Situated 5km off the coast of Donegal on the edge of the Atlantic Ocean, Arranmore Island has a rugged, unspoiled beauty that blends with its remote location. It’s an outlier both geographically and demographically; the island has a population of just 469 people, many of whom are elderly.
Yet residents and visitors alike can avail of new services like telemedicine from Arranmore’s General Practice thanks to improved broadband connectivity, while IoT technology is helping to deliver innovations in home care too. Arranmore island’s GP Dr Kevin Quinn explains more.
In some of the more remote parts of Ireland, ready access to hospitals and medical practitioners is not always a given. And as people are living longer, in greater numbers, this presents challenges for healthcare providers. This all adds up to a unique set of circumstances on the island of Arranmore, 5km off the coast of Donegal.
Dr Kevin Quinn has been the GP on the island for 35 years and together with support staff, a public health nurse and community nurse, his practice has seven surgeries a week. During the summertime, there’s an influx of tourists and students to the island’s Irish college. But for the entire year, the doctor and his staff spend most of their time taking care of Arranmore’s native population, many of whom are elderly.
The island’s largely older demographic means that chronic illnesses are more commonplace. Many patients need to take prescribed medication to manage ongoing conditions like rheumatoid arthritis or chronic heart disease.
Handling complex consultations
“The consultations tend to be complex. It’s about maintaining people with chronic illness, more than acute episodic illnesses. It’s a more complex practice than you would have with a younger population,” Dr Quinn explains. He and his team try to keep people as active as possible, by encouraging attendance at a day centre that’s attached to Arranmore’s health centre. “That can be a useful time for them to attend a GP and get their illnesses reviewed,” he says.
But although a GP is the first port of call for patients living on Arranmore, there are times when he needs to refer them to specialists about patients with heart conditions, for example. “Because general practice and management of chronic illness is becoming so complex, you need to be able to access experts in secondary care,” says Dr Quinn.
But this poses logistical challenges for an elderly populace, to say nothing of the physical strain involved. Seeing a cardiologist in Letterkenny for a half-hour appointment, or travelling further to Dublin for an outpatient appointment, for example, can take up to a day when travel times and ferry crossings are taken into consideration. In winter times with strong tides, the ferry may not even be running.
Medical professionals collaborate for better patient outcomes
Dr Quinn also needs to collaborate with colleagues in other healthcare facilities for patient x-rays or lab tests. Sending and receiving large medical imagery and files used to be difficult because of unreliable connectivity from the island. It also caused difficulties for the support staff, when processing documentation via the HSE’s PCRS website. Since Business Broadband+ connectivity was installed in the medical centre, it has become much easier and has enabled better communication between Dr Quinn’s practice and other medical professionals.
“It used to take my secretary two hours to enter 20 minutes’ worth of data, and now she can do it in a shorter timeframe. That’s made a big difference and emailing information to colleagues has also made a big difference,” says Dr Quinn. “We are beginning to use the connectivity more for things like dermatology because you can upload high-quality images whereas the image quality before had been poor.”
Refreshing knowledge through online learning
The improved connectivity has also been critical to another key part of a GP’s practice: staying up to date on the latest medical developments. Before, Dr Quinn had to travel to attend seminars on the mainland; now he does this through online training and holding virtual meetings with colleagues. The new technology has saved him a lot of time. “I take part in webinars, so connectivity is quite important, especially for people like myself who are working in remote locations. Access to continuing medical education is imperative. And if it’s interactive, the quality of that learning is much better. I can do a module online where I’m actively contributing and having my opinion tested,” he says.
The improved connectivity to Arranmore will also enable a range of improved services in the near future. Currently, some elderly residents living in the remote parts of the island have a button alarm in their houses or on-person alarms, which allows them to live independently because they have the option of using the button to call for help. However this only works if the person is able to physically activate the alarm.
IoT-assisted living in motion
As part of the ongoing collaboration with Three, IoT sensors were installed in elderly people’s homes as an assisted living solution. A water flow monitor would detect when, for example, a tap is used, or the toilet flushed; a smart plug in the kitchen mains socket could signal that the kettle has been switched on; a door-mounted sensor would show that a person has walked into another room in the house. The next phase of the project will be to set up an alerting system so that a nominated contact such as a designated carer or family member would then get an alert if there is any change to the elderly person’s usual daily pattern.
The sensors are standalone units that automatically measure data and send it back over the Three network to be analysed, so the resident doesn’t need to interact with the technology. Over time, it will be possible to build a picture of a normal day’s activity in the house from the sensor data. This way, the system can trigger an alarm where there’s any deviation to the usual pattern, such as a lack of activity that could indicate the resident is in difficulty.
The idea emerged from conversations with Arranmore residents, in view of the older demographic of the population, many of whose families have migrated away from Arranmore. A proof of concept is underway, and installation takes just a matter of hours.
This use of IoT is just what the doctor ordered. “The best quality care is when someone is maintained in their home environment as long as possible, with support services at hand, delivered locally. If technology is the solution to helping provide that service, it’s for the good. In that situation where you have some kind of monitoring that allows you to improve people’s safety and increase their autonomy, I think this kind of technology is a great advantage,” says Dr Quinn.