For Georgie, a British woman who at the age of 20 lost movement on her right side because of a neurological disease, an Amazon Echo has restored much of her independence, making routines such as online shopping and medication reminders far easier.
Georgie is among 50 people taking part in a pilot programme run by PA Consulting Group with Hampshire County Council to ease pressure on adult carers and restore independence. It is just one application of these kinds of technologies to health and social care.
Telemedicine once prompted images of surgery conducted using virtual reality or specialists making diagnoses via videoconferencing. But while today the applications are less likely to grab the headlines, many believe they are still where the real promise lies.
In developing countries, devices as simple as a mobile phone can transform access to healthcare. Phones allow health workers in remote areas to get the advice and expertise they need to conduct diagnoses.
“It’s empowering community health workers, who have access to medical professionals that they couldn’t have without the internet or mobile phone,” says Denis Gilhooly, chief strategy officer at the Commonwealth Centre for Digital Health, a global network promoting technology in healthcare.
Even relatively simple applications — such as being able to text patients to remind them to take their medications or attend a follow-up appointment — can be life-saving. And as technology advances, sophisticated applications are becoming available for mobile health, or mHealth as it has become known.
In Tanzania, for example, community workers are using a mobile app to log the wellbeing of pregnant women during routine visits. The information is transmitted to a server where an algorithm can determine a pregnant woman’s health status and offer advice or, if necessary, recommend medical interventions that could prevent a maternal or infant death.
In May, the World Health Organization raised the prominence of mHealth when the World Health Assembly passed a resolution to advance digital health. “That gives global legitimacy to the market,” says Mr Gilhooly. “It has taken a decade to get there, but this is the year it’s going to take off.”
Demand for telemedicine is certainly likely to increase. As people live longer but with one or more chronic conditions, technology will play an increasingly important role in healthcare.
And while much of mHealth uses familiar developments such as mobile devices, miniaturisation — along with newer technologies such as smart sensors and ultra-low-power chips — is making it possible for wearable and implantable devices to generate and transmit a constant flow of data.
As the volume of data that patients produce increases, technology will also be needed to analyse that data and determine the appropriate response. “This is where machines have to play a role,” says Joe Marks, executive director of the Center for Machine Learning and Health at Carnegie Mellon University. “It’s well within machine capability to detect an anomalous situation.”
For now, adoption rates for home health monitoring systems remain lower than for other functions. Last year, a Gartner survey of US, UK and Australian households found that home health and wellness management systems had lower adoption rates than home security (11 versus 18 per cent). However, as health monitoring technologies become more like consumer devices or integrated into them — for example in smart jewellery — this could change, removing the stigma that prevents many older people from wearing traditional monitoring devices.
This is part of the appeal of the Amazon Echo, says Steve Carefull, a government and public sector expert at PA Consulting, since the device is not only used for care but also for things that people enjoy, such as music.
“It’s not a device that has got one function that is a stigmatising signal of problems,” he says. “It’s in the house for a positive set of reasons but it can also play a caring role.”
Feedback from the pilot showed that being able to do even simple things such as turning on the lights has given users a new sense of freedom. “It turned out it was very good at returning a degree of control for people who as a result of their condition were reliant on carers,” says Mr Carefull.
Reducing reliance on humans will become more important as healthcare systems become increasingly stretched financially and growing numbers of people need long-term care.
“Where telemedicine is becoming real is in home healthcare,” says Prof Marks. “It’s less sexy and less high-tech, but it’s way more important and practical in terms of the numbers.”