Let’s take a look at what has been happening when it comes to emerging tech and smart tech for healthcare, from news in this area to innovative uses of this technology in the industry to research exploring the art of the possible.
Emerging tech, innovations and smart tech
In March, HTN reported how North Staffordshire Combined Healthcare NHS Trust launched a pilot utilising virtual reality technology with the aim of supporting staff wellbeing. The project saw staff working in the psychiatric intensive care unit provided with a VR headset designed to enable them to undergo a “short calming experience” in a VR world with “relaxing graphics and soothing commentary”. It took place through the trust’s Combined Virtual Reality programme, which saw other initiatives including use of VR to help staff understand delirium; a VR walkthrough to provide insight into facilities and locations; and VR experiences of trust events such as the public board meeting.
In April, we highlighted how Sheffield Teaching Hospitals NHS Foundation Trust utilised smart technologies with the aim of reversing the risk of nerve damage in people living with type 2 diabetes. This trial included use of wearable sensors, smart weighing scales and activity trackers to enable the monitoring and sharing of patient progress around specific metrics such as body fat and muscle mass, with the view to helping to reinforce lifestyle changes.
Also in April, VR use was trialled for medical students at Doncaster and Bassetlaw Teaching Hospitals, with a computer-generated scenario allowing participants to virtually interact with patients, administer tests, ask patients questions, interact with other medical professionals, diagnose and provide medication. Through the trial, software also tracked participants’ physical movements with a headset connected to a television allowing others to watch the scenario and the simulation software providing a percentage score to help students understand their performance.
Moving forwards to June, HTN explored the role of smart tech in the Cancer Research UK roadmap for the early detection and diagnosis of cancer; the roadmap proposed the use of a ‘digital health twin’ described as a “lifelong, personalised digital model mirroring an individual’s health history” which could be updated with risks, symptoms, diagnostic testing and more. The charity called this a “long-term, visionary pan-disease approach to proactive health management”, and also called for improved understanding of big data for early detection and diagnosis.
And bringing us nearly up-to-date by taking a look at news from October, we recently shared the news that the UK government has awarded £12 million in funding for projects utilising innovative technologies such as AI, VR and wearable sensors in supporting people with drug addictions and reducing drug-related deaths. Projects receiving funding here include a remote monitoring platform designed to detect respiratory issues related to opoid overdose; a wristband capable of monitoring vital signs such as body temperature and movement patterns to detect a potential overdose; and a VR project testing the ability of technology-enhanced CET (cue exposure therapy) to help reduce cravings.
Other examples of VR applied to healthcare have included chemotherapy patients at Royal Free London being offered “immersive calming visuals” via VR to help calm anxiety; The Christie launching a two-year project aiming to explore whether VR can help support children undergoing cancer treatment; and this month, a pilot at South West London and St George’s Mental Health NHS Trust combining VR and therapeutic exercises such as calming breathing and visualisation techniques in the hopes of easing symptoms such as hallucinations and delusions in patients with psychosis.
Practical applications of smart tech in the NHS: a wider view
Projects taking place through the NHS’s ‘Future Connectivity’ wireless trials showcase some of the ways in which smart tech can be applied to healthcare settings – for example, The Princess Alexandra Hospital NHS Trust is examining use of real-time location system tech to track beds, focusing on how different tagging technologies could create a “proof-of-concept RTLS system, investigating passive and active tags”.
North West Ambulance Service, meanwhile, has been working on a project that combined Li-Fi – a technology capable of transmitting information wirelessly with light – with Internet of Things devices, to support improved connectivity within an ambulance along with supporting automation of various tasks.
Also on the topic of IoT, a future procurement opportunity recently shared by NHS Shared Business Services highlights plans to put in place a framework agreement for the provision of IoT and smart connected healthcare environments. The procurement is split into four lots, including smart tech products covering maintenance, monitoring and management; IoT data analytics software and platforms; end-to-end smart technology solutions; and IoT and smart technology consultancy and advisory services.
Sharing more information, NHS SBS shares aims to deliver a “compliant route to market for IoT and smart technology products and services that will support the NHS and the wider public sector organisations in their attempt to adopt smart technology and solutions”. The notice adds that the tech is expected to help “with a myriad of problems – from asset tracking, waste, water, air quality and energy monitoring and management, efficient usage of buildings and workspaces, telematics, smart theatres, smart street lighting, real time visibility of medical devices, home monitoring based solutions, traffic insights and signals, CCTV, cameras, IoT sensors, and crime prevention”.
Looking to Leeds, there is the Leeds XR Health Hub (LXR Health Hub) – a joint venture between Leeds Teaching Hospitals’ Innovation Pop Up and the Centre for Immersive Technologies at the University of Leeds, which focus on technologies with as VR, augmented reality or mixed reality and aims to support development of technical expertise among staff to create in-house training solutions to meet unmet needs. The hub provides equipment for staff-led innovation projects along with training and device support. It runs hackathons with the intention of developing “novel” XR solutions, and seeks to create a network of XR leads to be embedded within the trust
And at Midlands Partnership University NHS Foundation Trust, smart tech has been utilised for mental health care, with a platform designed to monitor patient safety and wellbeing piloted at St George’s Hospital. The platform sees the utilisation of a secure optical sensor in the mental health wards, with the tech capable of remotely monitoring a patient’s pulse and breathing rate 24 hours a day by “measuring changes in skin tone and chest movements, even when patients are under bedding”. The sensors can also alert staff if patients are at risk of falling, if they get out of bed, or if they display “behaviour that may present a risk to their safety”.
The research perspective: exploring digital twins
An article published in Frontiers journal earlier this year explores use cases of medical digital twins in immunology, focusing on projects in different stages of development “that can lead to specific – and practical – medical digital twins or digital twins modelling platforms”.
By way of context, the authors begin by stating: “A fundamental challenge for personalised medicine is to capture enough of the complexity of an individual patient to determine an optimal way to keep them healthy or restore their health.” This, they continue, will require personalised computational models “of sufficient resolution and with enough mechanistic information to provide actionable information to the clinician”, adding that digital twin technology for health is “still in its infancy” with extensive research required.
The use of digital twins is “quite advanced” in other industries, the authors note, with models capturing machinery, physical plants or production and management operations in an “almost entirely mechanistic” manner and the Internet of Things supporting data coupling of the physical part of the twin with the underlying model. However, in healthcare, the authors note a number of challenges, including our own incomplete theoretical understanding of biological systems; genotypic and phenotypic diversity across individuals; and unpredictability in system dynamics.
However, to illustrate work in this area, the article highlights a number of ongoing digital twin projects by participants of the ‘Forum on Precision Immunology: Immune Digital Twins’ event held in Florida last year. One project is examining the data types and sources that are available for the data interface between a patient and digital twin, ranging from demographic and clinical descriptive data to more specific information that tends to be found in the research context, such as gene expression. Another project explores the approach by which the digital twin model can be personalised – ie. the ‘twinning’ process to an individual patient in the real world; later in development, this project will see the generation of virtual populations for the model to ‘twin’ to, with the potential of direct mapping to an individual patient in the real world in the future. Additionally, another project looks into the potential for the digital twin to have a patient-facing interface, exploring whether patient engagement capability might increase the willingness of potential patients to participate in such projects and potentially help establish a context for dealing with ethical issues such as patient privacy.
The authors also suggest a set of potential use cases for digital twins in the treatment of sepsis. Examples include employing a digital twin trained on physiological signals, electronic medical record data and standard laboratory values to deliver an “early warning system” for sepsis; predicting sepsis trajectory; optimising existing therapies; and discovery and deployment of new therapies. Here, the authors note that “effective treatment/control” for sepsis “requires identifying the best match between a given patient at a given time with the appropriate set of therapies” and add that “the current means of doing these tasks for a septic patient are woefully inadequate”. They suggest that digital twins could play an important role in personalising the characterisation of a sepsis patient to enable a ‘right patient, right time, right drugs’ approach.
Citation: Toward mechanistic medical digital twins: some use cases in immunology. Authors: Laubenbacher Reinhard, Adler Fred, An Gary, Castiglione Filippo, Eubank Stephen, Fonseca Luis L., Glazier James, Helikar Tomas, Jett-Tilton Marti, Kirschner Denise, Macklin Paul, Mehrad Borna, Moore Beth, Pasour Virginia, Shmulevich Ilya, Smith Amber, Voigt Isabel, Yankeelov Thomas E., Ziemssen Tjalf. Journal: Frontiers in Digital Health, volume 6, 2024. DOI=10.3389/fdgth.2024.1349595. ISSN=2673-253X. License here.
