Dr Sabrina Grant
Using home sensing data for patients undergoing a total hip or knee replacement -
Findings from the HEmiSPHERE study
24 June 2019
It was a pleasure to welcome Dr Sabrina Grant to give our third DHEZ Academic Seminar this year. Sabrina presented a talk about a study which is part of a wider collaborative research programme at the University of Bristol: the SPHERE project.
Sabrina’s talk described the development of a component of the SPHERE programme: the HEmiSPHERE project – looking at NHS application of sensors in the homes of patients undergoing a total hip or knee replacement.
SPHERE: Sensor Platform for HEalthcare in a Residential Environment
HEmiSPHERE: Hip and knEe Sensor Platform for HEalthcare in a Residential Environment
There are over 160, 000 people undergo total knee or hip replacement as a result of pain caused by osteoarthritis, and with the ageing population this number is set to increase. The HEmiSPHERE study aims to identify innovative approaches to monitoring post-operative recovery. The project aims also to compare outcome measures as collated from home sensors with conventional scoring systems e.g. Oxford Hip Score or Oxford Knee Score. It is anticipated that type of study will help clinicians to provide a more accurate assessment of patient recovery after surgery.
The study is anchored in the four principles of the Health Foundation person-centred care: where care is personalised, co-ordinated and enabling. The sensors that were deployed in people’s homes were initially developed in a “Test House” as part of the SPHERE project – this was done first to fine tune experimental design in areas such as data management, user acceptance, ethical processes and to also gain insights into the skills and training required for researchers to undertake such projects.
A number of sensors can be deployed:
- Environmental: temperature, humidity
- Wearable wristbands: activity, location
- Silhouette sensors: how people move, stand and sit
- Appliance monitors: electricity usage e.g. ovens, kettles, microwaves
- SPHERE Genie: a platform for home users which allows them to see battery status of home sensors
The HEmiSPHERE Study
The HEmiSPHERE study has installed the SPHERE system in the homes of 30 people as they underwent total knee or hip replacement. It has collated measurements of daily behaviour pre- and post-operatively over a 16-week period. This was done along in addition to interviews and focus groups with consultant orthopaedic surgeons. The interviews and focus groups aimed to access a greater understanding of the acceptability and accuracy of the data.
Developing the metrics of interest to be measured derived from discussions with the clinicians – they were asked what they wanted to learn from the sensors and responded with clinical observations such as “I’d like to see how patients are moving at home”. From this, it was possible to collect data that looked at movement patterns, durations spent in different rooms of the house, number of transfers between room etc.
The project is coming to a conclusion, and Sabrina and her colleagues are writing up their findings – so I’ll be keeping an eye out for publications in the near future.
This was a fascinating insight into how technology could be deployed to provide support for both patients and their clinical teams – it is early days… However, the ethical, person-centred and co-design approaches used in this study along with its dynamic multi-disciplinary nature signal very clearly how innovative healthcare projects should be designed and approached.
A common theme is emerging from our DHEZ Academic Seminar speakers so far:
the implementation of innovative healthcare solutions is complex and one that has teamwork at its heart.