Page Rupert A
Poole Hospital NHS Foundation Trust, Poole Hospital, Poole, BH15 2JB, UK.
Epilepsy Res. 2019 Jul;153:85-87. doi: 10.1016/j.eplepsyres.2019.02.016. Epub 2019 Feb 26.
The traditional models of epilepsy care provision have not changed substantially in more than a century, despite rapid advances in computing, technology and materials science. One consequence of these advances has been the near universal prevalence of smartphones. Wearable devices with a complex sensor arrays are an emerging technology. These devices provide a coalescence of digital computing and communication tools that offer a new way to detect, report and communicate about seizures. The pilot of a smartphone-based application for patients and cares allowing real-time reporting of seizures securely to the relevant epilepsy care team is described. Wrist-worn devices were evaluated for their ability to detect epileptic seizures. Relevant information, such as seizure notifications and live alerts for notification of emergency attendance or admission to the hospital, are sent securely to the epilepsy care team in real time. Tailored specialist advice following notification is provided along traditional lines. Compared to the year preceding the pilot, the interval between seizure occurrence in the community and notification of the specialist team reduced, with faster response times in terms of advice. There was a 30% reduction in admissions for patients with epilepsy and 10% reduction in length of stay. Patients using the technology report an increased feeling of empowerment. This model of care has several challenges and requires modification of existing working practices if benefits for patients are to be fully realised. The benefits and challenges of technology-enabled care in are discussed from the perspective of the experience from development to clinical deployment.
尽管计算机、技术和材料科学取得了飞速发展，但癫痫护理的传统模式在一个多世纪以来并没有实质性的改变。这些进步的一个结果是智能手机几乎普及。具有复杂传感器阵列的可穿戴设备是一项新兴技术。这些设备融合了数字计算和通信工具，为癫痫发作的检测、报告和交流提供了一种新方式。本文描述了一款基于智能手机的应用程序的试点情况，该应用程序可供患者及其护理人员使用，能将癫痫发作情况实时、安全地报告给相关的癫痫护理团队。对手腕佩戴设备检测癫痫发作的能力进行了评估。癫痫发作通知以及紧急出诊或住院通知的实时警报等相关信息会被安全地实时发送给癫痫护理团队。通知后会按照传统方式提供量身定制的专家建议。与试点前一年相比，社区癫痫发作与专家团队收到通知之间的间隔缩短了，提供建议的响应时间也更快。癫痫患者的住院人数减少了30%，住院时间缩短了10%。使用该技术的患者表示增强了自主感。这种护理模式存在一些挑战，如果要充分实现对患者的益处，就需要改变现有的工作方式。本文从从开发到临床部署的经验角度讨论了技术支持护理的益处和挑战。
