Wearables: more freedom with the smart care patch

Too many people in need of care and not enough health care professionals – we all know the problem. For years, research is underway to find digital solutions for Ambient Assisted Living (AAL) to support the growing number of older and sick adults. These new technologies aim to both alleviate caregiver burden and enhance everyday life of people in need of care with a minimum level of constraint whilst promoting independence.

In this MEDICA-tradefair.com interview, Jürgen Besser details the structural and medical challenges caregivers and people in need of care are facing today, explains how the smart moio.care system can overcome them and reveals why many earlier AAL solutions were actually not real solutions at all.

Mr. Besser, what prompted the idea to develop a telecare system?

Jürgen Besser: I worked for a major social service provider in Bavaria for seven years – right at the interface between healthcare practice and research IT. The product idea for our system originated during this time. The great demand and continued positive feedback prompted us to find ways to turn our idea into a reality. That's when we launched a startup at the end of 2017.

Your system is called moio.care. What is that exactly?

Besser: The system is comprised of a flat and flexible sensor module that people in need of care attach on their back via special patches. Thanks to its unique shape and soft material users are unable to see it and barely notice it's there. This makes our device the first wearable that is also accepted and tolerated by people with dementia as they don't even know that it's there. The problem with many other solutions on the market is that they often come in the shape of watches, necklaces, belt buckles or shoe inserts. Either users perceive them as foreign objects and remove them, or third-parties must ensure that the devices are indeed worn by the person in case he or she might get lost somewhere. Many wearables that are directly embedded in clothing are not useful for dementia care purposes. Our system is attached directly to the skin and under your clothing, providing around-the-clock monitoring – even at night – of body contact and allowing us to safeguard the module's function.

Which functions are these?

Besser: One of our primary objectives is to improve the interaction between caregivers and patients by taking the element of space out of the equation. This means the caregiver is aware of the patient's current status or whether something has happened to him or her, even if there is no visual contact. When it comes to the functions, we fundamentally focus on chief caregiver challenges. These are defined by the nursing standard of practice protocol and include the following problems: risk of bedsores (pressure ulcers), falls, disorientation, incontinence, and dehydration. Our moio.care system currently covers the areas of fall detection, prevention of pressure ulcers and disorientation.

I would like to explain in more detail how the prevention of pressure ulcers improves daily care plans for dementia. To prevent bedsores, patients should never remain in the same position for longer than four hours at a time to prevent tissue damage. A young, healthy person will eventually feel uncomfortable, prompting him or her to shift position – even automatically during his or her sleep. Meanwhile, a person with a physical disability or decreased pain sensation remains in the same position, thus causing tissue damage. This can be avoided by regularly repositioning the patient. To ensure this doesn't happen while patients are in professional care settings, residents in aged care facilities are repositioned by nursing staff during the night shift every four hours – regardless of whether there is an actual need for it or not. Our system allows a reduction in this activity as we monitor and document the wearer's movements. If the patient has turned in bed thirty degrees or more, the four-hour period starts again from the time of this repositioning activity. Caregiver staff only get alerted on their smartphone if someone has effectively not moved for four hours. Since staff then only have to reposition patients where truly needed, it drastically reduces their burden. At the same time, this boosts the well-being of residents as their sleep is no longer needlessly being disturbed unless it's absolutely necessary.

The same applies to disorientation. By using virtual zones, we promote more independence for people in need of care – while caregivers can be sure that it triggers an alert if patients leave these defined areas. This also eliminates the need for caregivers to be in close proximity at all times, while it affords patients more freedom of movement, greater autonomy and increased self-determination.

This actually benefits both caregivers and patients.

Besser: That's exactly right. It has always been very important to us that we don't create a positive impact for one party at the expense of the other. Caregivers and those in need of care benefit equally from our system.

How does this technology work?

Besser: The system works independently. You have a sensor that is worn on the body. It houses the sensor technology and intelligence. We are not continuously transferring raw data to a server for analysis. The sensor manages this process and only communicates the required information – any other data is lost. Not only is this important to us for ethical reasons, but also conforms with our approach to data minimization and data protection. It also increases consumer acceptance. Data is either transferred via mobile phone or GSM or via Bluetooth – in indoor settings – to our cloud. The GSM module makes us flexible and self-contained. You also don't need additional infrastructure to support private use. We use our cloud to send push notifications to the smartphones of the designated caregivers.

What is the latest status on solutions for ambient assisted living?

Besser: There has been a lot of research over the past ten years, but not much has actually made the leap into practical application. Many developments don't address the real need and don't solve the right problem. Or you have technical solutions to problems that have already been solved or are actually not problems at all. That's why we need a critical analysis to determine whether the developed systems truly yield an advantage in practical settings.