Elderly people to receive monitoring care in the "Hospital Without Walls"

Dr. Gill explained that changes in disease patterns, notably a shift to age-related and chronic conditions, are exacerbating this trend, and increasing the fact that numbers of patients are being cared for in their homes. By applying telemedicine techniques it is possible to move some functions of health care out of the hospital environment and doctors' surgeries into the home. "This not only reduces the costs of health care but it also allows individuals to maintain their independence by enabling them to remain in their homes", added Dr. Gill.

"Hospital Without Walls" is being developed in a modular form that permits application in a number of areas. The initial version monitors the vital signs of patients who have visited a hospital casualty department following an unexplained fall. The wireless fall monitoring system functions by having patients wear a small portable device with sensors capable of measuring heart rate and body movement. A personal computer within the home will record data from a number of sensors and upload to a remote assessment centre at regular intervals via the telephone network.

"It is very difficult to diagnose the causes of such falls without a record of vital signs at the time of the fall. This home telecare system will help to identify the possible causes of this type of falls, equally including a number of cardiovascular conditions which can only be diagnosed at the time of the fall", commented Dr. Gill. Visiting health professionals will be able to access complete records of vital signs and add to the patient's records.

Initial clinical trials of the system have begun at Ryde Hospital in Sydney. The principal aims of these trials are to confirm the technical efficacy of the technology, investigate patient and staff acceptance, and to explore the value of gait analysis in patients recovering from a major fall. Research work is also progressing on the wide-area networking aspects of the system, which will permit immediate access by health professionals, including the general practitioners and nurses to the latest patient data, and generate alerts in the case of a medical emergency.