Advance Risk Modelling for Early Detection, or ARMED, is a wearable device that collects data from the user and can help predict if the user is at risk of a fall. ARMED works by sending data to a cloud-based solution (MS Azure) and predictive analytics are used to develop a flag rating for each user. Flag ratings range from 0-4, with 0 being no intervention required, and 4 being immediate action is required. Based on the rating, advice would be given to the user on any measures that could help them avoid a fall.
This project aimed to trial 20 ARMED devices around Cardiff in order to prevent falls in users. It would also include a 'wellbeing' visit from a new post that was to be created, a 'Wellbeing Officer' who would perform a Multi-Factorial Assessment (MFA) within the home and correctly signpost onwards to the appropriate service.
This was a pioneering project using AI via predictive analytics. This had only previously been trialled in a 'scheme' setting and to the community. It was the first project of its kind in the UK.
- Identify the reason for falls before they happen
- Reduce the total number of falls
- Prevent hospital admissions due to falls
- Improve quality of life for users
- Promote self-management of health and wellbeing
- The current assumption is that strength and balance issues cause many falls and can be prevented. Eligibility for the pilot therefore focused on where this preventative approach could be best tested.
The current assumption is that strength and balance issues cause many falls and can be prevented. Eligibility for the pilot therefore focused on where this preventative approach could be best tested.
- Cardiff and Vale University Health Board
- Cardiff City Council
- HAS Technology Group
- Lessons learnt
End of Live Period
The devices were collected back from the users. There were no falls during this time period of 6 months. In the previous year, there were 22 falls across the group.
Due to the Covid pandemic, the AMRED devices were installed, ahead of its anticipated live date of April 2020.
Creation of Stategy
This detailed how we would move in this project from reactive to proactive and preventative. The need to do this came about because we found that people who fell once then tended to do so more frequently, and if they fell more than 5 times in a calendar year - becoming an ‘habitual faller’ – there was a 56% chance that they would then go into care or even die. We did not break down these stats further but used them, rather, as our impetus.
A full, formal strategy was created with the aim of looking at the effect of frequent falling, as well as the reasons behind falls. Response Service Officers collected this data from users during their visits, adding a section to their usual survey for people who had fallen to complete.
There were various challenges and lessons during this project, including:
- Users being reluctant to embrace tech
- The charging of the device proved challenging for some users, as they were not used to using tech items
- Staffing – there was only one person running this project
- Lack of signposting and lack of coordination across the stakeholder network – it took some time for the Physio Team in the local health board to parner fully and offer signposting; once onboard, then there was sometimes a lack of information regarding actions / users feeding back from the Physio Team. This was compounded by physios working from home during the pandemic.
- Lack of awareness of preventative services – people assumed this project was telecare, when in fact it was telehealth, a symptom of the fragmented health and care systems
- We were unable to create a new post, the ‘Wellbeing Officer’, as anticipated, for this project. Instead, the MFA would have been completed by the physiotherapist once we'd signposted someone across to them.
During this project:
- We had confirmation that ‘strength and balance’ is a reason behind many falls, as this project found that 60-70% of people completing the forms during the project’s scoping phases cited this as the reason for their fall.
- The people on the pilot said that they didn’t mind wearing the ARMED device, showing good satisfaction levels
- The number of falls in this group were 0 over 6 months, compared to the previous year which had seen 22 across the group. This provided significant benefits to the users, but also avoided hospital and care interventions.
In the longer term, ARMED could:
- Reduce the total number of falls
- Reduce GP calls
- Reduce calls to the Welsh Ambulance Service Trust (WAST)
- Reduce demand on health and care services
Between March 2020 and November 2020 - a 6 month period - there were no falls among users of the ARMED devices in our 20 device test group. In the previous year, there were 22 falls across the group overall. Therefore, the total number of falls had fallen significantly.