Technology
risk of acute events, such as heart failure or stroke, and alert them and their clinicians of any signs of deterioration or need for intervention. Identifying more at-risk cohorts in primary care in this way and using technology to gain a more comprehensive picture of health could be so powerful. Linking this data to their health records so that every clinician involved in a patient’s care journey is informed, connected and can make tailored decisions for that person would undoubtedly improve care. We should re-orientate the discussion to focus on promoting self-management too. Patients are often flying blind and have no way of understanding their general health and monitoring how lifestyle changes improve or harm it. Digital platforms and tools can provide patients with personalised and timely guidance and support for managing their chronic conditions, such as diabetes or hypertension, and improving their lifestyle habits. Providing patients with accessible data that
they can view and understand will empower and motivate them to take more responsibility for their own health and help improve their chances and prepare for planned acute care episodes, such as surgery or chemotherapy, by providing them with information, education, and coaching on what to expect and how to optimise their fitness before, during, and after the procedure. Secondly, technology must be used and
exploited after discharge. Capturing data on how rehabilitation is progressing and how a patient’s fitness is improving following discharge can help us understand patterns and develop better practice for how to successfully recover. This might involve matching pre-admission data with post- discharge data to understand how fitness impacts the speed of rehabilitation. Capturing and analysing this information could enable personalised care plans to be developed based on pre-admission health, lifestyle and fitness data to recommend what kind of rehabilitation activity is right for someone of a particular fitness level post operation, as measured through VO2 max. The potential impact of technology like this on the delivery of acute care is clear. In terms of efficient scheduling and theatre capacity optimisation, rapidly obtaining an accurate determination of a patient’s overall health can help reduce pre-operative assessment time and streamline the pre-surgical pathway. In terms of patient outcomes, VO2 max assessment can lead to better risk stratification, enabling the identification of patients at higher risk of complications and facilitating the implementation of targeted interventions. It
also supports personalised surgical planning and tailored post-operative rehabilitation programmes. This individualised approach can improve recovery and overall outcomes. Furthermore, remote monitoring tools allow a patient to be continuously assessed and for targeted primary care interventions to be made to improve early detection of potential complications.
Seismocardiography I have spent the last few years of my career diving into how CRF assessments could impact the way care is delivered and the outcomes it delivers. The reason the catch all question ‘how fit are you?’ has not been posed regularly by clinicians when conducting screening is largely down to practicalities. How does anyone really know? How can we measure it? Getting
an objective VO2 max measure is difficult and can only traditionally be done through a Cardiopulmonary Exercise Test (CPET). But this is extremely expensive, time consuming and not suitable for those who are not already reasonably fit. Importantly, this type of test creates bottlenecks in the pre-surgical pathway. A technique we are employing called seismocardiography is revolutionising how we capture and use health data. It works by using accelerometer technology to measure the movements in the chest wall caused by the beating heart vibrations. This gives us insight into the efficacy of the heart, by looking at the diastolic and systolic events. Together with our algorithm, this technology provides clinically relevant accuracy and reproducibility8
and
non-invasively estimates an individual’s VO2- max within three minutes, thus avoiding those
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