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Background

People with long-term conditions including diabetes and chronic obstructive pulmonary disease (COPD) may experience worsening of their heath including developing high blood glucose levels or chest infections. Medical care aims to provide support through education, support for self-management, monitoring, treatment and timely access to health care when needed to reduce the risk of complications or further deterioration in their illness.

Health care now collects much information electronically including descriptions of patients, laboratory results, records of treatment and even vital signs. Increasingly people with these conditions also collect their own information about their conditions, whether through monitoring symptoms or using electronic devices to measure data. Joining up this information, and linking it to risk prediction tools and decision support, and enabling access to this data to everyone (including patients themselves) involved in care has the potential to offer timely, personalised and effective support.

Aims

EDGE-2 is one of a series of projects being undertaken to use monitoring devices to identify progression of illness and make use of this information to offer patients better care. The aim is to deliver a series of digital "tools" to help improve care and that have been tested with patients.  The EDGE-2 project is based around a system comprising a tablet-computer used to monitor symptoms, provide personalised information and guidance, and linked to a pulse oximeter to measure vital signs. The studies are intended to make the system easier to use, develop algorithms to provide personalised alerts, and integrate the system into care for people at risk of hospital readmission. 

These include integration of low-cost monitoring systems with mobile phones and using health data to support patients in better self-management. Our research group is working towards developing and testing intelligent systems that can monitor patient condition from hospital to the home, and which can help patients better manage long-term conditions. The availability and use of such information will form a digital “backbone" to future healthcare delivery.

This programme involves the clinical application of new, potentially low-cost technology to address two health problems. Intelligent monitoring systems are required to address the needs of patients with long-term conditions in their homes. However, no wearable systems have penetrated into clinical practice at scale, due to: (i) poor tolerance of existing wearable devices for monitoring; (ii) a lack of robustness in the estimates of the vital signs that wearable sensors produce; (iii) very limited battery life that requires batteries to be re-charged at a rate that prevents their use on a large scale; and (iv) limited subsequent use of the data for helping the patient understand and manage their condition.