The Irish island using virtual means to tackle healthcare and loneliness

The Covid-19 pandemic speeded up some digital healthcare innovations as healthcare professionals introduced alternatives to face-to-face contacts with their patients to prevent the possible spread of infection.

Now, three years later, some GPs and consultants are continuing to use phone/video calls and virtual outpatients’ clinics for some of their patients. Now, a new project on Clare Island aims to develop several virtual projects to both monitor and enhance the health of the residents on this west of Ireland island.

Prof Derek O’Keeffe, the originator of the Clare Island Home Health Project, believes that healthcare should move towards a digital care model. With degrees in both engineering and medicine, the consultant physician in diabetes/endocrinology at University Hospital Galway and professor of medical devices at the University of Galway calls himself a physicianeer.

As the project leader for the Clare Island Home Health project, he is enthusiastic about the benefits of digital health to people in remote parts of Ireland. “The National Aeronautics and Space Administration (Nasa) picked extreme environments to practise their mission protocols before sending astronauts into space, so we think Clare Island is a great example of a location to test virtual healthcare. It’s a remote, rural location. If it works there, it can work in other locations,” says Prof O’Keeffe.

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The €1 million project, funded by the Science Foundation Ireland and Cisco, aims to offer the 150 islanders digital health monitoring, virtual chronic disease clinics and digital health promotion using personal fitness monitors. An emergency response using an all-terrain robot connected back to a hospital medical team is another ambitious part of the project.

Upgrading the broadband connectivity of the island is the crucial first step. And it’s hoped the new 5G network that will allow multi-platform communications between islanders and mainland health teams will be up and running soon.

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Meanwhile, the first recruits for digital health monitoring and virtual chronic disease clinics are pleased with their involvement so far.

Alan O’Grady (49), the skipper of the Clew Bay ferry suffers from high blood pressure. He now checks his blood pressure every evening and sends the results via Bluetooth on his phone to his doctor. “I then meet with the specialist from University Hospital Galway at the virtual medical hub on Clare Island every month or two so he can increase or decrease my medication as necessary.”

O’Grady has no qualms about replacing the in-person appointments with virtual ones. “It’s like sitting in his office in Galway without the hassle of getting the boat and driving to Galway city, finding parking and maybe arriving a bit late, which pushes my blood pressure up.”

Bernard McCabe (80), the owner of the Granuaile House Bed & Breakfast on Clare Island, is a diabetic. He now tests his blood sugar levels three times a day and feeds the information into his phone for checking with the diabetes team at University Hospital Galway. He also sends in his daily weight and blood pressure via his phone. “Not having to travel to the clinic is the main benefit for me. Instead, I just have to walk down the road to the medical hub,” explains McCabe.

Prof O’Keeffe, who is also the new HSE national clinical lead for diabetes, agrees that cutting out the long journeys is a huge benefit for many patients. “Five to 10 of the 50 patients in my outpatients’ clinic travel up to two hours to get there and then they wait up to 1½ hours for a 10-minute appointment. But we could see these patients over WebEx calls while being able to see all their physiological data on the screen too,” he explains.

The so-called dynamic appointment system, which is being trialled on Clare Island, will allow the medical team to see patients sooner (either virtually or in person) if there are concerns about changes to their blood pressure and blood sugar levels which have been picked up by remote monitors worn by the patients.

A six-month clinical trial will also look at how patients with chronic diseases on Clare Island having virtual consultations and monitoring fare compared with similar patients in Louisburgh, Co Mayo, who have a GP check-up at the start and end of the six-month period.

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Ian McCabe, who is the Clare Island-based project manager of Home Health, explains that he is currently recruiting islanders for a health promotion initiative. “We will offer them a personalised nutrition plan and a wearable device to track their activity levels. The idea is to set goals to do 10 per cent extra steps each week,” he explains.

One hundred of the 150 islanders have already expressed interest in wearing a pedometer which will record their baseline movements and encourage them to increase their activity incrementally. The overall activity level scores of different groups (members of music, sports and community activities) will be compared to add a bit of competitive fun to the exercise.

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Prof O’Keeffe is also excited about another dimension of the Clare Island Home Health project which aims to tackle loneliness. Exploring what he describes as “the edge of human connectivity”, this strand will offer people living alone the option to have a screen in their kitchen or livingroom connected for 12 hours a day to a family member living elsewhere.

On a video call from his office in Galway, he shows me the Temi robot on wheels which has a tablet screen, camera and microphone, which he says could also act as a household companion that connects the person as he/she moves around the house to the designated family member.

And if that sounds a bit futuristic, consider this: the project also hopes to trial the use of an all-terrain robot or “giant electronic dog”, as Prof O’Keeffe describes it, which would be deployed to any part of the island in an emergency. “We want to see if it’s possible to deliver remote emergency care via this quadruped robot. The medical team would guide the response virtually, giving people instructions on what to do with the patient,” he explains.

Many of these digital health protocols are being researched by Prof O’Keeffe’s team of about 30 researchers – clinicians, software and hardware engineers, scientists, health psychologists and educationalists – at the Health Innovation Via Engineering (HIVE) lab at the University of Galway. “We want to make sure that the services we offer people on Clare Island continue after this 18 month project ends.”