April 18th 2025

How fast can you bring new Surgical Robotics tech to market? Know the 3Cs to rapid development.

SUMMARY

Speed to market has essential benefits for all top Robotic Assisted Surgery (RAS) companies – from maintaining and driving investor confidence to realising the commercial value as quickly as possible. But speed is often associated with risk.

Bringing new surgical robotics development tech to market quickly and confidently requires the 3Cs: Capability, Capacity and Culture.

A skunkworks approach provides R&D teams with all 3Cs, allowing them to focus on working without interference or interruption.

Our RAS leadership team will be speaking at DeviceTalks Boston on April 30, on the 3Cs and showcasing an example of a successful robotic assisted surgery device design and product development for one of our clients.

Companies that build technologies for robotic-assisted surgery (RAS) are under growing pressure to deliver new products quickly. Whether you’re a global corporation or a small startup, you need to show executives and investors that you can rapidly innovate and go to market, and you need to realize the value of investment as quickly as possible. The keys to moving fast, avoiding risks and maximizing the odds of market success? Capability, Capacity and Culture.

If you’re a longtime leader in MedTech, you undoubtedly have capabilities with a large in-house talent pool of experienced engineers, design experts and other specialists. But your development efforts can stumble if teams are stretched thin across multiple projects or are delayed by bureaucratic red tape – which are problems of capacity and culture.

If you’re a startup, on the other hand, you might have launched with a promising concept but lack the breadth and depth of capabilities, and the maturity in all three Cs. Without a broad and deep field of experts – capability and capacity – and a proven culture built on the experience of delivering many other previous projects quickly, you might struggle to meet investors’ expectations of fast results.

What’s the solution to bringing all 3Cs together? A skunkworks approach.

“A skunkworks approach enables R&D teams to focus on projects in a way that’s protected from distraction, such as internal politics,” says James Boonzaier, Deputy Head of RAS and part of Cambridge Design Partnership’s new RAS leadership team. “Too often, what we see is that key people are constantly being pulled onto other projects, or they’re spread too thin, or there are political agendas getting in the way of things. In order to get these programs running fast, you need capability, capacity and culture. Capability means, ‘Do you have the required skills across your individual engineers’ brains?’ Capacity means, ‘Are they available right now?’ And culture is, ‘Are they able to work in the right kind of context for fast, deliberate progress?’”

“In order to get these programs running fast, you need capability, capacity and culture.”

James Boonzaier | Deputy Head of RAS at Cambridge Design Partnership

A Better Approach to Rapid Surgical Robotics Development & Design

Cambridge Design Partnership’s (CDP) new RAS leadership team is headed up by Tom Brittain, James Boonzaier and Jack Hornsby. Their focus on fast delivery reflects CDP’s ongoing investment and long record of success in surgical robotics

CDP strengthens its clients’ RAS programs by enhancing capability, capacity, and culture. The company’s specialists work closely with client development teams to accelerate innovation and delivery.

“Key to working this way is being able to match highly skilled and technically capable people with the right expertise, experience, personalities, and a passion for RAS, and providing them with the right tools, conditions and working environment within which to do the best possible job,” says Tom Brittain, Head of RAS. “By collaborating closely with our clients’ teams, we’re able to operate as an extension of their own pool of people. And since we’ve been active in this sector, having worked with a number of the big players in surgical robotics, we know this approach works time and time again.”

This way of working, Tom says, enables quick development by providing organizations with turnkey access to deep technical expertise, system-level thinking and user-focused design capabilities. He notes that CDP’s success in the sector relies on a team dedicated and often exclusive to surgical robotics, with bespoke teams of experts often embedding with clients according to the unique requirements of each project.

“We’re passionate about our mission and committed to helping our clients’ RAS projects succeed,” says Tom. “And our approach works, as our track record shows. Since 2019, we’ve built four complete systems, along with multiple subsystems, for clients from the ground up. These have included both blue-sky development and remedial redesign with total system architecture development. Each of these systems has been designed and manufactured in under a year, which represents extraordinary speed in this industry. We have supported several single port trans-umbilical NPD programs, with detailed engineering of capital equipment, disposables and reposables, draping systems and more. This was made possible only by having the right capabilities on site, with the right capacity available as needed, all supported by a culture of innovation.”

“Since 2019, CDP has played a substantial role in four notable product development programs in robotic-assisted surgery, delivering system-level prototypes from the ground up. Each of these has been designed and manufactured in under a year, which represents extraordinary speed in this industry.”

Tom Brittain | Head of RAS at Cambridge Design Partnership

You need a strong foundation from which to build any RAS system

The development of any RAS system requires a strong foundation of strategy and system architecture between hardware and software, all aligned to the clinical user’s needs.

James states, “To ensure strong system architecture for our clients, we really focus on conducting structured clinical needs gathering to generate solid initial hypotheses on key requirements and constraints. Once a strong foundation for the platform architecture is created, we shift our focus to the high-risk areas.”

Risk management is vital throughout the entire process. Jack calls the approach CDP takes “targeted derisking,” adding, “we know from experience what the concept killers are and what we need to do to gain confidence that we’ve solved or avoided them. That is a key element of moving quickly. Not only that, the way in which we derisk is targeted in such a way that we’re not adding more complexity or unknowns. This enables us to iterate designs quickly, learn from each step what works and what doesn’t, and develop working prototypes at speed.”

Putting this approach into practice, CDP developed a single-port RAS prototype platform, moving from an early-stage concept to an alpha system prototype for pre-clinical trials in just seven months. Jack makes the further point that “In addition to speed, the client gets to retain all knowledge and intellectual property rights for any technologies developed for them.”

“The way in which we derisk is targeted in such a way that we’re not adding more complexity or unknowns. This enables us to iterate designs quickly, learn from each step what works and what doesn’t, and develop working prototypes at speed.”

Jack Hornsby | Deputy Head of RAS at Cambridge Design Partnership

Meet the RAS Team at DeviceTalks Boston

Building a surgical robot takes true teamwork. Success demands rapid development while meeting strict clinical and regulatory requirements. Cambridge Design Partnership continues to invest in the expertise and processes that help clients bring advanced surgical robotics to market.

The result is a comprehensive offering with unmatched expertise. Clients gain immediate access to deep knowledge in kinematics, human factors, cart design, optics, systems engineering, and disposables development. And our 26,000-square-foot Pilot Production Center quickly takes a client’s project from concept to prototype build to transfer to manufacturing.

Tom, James and Jack will be speaking at DeviceTalks Boston on April 30 about the importance of the 3Cs (“How Fast Are You? Accelerating Next-Generation Surgical Robotics”). They’ll also be showcasing a platform we developed that demonstrates our approach, going from early concept to Alpha prototype for preclinical studies in under seven months. They will be on hand at stand 735 to talk about CDP’s approach to rapid development in RAS. You can also reach out in advance and chat, or book in some time to meet them in Boston.

Connect with CDP

If you would like to discuss the content of this article, please get in touch with our RAS leadership team; Tom Brittain, James Boonzaier and Jack Hornsby

Tom Brittain, Head of RAS
tom.brittain@cambridge-design.com

James Boonzaier, Deputy Head of RAS
james.boonzaier@cambridge-design.com

Jack Hornsby, Deputy Head of RAS
jack.hornsby@cambridge-design.com

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By Cambridge Design Partnership

September 6th 2024

Accurately Estimating Blood Loss

WHITE PAPER

Accurately Estimating Blood Loss

Navigating Design Challenges and Pioneering Future Solutions

BY BRIAN CHANG and MICHAEL MCKNIGHT

CDP whitepaper - Accurately Estimating Blood Loss

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Significant advancements in surgery, such as the emergence of surgical robotics and augmented reality (AR)-assisted instrument navigation, have revolutionized patient care. Despite these innovations, there are still critical needs that technology has yet to fully address. One such need is the accurate and easy estimation of blood loss during surgery. The lack of a comprehensive solution for real-time monitoring of blood loss poses serious risks to patient outcomes.

In this article, we will explore the challenges of estimating blood loss (EBL), evaluate the advantages and disadvantages of various novel solutions, and discuss the key factors necessary for achieving more accurate, timely, and insightful monitoring.

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Get in touch

At CDP, we integrate seamlessly with your team to accelerate your project’s development.
To discuss how we can help you, get in touch.

By Cambridge Design Partnership

September 5th 2024

Single-Use Endoscopes: A Greener Solution?

This article illustrates why developers of single-use endoscopes should consider sustainability concerns. It also presents counter-intuitive potential benefits for this sector and outlines Cambridge Design Partnership’s recommended framework for designing a greener solution.

Bronchoscopy, duodenoscopy and arthroscopy are just a few of the procedures being served by a growing device market segment: single-use endoscopes. Development in this space is active, with companies such as IQ Endoscopes and Pristine Surgical seeking to join market leaders like Boston Scientific, Olympus, and Ambu. With the size of its addressable markets and technical opportunities, I can see why this medical visualization segment is expected to grow significantly, with projected sales reaching $710 million in 2024 and potentially soaring to $3 billion by 2033.¹

Clinical and Care Provider Benefits

There are multiple clinical and stakeholder benefits of single-use endoscopes, with the primary one being reducing infection risks. For example, reusable bronchoscopes are particularly hard to disinfect due to their long, narrow channels, which have historically led to notable rates of infection and hospital readmission². For duodenoscopy, infection from ineffective decontamination of reusable scopes is so concerning for the FDA that they issued a communication to support the transition to fully or partially single-use versions.³

Removing the need for disinfection can also deliver benefits to healthcare providers. It will simplify device handling workflows by reducing user steps, eliminating maintenance, and requiring fewer personnel, capital equipment, facility space, quality processes, and training typically needed for disinfection.

As a result of these eliminations, the transition to single-use endoscopes is also expected to reduce total costs for certain procedures, as highlighted by some manufacturers. This shift could also improve provision for smaller population centres and future care pathways, such as the increased adoption of diagnostic clinics and ambulatory surgical centres.

Addressing Sustainability Concerns

While the benefits of single-use scopes appear clear, there are concerns about sustainability. The increased material usage and disposal of electronic components after a single use may seem to contradict sustainability goals, such as UK’s National Health Service 2045 net zero target for indirect emissions.

Can we reconcile the use of single-use disposable endoscopes with sustainability?

This question can be tackled from two angles:

The Strategy Angle

Given the contamination risks associated with reusable endoscopes, it’s understandable to question the emphasis on sustainability. Would you subject a loved one to a procedure with high risks of hospitalization and death, just to be environmentally friendly?⁴ Considering this, some might think that sustainability can be sidelined.

However, this approach doesn’t address the concerns of medical equipment buyers and other stakeholders – with evolving environmental policies and competition from the “greenest” manufacturers, ignoring sustainability could be costly. Moreover, our experience shows that designing for sustainability can bring commercial advantages, such as lower manufacturing costs and more streamlined supply chains.

Therefore, innovators of single-use endoscope should not become complacent about sustainability. Embracing design for sustainability is crucial to stay ahead of future policy and competitive forces.

The Measured Greener Angle

Endoscope innovators looking to incorporate sustainability thinking for their solution may wonder if single-use endoscopes can ever be greener than reusable versions. Surprisingly, the answer is “yes”, in some cases, single-use endoscopes might be better for the environment.

This seems to contradict the traditional “Reduce, Reuse, Recycle” principle. However, you cannot solely rely on the 3 R’s and have a narrow perspective. To accurately measure environmental impact, a comprehensive and systematic approach is necessary. Life Cycle Assessment (LCA) is a valuable methodology for this purpose.

Life Cycle Assessment

Life Cycle Assessment (LCA) involves assessing the environmental impacts associated with all stages of a product’s life cycle, including material usage, energy consumption, transportation and other metrics from production to end of use. By using specialized databases, LCA estimates environmental factors such as carbon footprint, water usage, resource use, and toxicity levels.

*Lifecycle steps analysed for assessment*

With this method, it is possible to conduct an impact analysis of a new product in comparison to an existing one to determine if the new proposition is more sustainable.

While we understand the limitations of LCA calculations, such as the accuracy of inventory data, challenges in addressing unknowns, complex transportation and establishing boundaries, it remains an appropriately credible approach with guidance available in the ISO 14044 standard.

Consider the comparison between single-use endoscopes and reusable ones in terms of sustainability factors, as outlined in Table 1.

Positive Sustainability Factors of Single-Use Scopes	Negative Sustainability Factors of Single-Use Scopes
Reduced material due to lack of need to withstand multiple uses and decontamination steps	Increased production of scopes and packaging
Decreased energy, water, and material usage as well as reduced need for personal protection equipment, due to elimination of decontamination cycle for each scope use	Higher transportation requirements for the increased number of scopes
Elimination of impacts for maintenance effort	Increased scope disposal
Reduced hospital re-admission due to reduced infection risks

The information in the table above might suggest that a reusable scope could be greener. However, conducting an LCA would be needed and can often yield surprising results.

Case Studies

An analysis published in the American Journal of Environmental Protection illustrated that the material and usage impact of decontamination of reusable scopes is so significant that Ambu’s single-use scope, the aScope 4 Cysto, has a lower carbon footprint when LCA-calculated.⁵

In another analysis where the effects of hospital re-admission were considered, Boston Scientific claims a 65% greenhouse gas reduction with their SpyGlass™ DS Cholangioscope, which incorporates a single-use disposable scope as part of the solution.⁶

While these examples show the potential for greener practices, it’s important to acknowledge that achieving sustainability may be challenging in other scenarios. Nevertheless, the key point is about environmental impact reduction, which is crucial for safeguarding the future market and conveying a compelling message to stakeholders.

https://www.ambu.co.uk/endoscopy/urology/cystoscopes/product/ambu-ascope-4-cysto

How to Make a Single-Use Scope Greener

For the successful sustainability-driven evolution of an existing single-use endoscope or the development of a new one, it is essential to have a structured process that provides essential market-related insights to the development team. This process should encourage creative exploration and enable credible evaluation of sustainability decisions, while ensuring clinical and commercial objectives are met.

Cambridge Design Partnership’s Approach

With our extensive experience in developing more sustainable products, including medical devices, the following outlines our approach, specifically related to this segment.

Prepare

Research & Define: Understand the environmental impacts that are important to your customers, such as carbon footprint, total waste, toxicity, or a combination of these factors.

Establish: Identify which endoscope and use cases you would like to be greener than.

Target: Define the extent to which you aim to improve environmental performance for each metric.

Equip: Gain an understanding of all design techniques for sustainability, going behind the conventional “reduce, reuse, recycle” approach.

Create

Imagine: Explore various design architectures for partially or fully disposable scopes and evaluate the inclusion of non-essential features in the design.

Explore: Identify potential waste management partners to find single-use scope recycling solutions.

Calculate: Conduct rough LCAs during the design phase using user-friendly tools to guide decision making.

Deliver

Test: Gather user feedback in real-world settings to validate the proposed design.

Check: Ensure that the design meets or surpasses performance, usability, cost, and stakeholder requirements to create the right product.

Sharpen: Once closer to finalizing a design, perform a more detailed LCA using ISO 14044 guidance and iterate as needed to achieve targets.

Conclusion

Single-use endoscopes is an exciting and growing domain with opportunities for developing new products to target new indications, offer cost reductions for care providers, improve hospital workflows and, critically, achieve better clinical outcomes by mitigating infection risks.

While pursuing these goals, innovators should not overlook the potential to create more sustainable solutions, which can yield environmental benefits, deliver commercial opportunities, and ensure market protection.

Addressing sustainability requires a departure from the conventional “reduce, reuse, recycle” mindset and a shift toward an informed, creative, and data-driven approach to developing sustainable offerings.

Connect with CDP

At Cambridge Design Partnership, our proven track record in enhancing the sustainability of medical devices can help you meet both regulatory and market demands.

If you have any questions about the content of this article, please get in touch with our team and email: hello@cambridge-design.com

References

https://www.precedenceresearch.com/disposable-endoscopes-market

5709_bsc_sustainability_storybook_aw_final

https://www.fda.gov/medical-devices/safety-communications/use-duodenoscopes-innovative-designs-enhance-safety-fda-safety-communication

https://ambu.co.uk/Files/Files/Downloads/Ambu%20UK/COVID-19/aScope-4-Broncho-Is-Clean-Really-Clean-brochure.pdf

https://d1jhm577bx9zey.cloudfront.net/Files/Images/ambu/Visualisation/In_Focus/Environmental_impact/Comparative%20study%20on%20Envoronmental%20impacts%20of%20reusable%20and%20Single-USe%20bronschopes.pdf

https://www.bostonscientific.com/en-EU/medical-specialties/gastroenterology/hpb-portfolio/expanding-partnership/sustainability.html

By Alejandra Sanchez and Sergio Malorni

November 10th 2023

Find the authors
on LinkedIn:

Alejandra Sanchez

Biomedical Engineer

Sergio Malorni

Senior Consultant

New frontiers in implantable neuromodulation therapies

Neuromodulation, where electrical signals in a patient’s nervous system are modified or stimulated to deliver a therapeutic effect, continues to be an exciting and evolving space within the healthcare sector.

There are many drivers contributing to its advancement. Ongoing clinical neuroscience research fueling new possibilities in neuromodulation therapies, the invention of new technologies, and the development of new product formats to meet unmet needs, are all notable factors.

Additionally, there has been increased acceptance and presence of established therapies for implantable devices – such as deep brain stimulation for Parkinson’s disease, spinal cord stimulation for chronic back and leg pain, and vagus nerve stimulation for epilepsy and depression – with Medtronic, Boston Scientific, Abbott, Nevro and others leading the industry.

In all, these factors have made the electrical-based neuromodulation space to become one of the fastest-growing medical device sectors, with market size expected to rise from $6.09 billion in 2021 to $14 billion by 2030¹.

The diversity of solutions is evident, with Figure 1 illustrating the current landscape of established and emerging implantable neuromodulation therapies.

Fig 1. Selection of established and emerging electrical neuromodulation technologies and their indications.

In this first article of a two-part series, we look at a few notable emerging therapies to illustrate how the implantable neuromodulation space is rapidly developing.

Bladder control: beyond sacral nerve stimulation

Addressing continence issues is a growing area in the healthcare sector, where neuromodulation is seeking to play a significant role in specific therapies.

Implant-based stimulation of the sacral nerve has relatively recently established itself as a way of addressing incontinence with the presence of Medtronic’s Interstim and Axonics’ product range. Alongside the sacral nerve, other nerves are being considered for implantable stimulation to address similar conditions and to respond to specific unmet clinical and patient needs.

One alternative is tibial nerve stimulation, which has a history of effectiveness for certain cases in its non-implantable form: percutaneous tibial nerve stimulation (PTNS). The implant-based approach seeks to address a patient and clinician inconvenience of PTNS, i.e., the need for repeated stimulation sessions and user steps².

An example of such is the BlueWind Revi, which is part implantable (the electrode is placed near the tibial nerve) and, for minimizing invasive procedures, part wearable (a through-body power source). The device stimulates the tibial nerve which is connected to the sacral nerve plexus, containing the efferent and afferent nerve fibers that control the bladder and are responsible for bladder function. Here, the electrical impulses aim to modify the compromised activity of the detrusor muscle in patients with overactive bladder³. The company has recently achieved clinical results on their pivotal trial evaluating safety and efficacy (still under review by the FDA)⁴.

Similarly, Medtronic is seeking to develop an implantable tibial nerve stimulation system for incontinence which is currently undergoing clinical trials⁵.

Another nerve for addressing incontinence is the pudendal nerve. Amber Therapeutics is currently developing an implantable closed-loop therapy, Amber-UI, for urge and mixed urinary incontinence. The therapy involves implanting electrodes that can sense, interpret, adapt and respond to individual patient signals, such as muscle contraction, in an attempt to restore normal bladder function. By accessing the pudendal nerve, it aims to treat both urge and stress incontinence episodes for the first time, not possible with existing neuromodulation devices, thereby expanding the overall addressable market. First-in-human clinical studies are expected to conclude by the end of 2023.

Emerging Vagus Nerve Stimulation (VNS) therapies

Along with established therapies for epilepsy and depression, VNS is also being explored for conditions such as Rheumatoid Arthritis (RA) to displace injectable and oral medication.

SetPoint Medical is currently evaluating a novel VNS treatment that activates the ‘inflammatory reflex’ pathway (neurophysiological mechanism by which the central nervous system regulates the immune system) that may decrease the type of excess inflammation that is the underlying cause of RA. Its multivitamin pill-sized MicroRegulator platform is currently an investigational device.

SetPoint Medical is progressing clinical trials not only for RA, but also for Crohn’s disease, and furthermore exploring the therapeutic effect, in animal models, to treat multiple sclerosis with VNS therapy.

Implantable VNS therapy is also being explored for other conditions such as sepsis, lung injury, stroke, traumatic brain injury (TBI), obesity, diabetes, pain management and cardiovascular conditions⁷. One example of cardio-based therapies include low stimulation of the vagus nerve to liberate the body’s own neurochemicals to improve heart function.

New pain indications

Neuromodulation has worked well in establishing itself to address specific intractable pain of the trunk and/or limbs and for diabetic nerve damage – both conditions treated by implanting electrodes in the epidural space using spinal cord stimulation. In light of this success and available product types, pain specialists are continually seeking solutions from neuromodulation to address different causes for different parts of the body.

This impetus was clearly illustrated in panel sessions and discussions with clinicians attending the American Society of Pain and Neuroscience 2023 conference in Miami. We heard testimonials of how specialists, using available stimulators, succeeded in treating a variety of new pain sources and anatomical locations in the wrist, joints, abdominal region and in one case, at the neck to relieve a patient’s sensation of being choked.

This dynamic led to some clinicians proposing that the future of neuromodulation should also consider the treatment of pain associated with oncology treatments, given the improved extended lives seen in cancer patients. This exploration and success could pave the way for the creation of more established therapies – which would be welcome given the prevalence of chronic pain in the general population and the initiative to deliver non-opioid alternatives.

Novel developments for spinal cord injuries

Along with surgical, drug and stem cell therapies, neuromodulation has also entered the frame for addressing spinal cord injuries.

ONWARD has seen success with its partial and fully implantable versions of its ARC Therapy™ product range, where electrodes are implanted in the epidural space to stimulate the lower portion of the spinal cord affected by the injury that fails to (properly) communicate with the brain. By stimulating these lower nerves, the system aims to help restore and optimize their functioning in connection with the brain. ONWARD indicated that for their ARC^IM product, one study demonstrated the ability for long-paralyzed people to stand and walk again with little or no assistance using this therapy.

ONWARD’s products have been granted Breakthrough Device Designation status for a range of indications such as improving upper and lower limb function; bladder control and blood pressure regulation; and alleviation of spasticity in patients with such injuries⁸.

Also in ONWARD’s pipeline is a plan to integrate an implanted Brain Computer Interface (BCI) which senses the patient’s brain signals relating to the intent of leg/joint movement. In turn, these signals are wirelessly sent to its spinal cord stimulator which can activate nerves which are poorly connected to the brain due to injury. This aims to create a “digital bridge” between the brain and poorly connected nerves to enable and improve the patient’s walking ability. Much research and iteration is anticipated; however, this ambition is indicative of how neuromodulation can be innovative and transformational to people’s lives.

The road ahead for neuromodulation

The above examples only skim the surface of emerging therapies; neurostimulation, neuro-adaptive therapies and BCI technologies are attracting significant research and investment to create new therapies by leveraging the body’s physiological pathways.

We foresee continued progress in materials science, engineering, device design and biomedical research into neuro-physiological understanding of the human body to fuel the foundations for new, highly functional and patient-centered neuromodulation platforms.

We also foresee exciting developments in how targeting different nerves can potentially tackle similar medical conditions while the same nerve can be used to address various indications.

In our next article, we will explore the varied technology drivers and their considerations that are leading to the creation of new, innovative neuromodulation implants.

References

Strategic Market Research website https://www.strategicmarketresearch.com/market-report/neuromodulation-devices-market visited on 12/07/2023
DOI: 10.1186/1471-2490-13-61
DOI: 10.2147/RRU.S231954
Clinical Study Results of the BlueWind System for Patients with Overactive Bladder Featured at the 2023 AUA Annual Meeting. https://www.prnewswire.com/news-releases/clinical-study-results-of-the-bluewind-system-for-patients-with-overactive-bladder-featured-at-the-2023-aua-annual-meeting-301811486.html
Evaluation of Implantable Tibial Neuromodulation Pivotal Study https://classic.clinicaltrials.gov/ct2/show/NCT05226286
DOI: 10.1016/j.xjtc.2022.03.007
DOI: 10.2147/JIR.S163248
Website Onwards https://www.onwd.com/ visited 12/07/2023

By Karla Sanchez

September 21st 2023

Find the authors
on LinkedIn:

Karla Sanchez

Head of Biomedical Engineering

Care tech: exploring the latest trends in dementia care

We are witnessing important advances in the treatment of the most common cause of dementia, Alzheimer’s disease, most noticeably by the emergence of disease-modifying therapeutics. And this trend is only set to continue, with new innovations and technologies promising to help slow the progression of this devastating disease.

However, patients who do not yet have access to these treatments or are in a more advanced stage of the disease will continue to require significant care support. The caregiving sector is already under significant pressure due to the increasing demand for long-term care within aging populations [1]. As the disease progresses, family members, including elderly spouses, are often the main caregiver – but they may be left poorly equipped to do this without the right support.

With the cost of dementia care running to £32,250 per person per annum [2] technology innovators are finding new ways to make resources go further and give dementia patients independence for longer – providing reassurance to the caregiver and peace of mind to family members.

The challenge lies in making these solutions accessible to caregivers and usable for patients. In this article, we take a deep dive into the technologies available to support dementia care and explore emerging trends that are transforming the landscape by using the right technology at the right time.

Dementia care: the current landscape

Alzheimer’s disease is a progressive and irreversible neurodegenerative condition that primarily affects the cognitive functions of the brain, particularly memory, thinking and behavior. It is the most common cause of dementia, a broader term for a set of symptoms that impact a person’s ability to live independently.

In the UK, it is estimated that more than 900,000 people live with dementia, and this is projected to double by 2040 [3]. Of the people diagnosed, up to a third live alone [4]. With the aging population outpacing the rate of training and recruiting caregivers, the already significant caregiver shortage is set to increase [5].

Meanwhile, family members are taking on caregiver responsibilities, often with unsustainable and distressing consequences. This is in part because every patient journey is different and the rate of their disease progression can vary widely. Some patients may require discreet support at the early stages of the disease, while others may require constant care. Knowing when and how to intervene to provide the care support needed is crucial.

The care sector is increasingly looking to technology to maximize the impact of the professional and informal caregiver workforce. There is an increasing recognition that caregivers require ongoing support to make their role more manageable, especially following the pandemic.

An overview of innovations

Assistive technologies rarely exist in isolation. In fact, it is often the combination of these technologies that yields the best results. Here are some of the technologies available to support independent living and managing disease progression.

Personal alarms and safety tracking

Alarms and tracking technologies allow people to call for help if they need it – wherever they are – as well as providing peace of mind for caregivers and family members when they are not there. They are simple to use and can help patients stay independent for longer.

Location. GPS trackers such as Mindme, Ubeequee, and Angelsense consist of battery powered or rechargeable wearables that connect to a 24/7 monitoring support center to alert family members and emergency services if a vulnerable adult is outside designated safe zones. Direct-to-consumer devices, such as Medpage, work similarly, but the information links directly to family members and may not have predefined safety zones or raise an alarm. Connectivity is based on broadband and subject to subscription charges.

Alarms and calls. Technologies such as Tunstall’s MyAmie, Oysta, and Saga’s SOS allow patients to raise an alarm for relatives, caregivers or emergency services with the use of a single button. These technologies often come in the form of a pendant worn around the house and are connected to a hub via a radio signal. The patient can also use the hub to raise an alarm. The pendant must be within reach of the hub for it to work. Other technologies, however, work similarly to the GPS tracker and can rely on broadband for wider network reach. These technologies often also incorporate fall detection and GPS.

Fall detection. Wearables such as Buddi, Telecare, and Careline are designed specifically for dementia care. These use inertia measurement units, gyroscopes, and pressure sensors to detect falls and automatically send messages to caregivers, family members, and first-aid responders. These devices are often accompanied by an alarm button for the user and GPS tracking. Many of these technologies can also be connected to a 24/7 monitoring support team.

Reminders and medication adherence. There are a variety of technologies in this category which allow caregivers to set reminders for patients to take medication, drink water, eat, or remember appointments or social events. Memory aid kits available include the MemRabel care alarm clock with a large screen, connected to a Pivotell Vibratime rechargeable wrist watch that vibrates for reminders. These can be in photo, video or audio format.

The challenge many of these technologies face is that they depend on a caregiver to ensure the patient remembers to engage with and wear the device, charge it when necessary, and crucially, press the button if in distress. In the case of some technologies, they must also be within reach of a hub.

These technologies are good for the early stages of the disease, but as cognitive decline continues, patients will rely more on caregivers to support them, thus limiting their advantages.

In other words, the longevity of these technologies can become incompatible with the patient’s journey, and this is one of the key hurdles to consider when designing and adopting technology in dementia care.

Remote monitoring

This is a fast-growing area for dementia care. Remote monitoring technologies share information on the patient’s daily living patterns with caregivers and family members. The purpose is to provide peace of mind to family members and enable caregivers to make informed care decisions in the short and long term.

Common functions include:

Movement monitoring. Generally delivered by several passive infrared (PIR) sensors installed around the house, and pressure mats in beds and sofas, connected to a hub.
House occupancy. Sensors on external doors to monitor whether an individual has left the house.
Appliance usage. Monitored by connected sensors placed between the mains inlet and the device plug.
Fall detection. Cameras or mmWave radar sensors to detect when an individual has had a fall, without the need for a wearable.

Many of these functions can be delivered by single systems, e.g. Taking Care Home Alert, with the more sophisticated fall detection systems generally targeted at professional care provider users, e.g. Hikvision and Vayyar Care.

It is also common for families to create their own solutions, especially when they feel no existing single solution works for them. This includes the use of consumer tech, such as smartphones, video doorbells, smart home speakers, and cameras around the house. Video doorbells, for example, can be valuable in preventing scams, while smart home speakers can set reminders, automate house functions, or call a relative. However, the use of cameras around the house does pose privacy concerns which need to be considered.

Although the overall objective is to monitor daily independent living, the information often requires interpretation by the caregiver. This can often be facilitated through a dashboard, although the information can be disjointed, and assessment of patterns may not be clear-cut.

Innovator Matt Ash from Supersense Technologies, however, believes we can do more to obtain valuable insights and monitor disease progression efficiently and noninvasively.

“There is a real need for technologies that support caregivers in their role and provide them with the confidence to take a break, knowing their loved one is safe. Though there are some credible assistive technologies out there, the unique needs of families living with dementia are not well served. Projects like the Longitude Prize on Dementia are investing in radical thinking to generate solutions with families living with dementia.”

Talking about some of the latest advancements being tested, Ash continues:

“Everyone’s journey with dementia is different. Right now, we are working on leveraging recent consumer developments in sensor technology, machine learning, and user experience to create personalized assistive systems that can evolve with the needs of an individual with dementia and their caregivers. It’s an incredible opportunity to provide the community with supporting technologies that serve their needs.”

Adopting the right intervention at the right time

If we want to empower those with dementia to live independently, maximize the impact of caregivers, and provide peace of mind to family members, we must enable the right type of intervention at the right time. Someone with early Alzheimer’s disease may feel overwhelmed or suspicious of new technology, while a person in later stages may be too vulnerable to learn how to use it.

The future of dementia care will center around collecting the right data and extracting the right insights from it to enable better care choices. By allowing technology to provide information on the progression rate of the disease for a particular patient, we can start building a profile of care by recognizing changes in patterns to a baseline. Emerging technologies such as remote monitoring platforms can support this and guide the longevity of other technological interventions to ensure that they align with the individual patient’s journey. At the heart of these technologies, privacy must be a top priority, which may include the use of AI and other methods to allow for patterns to be recognized quickly and with minimal need of human intervention.

We are entering a new era of therapeutics for Alzheimer’s disease, but there is still much to do, particularly in care. Although the use of technology can ultimately support patients, caregivers and family members, it is often incompatible with the individual’s stage of the disease, or inaccessible to caregivers. But as new technologies emerge, data and AI can unlock new insights to support a personalized care plan that scopes each patient to their individual needs – allowing caregivers and families to provide the best care at the right time.

References

E. adult social care insight. The size and structure of the adult social care sector and workforce in England. Technical report, Skills for Care, Workforce Intelligence, 2023.
Alzheimer’s Society, How much does dementia care cost? https://www.alzheimers.org.uk/blog/how-much-does-dementia-care-cost
L. B.-A. A. R. Raphael Wittenberg, Bo Hu. Projections of older people with dementia and costs of dementia care in the United Kingdom, 2019–2040. Technical report, Care Policy and Evaluation Centre, London School of Economics and Political Science, 2019.
B. W. Claudia Miranda-Castillo and M. Orrell. People with dementia living alone: what are their needs and what kind of support are they receiving? International Psychogeriatrics, 2010.
E. adult social care insight. The size and structure of the adult social care sector and workforce in England. Technical report, Skills for Care, Workforce Intelligence, 2023.