Digital Britain – Enabling Healthcare

Last week Stephen Carter, UK Minister for Communications, Technology and Broadcasting, launched the Government’s Interim report on Digital Britain.  I’d recommend reading it – its scope is wide and it contains a refreshing amount of joined up thinking.  The initial press coverage concentrated on its aim to bring broadband to all UK homes by 2012.  That’s a highly laudable aim, but by concentrating on that one conclusion the media missed much of the more promising underlying detail, particularly its relevance to home telecare.

eHealth, Assisted Living, telecare – call it what you will, is generally considered to be a vital part of our future if healthcare systems are not going to go bankrupt.  However, a major stumbling block is how to deploy it.  The industry loves trials and hates deployment.  That means we have a myriad of projects that connect up a handful of patients, but little concept of how to scale from the current few to the millions who could benefit from it.  That’s a goal that the Assisted Living Innovation Program, funded by the UK’s Technology Strategy Board was meant to address, but the initiative appears to have been subverted back to the old paradigm of small scale trials.

Designing sensors for assisted living and eHealth should not be difficult.  Much of the current deployed technology is over twenty years old, and most use cases can be met easily and cheaply with currently available sensor technology.  Admittedly there are usability issues, but those are generally the consequence of an overly patronising set of designers who take the medical viewpoint that “they know what the patient wants”.  The black hole in mass deployment is the means to get data back from the sensors to a monitoring service.  Almost every eHealth deployment today uses a standard analogue phone line and needs expensive equipment to attach it to the sensor, along with professional installation.  That makes installing assisted living sensors a costly operation.  To shift gear to a new level of deployment requires a simpler, more universal method of providing the data link from the sensor to the monitoring application.

Hidden away on page 32 of the interim report is a revelation – Action Item 7 is a request to consider “at what point the standard offer provided by the Digital Television Switchover Help Scheme could have a return path capability”.  If it doesn’t sound like a revelation, let me explain why it is:

The UK is leading the rest of the world in moving from analogue to digital TV.  It has set a goal to turn off its analogue TV signals in 2012, freeing up the frequency bands for reuse.  What that means is that every TV viewer will either need to purchase a new digital TV set before this date, or install an adaptor that will allow their existing analogue set to receive broadcast digital signals.  As a result of a good educational campaign, alongside the launch and promotion of Freeview digital channels, the take-up and sale of digital enabled TV sets has been much greater than anticipated.  However, there remains a segment of the population who are unlikely to upgrade and who would thus lose the ability to receive TV.

As politicians of all shades can’t tolerate the prospect that some of their constituents might not be able to see or hear their latest pronouncements, the Government is funding a scheme that will install digital adapters free of charge for this portion of the population.  It’s the Digital Television Switchover Help Scheme.

That’s where the interesting synergy and revelation comes in.  The sector most likely to need digital TV adaptors is the elderly, as they tend not to go out and buy the latest consumer gadgets.  Under the Government’s Switchover Help Scheme they will be provided with free digital adaptor boxes and free installation.  They also form the sector of the population that is most likely to benefit from some form of home health monitoring, such as assisted living, fall alarms or chronic disease monitoring. If we could combine a back channel and/or an expansion port into the digital adaptors at a sensible price, then one visit by an installer would prepare around five million homes for a future eHealth program.

It’s a synergy that is almost too good to be true.  It would place the UK far ahead of any other nation in the deployment of home monitoring and provide the infrastructure for the UK to gain a leading position in eHealth.  Although the media will probably still focus on the promise of universal broadband, Action 7 of the report could have a much greater effect, as it would place UK plc at the forefront of healthcare technology in the next decade.  If you are involved in eHealth or Assisted Living, join the discussion by sending your views to digitalbritain@berr.gsi.gov.uk.