协调的卫生和社会保健而变得更糟。我们面临的挑战是通过知情的自我护理和保持独立性来改善结果，同时降低医疗成本。许多多国家庭目前的模式是，当人们无法在家中解决问题时，向紧急护理服务机构求助。这种反应性方法导致在发生严重事件时频繁使用医院急诊服务，将护理的重点转移到医院。然后，管理遵循急性医疗保健中的一般途径，试图稳定患者的病情。信息驱动的技术将使人们能够进行自己的健康管理，这将改变护理模式。个人将能够主动管理自己的状况。整合有关个体合并症的知识（这在MLTCs中很常见）将允许个性化治疗，进一步保持独立性，改善患者预后，并优化资源利用。拟议的“独立生活的医疗可穿戴设备”（HW-IL）计划旨在首次开发一套基于常规可穿戴设备的预测工具，以允许MLTCs患者的自我护理逐步改变，并通过避免恶化来维持他们的独立性。将利用这些工具指导患者及其护理人员进行预防性管理。这类工具将首次采用一种综合方法，利用患者佩戴的设备（在患者身边或附近）和医疗保健数据（来自全科医生和医院信息系统），实时工作。所有的工作都将得到道德上的批准，并符合病人保密的最高标准。

Around 1 in 4 people have multiple long-term conditions (MLTCs) rising to up to two-thirds in people over the age of 65 years. Treatment for this group is estimated to take up 70% of health care expenditure. Such people have poorer health, poorer quality of life, and a higher risk of dying. Key challenges for this group of people include maintaining their independence in their homes, avoiding developing further conditions that can threaten their health, and which would further impair their quality of life and minimising the high burden of healthcare for this group potentially made worse by uncoordinated health and social care. Our challenge is to improve outcomes through informed self-care and maintaining independence, while reducing healthcare costs. The current model for many MLTCs is for people to present to urgent care services when they can no longer cope at home. This reactive approach leads to frequent use of emergency hospital services when a severe episode occurs, shifting the focus of care to hospitals. Management then follows generic pathways within acute healthcare, in an attempt to stabilise the condition of the patient. Information-driven technologies will enable people to perform their own health management, which will change the model of care. Individuals will be able to manage their condition proactively. The integration of knowledge concerning individuals' co-morbidities (which are common in MLTCs) will allow personalised therapy, further maintaining independence, improving patient outcomes, and optimising the use of resources.The proposed programme "Healthcare Wearables for Independent Living" (HW-IL) aims to develop, for the first time, a suite of predictive tools, based on regular wearable devices, to allow a step-change in the self-care of patients with MLTCs, and in the maintenance of their independence by avoiding deterioration. Patients and their carers will be guided, using such tools, to preventative management. For the first time, such tools will incorporate an integrated approach, exploiting patient-worn devices (at or near the patient), and healthcare data (from GPs and hospital information systems), working in real-time. All work will be ethically approved, and accord to the highest standards of patient confidentiality.