Digital inclusion in healthcare.

‘When I set up Docobo back in 2001, the main focus was to reduce hospital admissions and 999 conveyances by utilising technology and remote monitoring in order to support out-of-hospital care for Long Term Condition patients. Initially, our focus was on older people, and we gained a lot of experience about the needs and cognitive abilities of the folk typically suffering one or more long term condition.

As the company has grown and expanded, and technologies such as Apps and web become widely accepted, our solution offering has become broader in terms of who we can support with remote patient monitoring and how we can support our customers to ensure digital inclusion and reduce inequalities in healthcare provision.

Over the last few years, we have seen a plethora of companies springing up offering various levels of remote monitoring capability with downloadable Apps. But our experience working amongst patients with technical and cognitive difficulties has been at the heart of our product range. In 2010, we worked with AgeUK and undertook research with a group of older people to develop our Class IIa medical device, CAREPORTAL®. This user-led research was fundamental in helping us create something that would be easy for the older population to use. Our CAREPORTAL now enables people who might be less tech savvy to collect key measurements, such as ECGs, and record other vital sign and symptomatic measurements easily and quickly, which are then automatically sent to a clinical hub for remote monitoring. Our DocoboAPP, available in the App stores, has been designed to be simple to use and navigate, and has options for visually impaired and speech synthesis.

Digital inclusion – and making technology accessible to all regardless of age and ability – has always been really important to us as a company and has guided our product development throughout the years. More recently, Docobo having been acquired by Graphnet and becoming part of the System C & Graphnet Care Alliance, this has continued to guide our thinking, development and pathways.

Digital inequality has become a hot topic in healthcare, not least with the pandemic and the huge challenges that this created for the whole of the NHS. During the pandemic, we were able to work closely with clients to expand the use of both CAREPORTAL and locked down smartphones, to deliver an increased number of devices to those most effected by the pandemic, in areas such as Liverpool. We were also able to continue with the great work our clients were doing, by advancing into regions across the home counties and the West Midlands.

Supporting government and industry initiatives to counter digital inequality

There has been a raft of government and industry directives that support digital inclusion over the last few years, and we at Docobo – and the System C & Graphnet Care Alliance – are wholly supportive of these efforts. We actively support frameworks such as Ageing Well within the NHS Long Term Plan) which encourages people to have more autonomy in the care and support they receive, as well as promoting a multidisciplinary approach to integrated care to help people live well and independently at home for longer. We also support the Enhanced Health in Care Homes (EHCH) which looks at more effective use of technology in care homes, encouraging clinical teams to advance their use of technology ‘to make joint decisions about the care of individuals. For example, they may be able to assess some residents remotely, thereby avoiding unnecessary trips to hospitals or call-outs of NHS staff to care homes.’ This is exactly what our technology is able to – and does – support.

We’re also supporting initiatives such as the ‘What Good Looks Like’ (WGLL) framework which supports empowering citizens and healthy populations.  The recent Tech UK report ‘Right from the Start: What should Integrated Care Systems prioritise to make digital, data and technology work for them and their populations?’ also highlights the use of remote care and virtual wards while encouraging digital inclusion.

CAREPORTAL – supporting digital inclusion

CAREPORTAL® is our Class IIa medical device (MDD – European Medical Device Directive) which was initially co-designed with older people and Age UK to specifically meet the needs of users who are not so tech savvy. We wanted to address the challenges that can be associated with ageing – including digital illiteracy, social isolation and families living further away, managing long-term conditions, cognitive impairment, or deterioration of ability to perform activities of daily living.

We spent a long time in development sessions with groups of older people and Age UK to design and develop a device that displays a simple graphical user interface (GUI) and has built-in functionality to acquire ECG and breathing rate measurements. Using ‘use-case’ and ‘user-centred’ design processes, we were able to introduce a device that is easy to use, with minimal training and can be used by people with hindered dexterity – meeting the wider requirements of the ageing population (as well as individuals with other impairments) and to encourage digital inclusion.

We’re extremely proud of CAREPORTAL and our achievement to produce a device that promotes such digital inclusivity. With support and training, people can use CAREPORTAL to enter information into the DOC@HOME remote monitoring portal. It records ECG, heart rate, and measures heart rate variability without the need for wires or leads, the user simply holds the unit in their hands. CAREPORTAL provides the functionality of a smart phone or tablet, so can be used to monitor the full range of physiological and symptomatic measurements that are monitored within the DOC@HOME system, and – as it is kept in an intelligent docking station with added connectivity – charging requires no user intervention. The ‘always on’ feature (even in sleep mode) means carers can send an audible medication reminder if required.

CAREPORTAL is used in the home, while its ‘multi-user’ capabilities enable care and nursing homes to manage all their residents with just one or two devices. CAREPORTAL’s ECG recording offers the option to monitor for atrial fibrillation (AF) and other dysrhythmias and assists with fall prevention.

We’ve seen the overwhelming benefits of people using CAREPORTAL – how it empowers patients, residents, and users – and we celebrate the opportunity to work with forward thinking care providers to encourage the use of technology for people who may have previously been unwilling to do so, and not experienced the benefits.

What’s been really satisfying is seeing how – with CAREPORTAL and our remote monitoring platform – what we developed and continue to develop is being more and more widely used to enhance people’s lives and making care more equitable…. Our vision is ever growing … watch this space!