5G in Wellness, Self-Care and Prevention

Telemedicine and other emerging care technologies are key enablers for the future delivery of health and social care. Though not a new concept, when harnessing the power of advanced connectivity, the quality and effectiveness of monitoring increases, individuals are empowered to manage their own wellbeing, and providers benefit from operational efficiencies and scale. 5G networks provide a scalable, reliable infrastructure for Internet of Things (IoT) sensors to enable care and health staff to access the information they need to deliver personalised care, such as an individual’s movement patterns or air quality in their home. Analytics software enhanced with Artificial Intelligence (AI) capabilities could introduce non-intrusive remote monitoring of people, including those with additional needs (including drug adherence, breathing and biometrics), while maintaining data privacy standards. 

Research suggests video conferencing and real-time monitoring will free up 1.1 million hours for GPs that can be directed towards patient care instead of administrative tasks, and reduce social care budgets by an estimated five per cent, saving £890 million to reinvest in other services that can benefit the population. 5G-powered telemedicine will help to decentralise healthcare — facilitating a necessary transition from reactive to preventative practices. Potential risks can be identified earlier and resolved more rapidly before illnesses or unwanted situations arise, helping to deliver better outcomes for people. It also means individuals will be able to access the specialists they need, wherever they are based - something that is particularly of value to those in rural or remote locations where travelling to see specialists can be costly, time-consuming and inconvenient. This is not about removing human interaction from health and social care; instead advanced connectivity solutions can assist health and social care workers, ultimately delivering better outcomes and benefits for individuals and the wider system, helping to reduce pressure on general practice, hospitals and social care.

Some consumers and care providers may have concerns about the reliability of devices and wireless connections, particularly in more rural areas. 5G has a high bandwidth and capabilities that provide more robust connectivity than 4G. Its ability to utilise mobile edge computing also enables longer device battery life. Advanced connectivity, and the solutions it enables, will have a major impact on loneliness and quality of life, too: patients living alone are 50% more likely to access emergency care services and are 40% more likely to have more than 12 GP appointments in a year. The benefits of advanced connectivity for the health and social care sector must not be understated.  From accessing care digitally or using smartphone apps to manage sleep patterns and find like-minded people to socialise with — 5G can help build towards a happier, healthier population.

Read more below on wellness, self-care and prevention applications.

WM5G used 5G to enable remote monitoring of care home residents, while the Liverpool 5G Create project deployed sensors under care home beds to monitor the vital signs of residents. Using Artificial Intelligence (AI), staff were notified to assist; enabling more personalised, tailored care that should reduce the number of accidents.

In South Korea’s Samsung Medical Center, an AI-powered in-patient care platform runs on a 5G network to regularly monitor patients. This includes the air quality of the room, patient’s condition and sleep quality, with AI detecting and alerting the hospital staff to potential issues. This enables more efficient responses to potential emergencies and improves the inpatient experience.

The Yonsei University Health System — also in South Korea — is deploying devices in patient rooms that enable facial recognition systems to monitor patients and visitors. Signs of distress or discomfort can be recognised in real-time by way of AI, alerting hospital workers that help may be required. 

Acceptance and familiarity with advanced technology, including robotics, are generally greater in East Asia than the UK, meaning such solutions might not be suitable for immediate and exact replication and adoption into our health and social care system. However these examples clearly demonstrate what is possible, and the impact it can have in the provision of health and social care. Learnings and insights from such deployments can also help to steer the UK in deciding how best it can use advanced connectivity solutions to digitise the sector and deliver better outcomes for individuals.

5G was used to deliver telehealth monitoring in the Liverpool 5G Create project. A Care Portal device, including a built-in ECG monitor, was used by individuals and connected to a Telehealth Hub staffed by nurses and healthcare assistants. This real-time monitoring provides clinicians with more data and should help problems to be identified before they become emergencies, reduce district nurse visits and enable people to stay in their homes for longer.

A variety of solutions already exist to monitor those suffering from chronic illnesses. For example, home glucose monitoring is essential to the management of diabetes and the prevention of complications. Diabetacare trialled a new blood sugar level device with remote monitoring capability across 800 patients in Bangalore, India. Working in tandem with eight day clinics in the city, the devices provided regular monitoring along with personalised treatment schedules; specially trained nurses monitored the daily data and diabetes doctors reviewed progress and dealt with emergencies. The trial has been successfully deployed without 5G but since 100 million people suffer from diabetes in India, rolling out more broadly on existing connectivity solutions will be challenging. 5G’s capacity to scale to a far greater density and enable ubiquitous secure connectivity is crucial and will enable more complex monitoring, for instance of individuals with multiple long term conditions.

The Future Healthcare Journal states that AI technology is especially important when talking about severe diseases. IBM released findings that its model could detect breast cancer in an astonishing 87% of cases analysed. With 5G-enabled AI, medical experts can make decisions based on their experience and large volumes of data, taking their decision-making to a whole new level.

A private 5G network from AT&T is helping to revolutionise the way patients and researchers connect at the Lawrence J. Ellison Institute for Transformative Medicine of USC, USA. The on-site 5G network provides ultra-fast connectivity for patient-centred cancer research, treatment, and wellness education.

Sharing his thoughts, Joe Drygas, AT&T VP of Healthcare Industry Solutions, USA said, “5G has the potential to offer massive connection power, fast speeds and low latency that can help transform how healthcare is delivered. Think remote robotic surgery and quick downloads and transference of massive data files of medical imagery. 5G not only has the capacity to impact the Internet of Medical Things, but it also will help enable medical innovations using augmented reality, virtual reality, artificial intelligence, remote medical learning, remote patient monitoring, and more. Healthcare providers will be able to build an entire ecosystem that creates highly responsive, effective, patient-centric experiences”.

The Liverpool 5G projects explored how 5G can facilitate more effective remote monitoring of people with additional needs. As part of the Liverpool 5G Health and Social Care Testbed, Safehouse Technology Ltd provided sensor technology to monitor the homes of over 80 people living independently with at-home support and alarm buttons. Conditions and environments that could adversely affect health and wellbeing were monitored, and alerts were sent to friends, family and professional carers, including the emergency services when required. Vitally, this system could also be used to highlight at-risk correlates of illness such as fuel poverty, power outages and humidity fluctuations. The project calculated £38,020 per 100 users as the potential cost savings to health and social care services per year; this was attributed to reduced costs of telecare and a decrease in hospital admissions and average GP visits. 

The Liverpool 5G Create project went on to test a further range of telecare equipment and used AI to monitor nutrition, hydration, independence, and activity via IoT (Internet of Things) sensors around the home. The technology alerts support networks to any changes in behaviour or deterioration. Early prevention was a core principle of the trials, for instance, a WarnHydrate device trialled with a social care provider in the context of domiciliary care connected to 5G via LoRaWAN, and sent data to care providers to detect early signs of dehydration.  

Liverpool also explored continuous monitoring in care home settings with chromatic sensors — designed by the University of Liverpool — to predict falls and unusual patterns of behaviour in old people. The sensors, which are placed on the ceiling and look similar to conventional smoke detectors, alert carers in the case of an emergency. A 5G connection allowed high speed data transmission, critical for time-sensitive alerts; the care home participating in the trial reported alerts from the device had provided effective early indicators to care workers, enabling them to deal with problems before they became an emergency. The end goal is to reduce the amount of time care workers spend dealing with incidents.

Amongst social care and support providers there is of course varying adoption and familiarity with digital technology.  However, across the UK work is underway to support the infrastructure, skills and wider cultural shifts that will enable the sector to move towards adoption and use of advanced connectivity solutions.

Beyond the UK, other solutions are being deployed with 5G to effectively monitor people accessing care and support to enable early intervention. In California, People Power has developed an AI-based telehomecare solution, which monitors individuals in their homes 24 hours a day by way of a remote support team that monitors their wellbeing. The sensors can both detect a fall and predict that a fall may occur, enabling truly preventative care via AI.

Meanwhile, in South Korea, AI speakers are being deployed to the country’s ageing population, many of whom are increasingly likely to live on their own. The device captures data that is monitored to enhance its personalised services and recognise abnormalities: for example, should a user say “Help!”, the speaker will instantly report this.

Taking a different approach, the 5G Barcelona project has deployed 5G-supported robots into the homes of 12 elderly individuals. The robots are capable of moving and interacting with the user to provide support, care and supervision. Critically, they are able to monitor and analyse the individual’s cognitive condition based on interaction through language. While such solutions might not be suitable for broad deployment in the UK, they demonstrate the extent to which 5G can support significant change in how we monitor and care for people.

The Liverpool 5G Health & Social Care project partnered with the Royal Liverpool and Broadgreen University Hospital Trust to develop a telehealth in a box solution, using 5G. The network connected the hospital to community patients through assistive technology to support earlier discharge. A portable multimedia telehealth monitor was used to record clinical, lifestyle and quality of life data each day. The device also delivered information, supporting people to self-manage their conditions more effectively. This resulted in a decreased use of primary health services and hospital services, in addition to improved health for service users who were more readily able to manage their own health. 

In Greece, Vodafone’s Telehealth Monitoring service has enabled remote monitoring of patients post acute care. The project focuses on remote communities, where travel for follow-up hospital appointments can be time consuming and expensive; this offers significant convenience to patients, as well as increased efficiency through reduced readmissions for the healthcare sector.

While Swansea University has run trials with 5G smart bandages: 3D-printed bandages, fitted with nano-sized 5G sensors, are able to relay data about the progress of the wound, as well as information about the patient’s activity. This will enable safe discharge from acute settings and the development of tailored treatment plans. 

In May 2020, a Covid-19 NHS patient with severe asthma and phobia of hospitals was selected by clinicians for remote monitoring. On day seven of her infection, the clinical team were alerted to worsening oxygen saturation levels and quick action was taken to triage her into an acute setting for proactive management of her symptoms. Had she not been monitored it is expected the patient would have presented late through emergency and required more intensive and costly critical care.

But to implement such services at scale requires a connectivity solution that supports a significant density of sensors: 5G. 

The Liverpool 5G Health & Social Care project explored the potential of 5G to support medication adherence through the deployment of PAMAN, a remote monitoring system with a simple video audio device. After a medication review with a clinical pharmacist, over 30 users were provided with a device in their home that connected to the PAMAN monitoring centre with a simple button. Pharmacists and pharmacy technicians could observe people in their homes taking their medication, as well as answer any questions, liaise with pharmacies and GPs on the patient’s behalf and facilitate repeat prescriptions. 5G provides a reliable, consistent connection and enables ultra high definition video. 

As an example of the impact this service can have, one service user, A, has several health issues, and requires an inhaler and strong pain medication. At the initial medication review, The Medication Support Company’s clinical pharmacist found that A had been without her medication for almost four months. On enquiry, the pharmacy had medication waiting to be collected, and they were unable to deliver it. Carers were unaware of these difficulties. It was also discovered that, when available, A was taking her medication incorrectly. For instance, one medication was being taken with milk which negated its benefit by rendering it nonabsorbable. Unfortunately, the labelling on blister packs did not give enough information about how and when to take them. After the review, the PAMAN clinical pharmacist collected A’s medication from the pharmacy, gathered up all the empty medicine packages, discontinued and out of date medicines in her home, and put the new medicines in one location in Medibox. The clinical pharmacist liaised extensively with the pharmacy and GP surgery, addressing medication issues. The PAMAN team now manages the repeat prescription request process, making sure appropriate medication is ordered and in the correct quantities, and this is now delivered to A at home.

The results of the trial were striking: with medication adherence levels rising to 95 percent (compared to the 55 percent national average), a 51 percent drop in the number of service users who had a medication error, a 50 percent reduction in medication costs through reduced wastage and a significant reduction in carer hours needed to provide medication administration support. Importantly, the quality of life for users also significantly improved with a 73 percent increase in those feeling confident and happy to take medication, 53 percent increase in those who felt safe and 40 percent increase in feelings of independence. These considerable benefits combine to deliver a potential cost saving to health and social care services of £208,800 per 100 users per year.

High definition video and remote support is, however, not the only way to monitor medication adherence. Abilify Mycite is a smart pill used to treat schizophrenia and contains a sensor that connects to an app to record that medication has been taken. While the pill does not require 5G, next generation connectivity provides a more secure and reliable service.

Working with the Royal Liverpool and Broadgreen University Hospital Trust, the Liverpool 5G Health & Social Care project delivered 5G connected VR headsets for palliative care. The headsets were used as distraction therapy to help manage patient pain. Patient feedback was overwhelmingly positive, reporting increased quality of life and some reduction in pain medication. The hospital sees applications for the tech beyond palliative care, supporting patients in critical care units with rehabilitation and ventilation weaning.

David Walliker, Chief Information Officer at the Royal Liverpool and Broadgreen University Hospitals NHS Trust, said: 

"Using 5G technology we have been able to expand our virtual reality (VR) use in our pallative care service to provide VR sessions for our patients who need it most. Previously we were limited to a preloaded beach or forest experience of 15 minutes, but since connecting our VR devices to Liverpool 5G Health and Social Care's 5G network we have been able to offer patients a personalised experience aas an effective distraction therapy technique."

A hospice in Leicester has also been using VR in end of life care, specifically with a focus on improving quality of life. VR experiences are used for those with limited mobility, providing experiences such as the chance to explore new locations. 

Mixed reality is also being effectively used by Immerse Health for people living with dementia, boosting wellbeing and stimulating conversation. Care homes have reported more meaningful interactions with carers, reduced aggression and even the recall of past memories. While the solution doesn’t require 5G, advanced wire-free connectivity offers a far richer, more immersive level of interactivity.

In South Korea, the Pusan National University Yangsan Hospital Children’s Ward has created a “5G playground” for long term patients who are unable to leave the hospital. In this virtual playground, large LCD screens connected to virtual reality content and a 5G network take children to places on their wishlist (including travel spots, aquariums, amusement parks, zoos and even outer space.) It also allows children to play games and conduct physical activities using augmented reality technology, supporting their general wellbeing and providing mental stimulation.

5G is also being used to boost the wellbeing of those who are unable to physically interact with others. In the Yongin Severance Hospital in South Korea, patients can now have their families and friends virtually visit them using a hologram and 360° VR visiting system. Closer to home, the Liverpool 5G Create project tackled the Covid-induced social isolation of care home residents head on, with “haptic hug” T-shirts. When a resident is wearing the shirt, their loved one can ‘hug’ them via the app, and the shirt squeezes the resident who feels the sensation of a hug. These devices were found to have a significant impact on the wellbeing of care home residents, helping reduce feelings of isolation and loneliness. The shirts were connected via the project’s private 5G network and required a level of connectivity similar to simultaneously streaming HD video and audio, which 3G and 4G struggle to support.   

Liverpool 5G Create also developed a 5G connected app to boost wellbeing and reduce anxiety amongst children under the age of eight. The Chill Panda application features a panda that expresses the user’s emotions based on their heart rate and mood ratings, with an AI driven recommendation engine creating personalised anxiety reduction content. Its design was informed by paediatric studies to improve child mental health, in addition to helping remove the stigma around mental health challenges amongst children.

The Liverpool 5G project explored a number of solutions and devices to tackle loneliness and social isolation. A digital loneliness device called ‘Push-to-Talk’ was deployed to over 40 individuals of different ages and personal circumstances, who struggled to get out their homes and socialise. The device, connected to a 5G network, enabled communication with a range of users in different communities, with a maximum 30 second delay from pushing the button to gaining a connection. The trial showed a marked reduction in loneliness amongst users, with a 50 percent increase in those who said they “rarely felt isolated” from others, an impressive 30 percent reduction in the number of people who visited their GP, and a 16 percent drop in the average number of visits per user. The project calculated that the potential cost saving of deploying the Push to Talk service was £868 per year per 100 users.

Mary Brandt from Kensington, who was introduced to the Push to Talk solution by the Liverpool Carers Centre, said: 

"I love using it. I contact other carers and we talk and have a laugh. It does everybody good. We don't always have to talk to each other about our problems, we just chat... When I met with people from Local Solutions, who introduced me to Push to Talk, I felt like they were giving a voice to the carers."

A similar solution has been explored by the 5G Barcelona project, which has developed a collaboration platform that allows older people to participate in experiences and activities remotely. Users with health and mobility constraints can virtually take part in activities — including visiting a museum, partaking in a book club, engaging in cooking lessons or contacting their grandchildren. The device features a presence sensor that automatically detects when someone enters the room and triggers instructions to start using the device. Each device is personalised to suit personal preferences and tastes, with individual interests used to create virtual conferencing rooms with other users. With 5G’s security, reliability and high bandwidth, users benefit from high quality video conferencing with minimal delay and can interact with multiple users simultaneously.

What’s more, Angus Council in Scotland has tested a solution called KOMP: a one-button computer, designed and produced for isolated individuals who struggle with using modern day technology. KOMP requires no prior digital skills from its user and family, friends and carers can send photos, messages and make video calls. The platform can also be used to administer reminders tailored to an individual’s needs or care programmes. 

Technology has the potential to tackle social isolation—but only if individuals are comfortable using digital tools. Liverpool worked with CGA to create a Loneliness Quizzing and Gaming App, a social gaming app that brings people together to take part in online quizzing, games and chat to combat social isolation. It features video communication to allow users to meet and take part in the game from different locations. Crucially, the app was adapted following feedback from user groups, including: individuals with varied learning difficulties attending the Kensington Community Centre; a residential home with users over the age of 60, many of whom suffer from dementia; and a supported living centre where users had a range of learning disabilities and varied in age from 30 to 80. Trialling with a diverse range of users ensured it was suitable for use and helped build digital skills, as well as confidence.

The app is a perfect test case for 5G technology because it needs a high bandwidth to drive the device-to-device video capability, requiring around 80 Megabit bandwidth and low latency. Users reported marked reductions in loneliness with a 26% decrease in those who said they often felt isolated from others. Quality of life for service users also showed a positive improvement, with an increase of an average of 1.4 points on the life satisfaction scale.

In California, VITAS healthcare has partnered with AT&T to deliver VR therapy over 5G, which has proved to be an effective way to tackle loneliness amongst end of life patients. VR technology makes it possible to bring a hospice patient out of bed and into situations where they feel more present. Headsets can also be configured to transmit the same imagery between two viewers, enabling shared experiences between a patient and their loved one, carer or another party.

Dr. Joseph Shega, senior vice president and chief medical officer for VITAS, said: “As a patient approaches the end of life, the effects of illness can shrink their world until it’s no bigger than their home or bedroom. This can be incredibly disheartening to patients and their families. Part of leading the way in hospice care is searching constantly for new approaches to enhance quality of life for VITAS patients. Already, VR technology is showing an incredible capacity to elevate our patients’ moods, diminish their symptom load, and provide opportunities to explore and remain connected with the outside world.”

Liverpool tackled the Covid-induced social isolation of care home residents head on, with “haptic hug” T-shirts. When a resident was wearing the shirt, their loved one could ‘hug’ them via the app, and the shirt squeezed the resident who felt the sensation of a hug. These devices can have a significant impact on the wellbeing of care home residents, helping reduce feelings of isolation and loneliness. The shirts were connected via the project’s private 5G network and require a level of connectivity similar to simultaneously streaming HD video and audio, which 3G and 4G struggle to support.   

Perhaps the most radical solution, though, has been tested by 5G Barcelona who deployed emotional robots to the homes of 12 elderly people. The robots are designed to create company for users; they can follow individuals and engage them in conversation. 

The Liverpool 5G Health & Social Care project worked with CGA to create a social gaming application. Bringing people together, it offered online quizzing, games and chat groups. Such digital skills are important in a world that is becoming increasingly online. Importantly, the application was adapted following feedback from user groups including: individuals with varied learning difficulties attending the Kensington Community Centre; a residential home with users over the age of 60, many of whom suffer from dementia; and a supported living centre where users had a range of learning disabilities and varied in age from 30 to 80. This ensured it was suitable for use by a diverse range of users.

The application was a perfect test case for 5G technology as it needed the high bandwidth and low latency offered by 5G to drive the device-to-device video capability. 

Vodafone has partnered with Mencap to develop a Connected Living solution to help people with care and support needs to receive tailored and personalised support. It uses a range of intuitive and user-friendly IoT devices to make everyday activities easier. These devices are controlled by a bespoke application, helping the user to control their own environment with greater independence. 

In the 5G-enabled health ecosystem, patients will become less passive consumers of healthcare and more engaged participants in driving their own outcomes. Currently, the average patient in the US spends about 15 hours a year with a healthcare provider but has more than 5,000 waking hours to care for themselves. By ‘activating’ some of those 5,000 hours - that is, taking independent actions to manage their wellbeing, diagnostics and treatments - patients can improve their quality of life and medical outcomes and, at the same time, reduce overall costs in the healthcare system. According to PWC, one study found that an activated patient costs US$1,987 less annually than a less activated patient, a 31% difference.