Home as the locus for modern healthcare

Posted: 23 March 2011 by Andrew Price

When we plan for healthcare infrastructure, we are accustomed to thinking about hospitals and health centres, but we now need to take a serious look at homes.

When we plan for healthcare infrastructure, we are accustomed to thinking about hospitals and health centres, but we now need to take a serious look at homes.

Technology, cost-effectiveness, efficiency – and patient safety with respect to infection - suggest that homes will increasingly become an important locus of healthcare delivery.

This is going to demand fresh thinking. Traditionally, we have looked at domestic housing in a public health context, but rarely in terms of delivering healthcare.

Even though the potential impact of telecare is becoming better understood, it is still used on a largely ad hoc basis. We have yet to work out how it should be knitted into healthcare strategy, so that it is perceived not as a bolt-on with extra costs, but an opportunity for cost-effective healthcare infrastructure.

Also, we need to discuss the nature of our housing stock. If it is going to be used for healthcare delivery – and not just for living – then it needs to be rethought. This is particularly the case with regard to elderly people, if they are to spend more of their later years in their own homes, rather than in hospital or in residential care.

In terms of technology, we are now able to monitor not only individuals remotely, but also their environments. There has been European funding for supporting ambient assisted living, with gadgets in the home to record remotely. As these become cheaper and efficient, they open up opportunities to manage facilities not just for heat and light, but for monitoring the occupants’ patterns of lifestyle and providing early warning systems, should there be a problem.

For example, if someone forgets to flush the toilet or does not put the kettle on as usual at 8am, it might flag up an issue to the outside world. Additionally, if we can see what is happening remotely, we can also, via wireless connection, control the patient’s environment if they are not able to do so. Perhaps the patient has dementia – an outside agency can make sure remotely that the heating is on at the right times.

The potential of this remote care is particularly impressive for developing countries that do not have our comprehensive network of healthcare coverage. It may be that wireless connections, combined with remote monitoring and imaging devices, hold the key to bringing expert care into rural environments where, in the past, people might have died for lack of sound diagnosis and medical care.

Andrew Price is Professor of Project Management, Loughborough University and an Executive Director of HaCIRIC.