Communication is key in a people business like healthcare. At the very least, clinicians need to be able to communicate effectively with their patients it gather and record information to provide the best care possible.
Technology is now bringing down many former barriers to such communication, and two developments that could take the trend further are the development of Multilingual Interpreting Communications System (MICS) and PassivSystem's telecare product.
MICS is a PC based translation system to facilitate short structured conversations such as in helping patients to fill out forms.
The technology comprises a software module installed on the user's desktop and an online database of useful phrases at the back end. Both Kurdish and Arabic are supported at the moment, with Portuguese and Polish to follow.
When clinicians (or even receptionists) wish to initiate a conversation, they simply log on to the system and are authenticated against the online database. They then select from a range of subject options on the screen, before choosing a suitable phrase, which is both written down and spoken in the relevant language. Patients then select the correct answer from a multiple choice menu, which is highlighted on the screen as it is verbalised.
The idea came from Dr Cort Williamson, a GP and public health specialist at the Suffolk Refugee team, who spotted a need for such a tool during the course of his work with people of many nationalities.
He subsequently approached Health Enterprise East (HEE) with the concept in late 2007. It set up a project within its NHS Innovations East hub to develop a proof-of-concept, and has since spent £50,000 on development work, filing patents and the like.
HEE also received a grant of £20,000 from the Regional Development Agency last year for market research into the offering's commercial potential. It was completed this February and the plan is now to either find a commercial partner to licence the technology or spin it out as a commercial venture. The latter could involve a partnership arrangement or housing the product in a start-up vehicle.
Dr Chandu Patil, senior innovation manager at NHS Innovations East, says he believes that one of the key benefits is its cost-saving potential. A study will begin in the next three months to generate concrete figures, but initial estimates indicate that the system could save hospital departments as much as 30% of their existing bills on interpreting services.
"The assumption is that a busy department makes an average of 10 calls per day to telephone language lines, which cost on average about £1 per minute," Patil said. "Some trusts put on a limit of 15 minutes per phone call, so that's £15 each time. But we estimate that trusts may no longer have to make up to a third of those calls, which would save them significant amounts of money."
The aim is to secure a commercial arrangement between six and nine months after the costing study has been completed, with the first target markets likely to be A&E and GP practices in that order.
A longer term goal is to port the system onto mobile devices such as smartphones, while incorporating telephone helpline support so that users can access such services seamlessly - hopefully at discounted levels - if required.
Another organisation that is facilitating communication in a slightly different way is PassivSystems. It was incorporated in September 2008 and started selling its first product, PassivEnergy, a wireless energy management system for home use, in May of this year.
The supplier is also developing "early stage elective" telecare applications to run on the same back end, internet based platform that is now installed at the firm's headquarters in Newbury, Berkshire. The aim of the system is to monitor the daily routine of elderly people and flag up any exceptions, such as a poor night's sleep, to either clinicians or carers, depending on the severity of the problem.
The objective, said development director Fraser Harding, is to help people stay in their homes for longer by undertaking "non-invasive monitoring of their daily routine".
"So what this platform will provide is a level of remote monitoring by picking up signals from sensors and funnelling them, maybe via a text message or interactive voice response call, to carers for low priority issues or to a monitoring centre that is able to respond medically for high priority ones," he explained.
The idea is that customers would receive a 'home hub' similar to the routers supplied by broadband providers today in order to manage the wireless network. Specialised trained resellers would install a series of sensors to detect "occupancy movement", and the anonymised, encrypted information would be sent over the internet to PassivSystems' back end, Java based applications for monitoring. The packages are expected to run on standard Linux based hardware under an Oracle database.
The vendor has also received a grant from the South East Health Technology Alliance to test the suitability of new Electric Potential (EP) sensors developed by the University of Sussex.
Unlike the dry or wet gel sensors that are currently used in telecare, the EP devices neither require skin preparation to be worn nor are they affected by changes in skin resistance. This makes them comfortable to wear and suitable for use over long time periods.
The firm began a year long test of the sensors in its laboratories in mid-May, and so far the results appear positive. But it also expects to begin asking staff to employ them in their home environments from the fourth quarter of this year for field testing.
"We want to make sure that the potential they show is realisable for a product that can be delivered at a mass market price point and that has to be absolutely reliable. If they give false positives and people get messages or calls to say that someone is unwell because the sensors have triggered, they become desensitised," Harding said.
But the organisation is also working with the University of Portsmouth's telemedicine practice to make sure that the interface as easy to use as possible for a non-clinical consumer audience.
To protect personal privacy, for example, activity such as going to the toilet x number of times during the night will not be recorded, but rather highlighted as a 'disrupted night' using a traffic light system to indicate the severity of the problem.
Although PassivSystem's telecare offering will not appear on the market until 2011 at the earliest, the expectation is that it will cost customers no more than a couple of hundred pounds. A potential future aim over time, however, would be to broaden out the use of the system to monitor vital signs such as blood pressure and insulin levels.
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