Bide - simple tech that could save the NHS millions
The NHS seems to be in deep crisis, overwhelmed by emergency cases arriving at A&E in ambulances which become not-so-temporary hospital beds. In such circumstances it is difficult to think about the longer term, and whether technology could help the health service tackle the challenges it faces. But if we want to cut the traffic to overstretched emergency departments, tech could be part of the answer - and it doesn’t have to be complex or expensive.
That’s what I learned from a GP-turned-inventor Tom Adler. He’s spent the last five years trying to find a way to cut the number of elderly people suffering falls, many of whom end up in those ambulances heading to A&E. “The eureka moment,” he explains, “came four or five years ago, sitting at my desk seeing yet another woman in her 40s or 50s coming in in a distressed state reporting that her mum had had a fall in the night, broken her hip and was in hospital.”
He reels off a series of stats about falls - they are costing the NHS and social care £4.4 billion a year, people with dementia are nine times more likely to fall, particularly at night, and if you're over 65 and you spend more than an hour on the floor at night after a fall, there's a 50% chance of you being dead in six months.
“It’s a disaster and it’s not being sorted at the moment.”
Dr Adler says there is plenty of technology, much of it quite sophisticated, to monitor elderly people, detect when they fall and raise the alarm - but none of it seems to be able to cut the enormous number of people falling over and suffering fractures.
He decided that the focus needed to be on elderly people who fall when they get up in the night, probably to go to the loo. “We've noticed that, on going into care homes, people often fall in the first 48 hours because they reach out for that sideboard that they usually hang on to and it's not there and they're gone. “
His answer is a device called Bide. It’s not smart, it’s not even connected to the internet but it does one thing - detects someone getting out of bed and then plays them a pre-recorded message. The Bide is a square box with just a few buttons which you plug in and put on your bedside table. Recording a message is a simple process which can be done by the user, a carer or a relative. Tom Adler gives some examples:
“Dad, let's count down from 10 together - it’s David, we love you.”
“Mum, please remember your stick so that you can get out of bed more safely.”
“And the commonest message we’ve found successful is ‘John It's David, your carer, here. Please press your buzzer so that we can come and help you get to the toilet.”
The device, which only works when the room is dark, has motion sensors to detect when you get out of bed but I wondered whether it might activate every time someone rolled over. Tom Adler explains that you can adjust the position of the Bide to make it less sensitive but says it’s better to have the odd false alarm than for the device to miss the user getting up.
After working to produce a prototype with a local manufacturer in Derbyshire where he was based as a GP, Tom Adler decided it was time to mount some sort of trial. A 30 bed care home took two Bides and installed them in the rooms of its two most frequent fallers: “And those two frequent fallers did not fall once during the two and a half month trial.”
He admits that one small case study is pretty meaningless and, if he is to achieve his ambition of getting the Bide approved by regulators for use in the NHS and social care, a lot more work - and investment - will be needed. So far, the whole project has been. funded by friends and family and for a rural GP without easy access to the venture capital world getting to the next stage sounds daunting. But Tom has proved adept in finding his way through the complex maze that is the UK’s support system for healthtech startups.
He is working with an AHSN - an Academic Health Science Network, one of 15 set up in England to offer private companies help in working with the NHS: “They don't give money. They just make networks and are supportive.” The network helped Tom to work with the University of Central Lancashire setting up a trial over three months with 30 Bides in five care homes:
“Then we'll get a report at the end of it looking at has it reduced falls, has it reduced fear of falling because that's an enormous problem. For people who have fallen once there's a fear of falling again, which inevitably makes you more likely to fall again and two thirds of people will fall again within 12 months.”
While waiting for the results of that trial, Dr Adler and his small team have started manufacturing the Bide on a small scale, offering it for sale at £149. But longer term he’s thinking big: “We think it's an enormous opportunity - for example, non fatal falls cost $50 billion in America every year. It's a worldwide problem.”
There is a lot of talk of introducing advanced technology such as AI into healthcare, with some great projects, from a plan to predict arrivals at A&E to the Longitude Prize, which seeks to improve the lives of people with dementia. But maybe a device not much more complicated than an answering machine could be part of the answer to tackling a problem that’s costing the health service billions.
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This is a conceptually simple approach the nub of which is that it is preventive rather than reactive. The challenge is to make it adaptable to a range of circumstances where falls could be expected. I am 73 and have to get up in the night every night. We have a Hive system in our house that includes motion sensors that are programmed, not to talk to me, but to switch on a couple of lights to guide me to the bathroom and ensure that I successfully negotiate two pairs of steps on the way. Maybe Dr Adler's device could incorporate this added benefit in some way.
Might just be worth talking to Apple - they already have fall detection software on a wearable device after all?
Haddon