1. John Melarkey Director of Connected Healthcare Tunstall Healthcare
The digital difference How Connected Healthcare can revolutionise health and care
John Melarkey
Director of Connected Healthcare
Tunstall Healthcare

2. The digital effect The story so far
2025
The story so far
Digital technology is now part of everyone’s day-to-day life
From online shopping and banking, to entertainment and health it has revolutionised the way we live in the last ten years
Except . . .
More than 1 in 10 of the world’s pagers is being used in the NHS
Electronic prescribing is in place in only 12% of UK hospitals
30% of social care staff still predominately rely on paper methods of care planning and managing care delivery
LTE
2010
2000
1996
We are all, both personally and professionally, increasingly relying on digital services. As consumers, we are benefiting in many different aspects of our daily lives whether it provides more choice, value, greater availability or convenience.
Taking entertainment as an example, we have progressed from three mono television channels to an unimaginable choice of digital content, available whenever, wherever and on whichever device we want it.
More than one in 10 of the world’s pagers is being used in the NHS, according to estimates.
A report looking at communications within the National Health Service said around 130,000 of the devices were employed at an annual cost of £6.6m. Replacing the nearly 130,000 pagers with use of mobile software could save the NHS £2.7m a year, the report found.
Electronic prescribing is in place in only 12% of UK hospitals
30% of social care staff still predominately rely on paper methods of care planning and managing care delivery
1992 Motorola 3200 and Nokia 1011 – first GSM hand portables
First GSM phone
GSM

3. The digital age
90%
of UK households have internet access, an increase from 89% in 2016 and 57% in 2006
73%
of adults accessed the internet using a mobile phone or smartphone, more than double the 2011 rate of 36%
77%
of adults bought goods or services online, up from 53% in 2008
56%
Clothes or sports goods were purchased by 56% of adults, making these the most popular online purchase in 2017
66%
Use of the internet for social networking rose from 45% in 2011, to 66% in 2017

4. IP benefits
The benefits of digital, provided by Internet Protocol (IP) technology:
Digital and mobile technology make new models of service delivery achievable, with the power to:
Always on
Able to handle voice, video and information as data
Fast
Data rich
Future ready
Cloud-based services
Empower and enable
Safeguard and support
Improve quality of life
Bring people closer together
Give increased control over the way people live their lives
Tunstall’s focus is on developing services to enable users, families and providers to harness the power of digital connectivity to underpin the delivery of cost effective and coordinated health and social care in the community. This paper sets out our journey to 2025 and beyond.

5. We continue to face the same challenges
2000
2017
2025
UK Population (millions)
58.9 66 69
Age 65 and over (millions)
8.9 (15% of total)
11.8 (18%)
13.9 (20%)
Age 75 and over (millions)
4.4 (7% of total)
5.0 (8%)
6.4 (10%)
State Funding
(Social care spending per adult)
Demand
£439
£379
People with multiple LTCs rising from 1.9m in 2008 to 2.9 m in 2018
60% increase in bed days used by delayed patients 2011/ /15
UK population source:
People over 65 source:
NOTE: Total public spending on older people’s social care, in real terms, fluctuated between £8.3 and just over £8.5 billion between 2005/06 and 2010/11, before falling steeply to £7.75 billion pounds in 2013/14. In total, by 2015/16 there had been a £160 million cut in total spending in real terms on older people’s social care since 2010/11
Social care funding reference:
LTC source:
DTOC source:
Between 2011/12 and 2014/15, the number of bed days used by patients who were delayed grew by 60 per cent. This means that by October 2016, over 4,500 acute beds and 2,200 non-acute beds were occupied by these patients at any given time. That is the equivalent of more than ten 650-bed hospitals.

6. Three areas of focus
Digital Connected Healthcare will uniquely enable all the elements to link together in real time, all the time - service users, the devices that support them, service providers, formal and informal carers, social care, health and housing providers. This will lead to significant enhancements in the quality of care and support provided in the home.
Tunstall’s digital Connected Healthcare eco system, using cloud-based software will support a new generation of solutions which can provide intelligent, unobtrusive and person-centred care and help to manage demand using innovative service models.

7. A more holistic approach
Housing
Social Care
Health

8. The Connected Healthcare setting

9. “By 2025 all BT customers will be using IP Voice.”
The digital driver
“By 2025 all BT customers will be using IP Voice.”
Gavin Patterson, CEO, BT Group
2016
2017
2020
2025
2015
2018
2019
2021
2022
2023
2024
Australia switch off analogue lines
Analogue line switch off in UK (end date)
USA switch off analogue lines
Europe switch off analogue lines
ISDN lines no longer available in UK

10.   The digital journey IP platform Contact Centre
Digital home unit
Health & wellbeing services
Health & wellbeing services  
Connected Health
PNC 8.1
Connected home
IP platform
Social inclusion
Social isolation
Connected Health triage
Contact Centre
Carer support
Alarm call response
Communicall Vi IP
Mobile telecare
Proactive calling
Friends, family and carers

11. The future What we know The world’s population is ageing
Current models of service delivery are unsustainable
Resources are under increasing pressure
What we can do
Enable more proactive and preventative approaches
Embrace the technology opportunity
Reduce pressure on the health and social care system

12. The start of the journey
The opportunity of IP
The advent of IP and mobile technology means that for the first time service users, the devices that protect and monitor them, and the carers and health professionals who look after them, can all be connected to one another in real time all the time.
The start of the journey
Wearables
IoT
Smart Home
Data cloud
The rise of IP connected products in the consumer market
What IP can offer – connectivity (real time monitoring etc.)
So Lets now continue our Journey and lets me tell you how Tunstall and help you connect with the future.

13. What is driving the need for IP?
3 core drivers influencing the speed of IP based services into the market
Connected Home
Consumerisation
Regulatory driver
Governments driving adoption through switch-over
Pace varies across markets
Australia NBN switch announced
Sweden already in progress
UK – BT announce 2025 switch over end date
Consumers looking to leverage internet
Growth in use of wearables
Seeking service enabling solutions, which apply in home and mobile
Growing area of focus
Initial developments in remote heating management
Product and service retailers showing major interest
Market still immature   
Market positioning – What is driving IP – why we need to have an IP solution.
(1) Speeding up connectivity – Regulation = high speed connectivity for all, lower cost infrastructure
(2) Consumerisation – demand driven consumers expecting more
(3) Technology looking for a market – health and social care has a need in this space
There are 3 core elements influencing the IP acceleration into the market.
Regulation is forcing connection speeds up, demanding and we “catch up” with the rest of the world. Tunstall is already providing IP based equipment and service in both Australia and Sweden and the BT announcement of 2025 as the switch over date for the UK is a clear statement of intent.
We all as consumers are also expecting more, I still use credit cards to buy things, my son uses his smart watch.
Finally the connected home is becoming a reality, we can all now control our heating from our phone, but more will follow. Health and social care has a real need for a connected home, hopefully you will all be aware of Mary’s House and its capabilities.

14. Connected Home | What is the Connected Home?
(source-Rica)
Smart devices
30bn
By 2020
Market value
$37bn
By 2020
The typical top 3 smart devices used within a connected home are;
(source-Parks Associates)
Light bulbs
Power supply (sockets)
A lot of current Connected home has strong use cases in Independent living – older population, assistance around the home – turning on lights, power, managing appliances etc.
A lot of current Connected home devices have a strong usage application for Independent living For those who are vulnerable in society, both young and old, using technology is an assistance around the home. Managing automatic lighting to avoid falls, Smart Thermostats to make sure the house is kept warm in winter, smart plugs to make sure cookers, kettles or microwaves are being used. There is also application for general well being, if the boiler breaks, it tells the maintenance company, if excessive electricity or gas is used, it might suggest a problem. Its about smart appropriate support.
Home appliances

15. Connected Home | IoT sensors, use cases and benefits
Activity sensor
Alert if long periods of non activity
Electrical usage
Monitor/ track for safety and eating patterns
Heating control
Control and set heating and adjust remotely – control by friends / family if required
Bed occupancy sensor
Track sleep patterns, alert if no activity
Light control
Intelligently switch lights on and off as part of a pre set pattern or reacting to User activity (getting in / out of bed)
Chair occupancy sensor
Monitor and track activity
Control and set lights to a program or react to an alarm (flash / change colour)
Connected Home in IL setting – example of use cases
Here are more specific examples in Independent Living that are now become a real. There needs to be a smart device to provide simple assistance to manage all of these examples. Keeping service users safe, secure and offering assistance for them to remain independent for as long as possible.

16. Cloud-based services
ALARM CALLS
DATA
The Smart Hub is the clear choice for the new IP digital connected home. Managing multiple devices in the connected home providing alerts and data to the appropriate Service platform, be it alarm calls to the monitoring centre or maintenance data to the DMP or Telehealth data to clinicians. All operating in real time into the cloud.

17. Housing LIN reports growing demand for change
56%
of housing associations already have plans to move from a traditional analogue warden/community call system to a digital system.
84%
of housing organisations say that digital technologies will be critical for future success, but only 39% say they’re a digital business today.
What do you see as the key benefits of a digital care system?
Future proof – 62%
Resilience – 58%
Connectivity – 51%
Communications/inclusion – 45%
Access to richer date – 40%
Source: Fast Forward to Digital Care Housing LIN 2017

18. Growing resident demand
Increase of internet access in the over 75s
Most popular device to access the internet is a laptop
Issue of cost becoming less important
Internet Access is higher among ABC’s than DE’s
+50%
Source: Ofcom

19. The challenge – Connected Health
The number of people aged 65+ is projected to rise by 40% in the next 17 years to over 16 million
An estimated 4 million older people in the UK have a limiting longstanding illness - 40% of all people aged 65+
People with long-term conditions account for 50% of all GP appointments, 64% of all outpatient appointments and over 70% of all inpatient bed days.
Treatment and care for people with long-term conditions is estimated to take up around £7 in every £10 of total health and social care expenditure

20. Key challenges PREVENTION improving health and wellbeing
Addressing the causes of illness will help keep our population healthy and in turn reduce the need for health and social care services
CARE IN COMMUNITY
improving the care provided and the quality of services
All partners are committed to moving resources from hospitals to the community,
FUNDING
tackling the growing pressure on health and social care budgets
We have to do things differently, reduce any unnecessary costs and ensure we get the best value for money from every pound spent.
Ensuring that people receive the right care, in the right place, at the right time will be essential to our plans.

21. The digital healthcare platform
AT HOME
HOSPITAL
CARE HOME
ON THE MOVE
TEXT
INTERACTIVE PHONE CALL
3RD PARTY WEBSITES
PATIENT APPS
WEARABLES & MED TECH
CONNECTED HOME
3RD PARTY APPS
MYMEDIC II
TELECARE SYSTEM
Digital Healthcare Platform
Powered by Inhealthcare
HCP APP
CLINICIAN PORTAL (N3)
ICP TRIAGE MANAGER (N3)
CARE HOME
PORTAL
APP
PATIENT PORTAL
MONITORING CENTRE
SOCIAL CARE PROFESSIONAL
HEALTH PROFESSIONAL
HOUSING PROFESSIONAL
PATIENT
CARER
FAMILY

22. Connected Healthcare benefits
Patient
Improves QOL and independence
Supports wellbeing, safety and security
Improves medication adherence, self-management, knowledge, confidence
Reduces hospital visits and admissions
Nurse / Staff
Enables effective multidisciplinary team working
Improves prioritisation and efficiency
Enables early intervention and prevention
Supports staff knowledge and confidence
Improves quality of interaction with patient
Organisation
Improves resourcing, capacity, productivity
Reduces costly f2f visits
Enables continuity of care
Facilitates service diversification
Supports data collection
Health & Care
Reduces A&E visits, hospital admissions, demand on GPs/community teams
Reduces DTOC, care packages, care home admissions
Suitable for numerous conditions, cohorts, pathways, care environments

23. Digital healthcare improves efficiency and productivity
Costs reduction
Through remote monitoring of care home residents, Southern Health and Social Care Trust reduced travel time of their Nutrition & Dietetic department by 95%. The monitoring system was also managed by Band 2 healthcare assistants, and only involved Band 5/6 dietitians when necessary.
Real-time pathway tracking
Newcastle Hospitals are using Inhealthcare’s digital platform to develop a cancer patient tracking system to provide real-time data on patients in their 62 day pathway. This allows staff to be used more effectively and helps the Trust avoid breaching national targets.

24. Digital healthcare reduces demand for services
Enhanced services in primary care
Wigan Borough CCG are moving anticoagulation services out of the hospital and into primary care. 100’s of warfarin patients in Wigan now self-test at home with their dose calculated by their local GP, avoiding 1000’s of outpatient clinic appointments at the hospital.
Long-term condition management
Evaluation showed a reduction in the frequency of home visits and a reduced number of inappropriate visits. Results also showed hospital admissions down by 38%, reduced bed days and the enablement of earlier intervention avoiding the need for more complex care.

25. Digital healthcare at scale
TF3 has so far provided over 2.2 million monitored patient days for over 5,600 people with LTCs in Northern Ireland, targeting proactive support to patients and supporting HCPs in patient-centred case management. Monitoring services have successfully reduced inpatient admissions, optimised staffing resource and resulted in only 3.5% of triaged alerts being escalated to clinical response.
Addressing secondary and primary care challenges
24 care homes were given connected healthcare systems to support the needs of up to 1,000 residents. Over 2 years a £1.3m saving on the cost of hospital stays was achieved plus reductions in emergency admissions of 33%, bed days of 30% and GP care home visits of 45%.

26. Thank you

27. Thank you