Resistance to sensor ‘spying’ could impact smart city healthcare plans

Profile picture for user gflood By Gary Flood February 27, 2018
Early results out of Manchester’s IoT smart city Demonstrator could provide clues as to what does and doesn’t work for healthcare and technology

CityVerve, Manchester’s smart city Demonstrator project that kicked off in July 2016 is six quarters in of its proposed nine.

That means that the June finish line is in sight - and this week diginomica/government got some preliminary insights into what one of its four ‘themes’, how Internet of Things tech could potentially help UK health and social care, has played out.

Bottom line: users like connectivity and in fact want more than the NHS provides - but just don’t want sensors ‘spying’ on them, in their homes.

Let’s back up a little to see why these results could be significant. In 2015 the new Tory government in the shape of the Department of Digital, Culture Media and Sport ran a national competition to explore the use of IoT, supported by Innovate UK.

Manchester’s bid beat off 22 entries from 34 other UK cities and won out over a final shortlist of six, so scooping the £10m on offer.

Hence CityVerve, an initiative led by Greater Manchester Local Enterprise Partnership and deemed the best smart city testbed option because of its “ambition, scale, coordination across the public and private sector, and potential for success”.

Covering the four key areas of healthcare, transport, energy and environment and culture and community the idea was to demonstrate a smart city “at scale” that could provide a replicable model for other cities in the UK and beyond. Ideas included smart bus stops, a network of sensors positioned in parks to help get residents more active, and advanced street lighting systems. Main deliverable: a ‘platform of platforms’ – a technology layer to create a secure ‘catalogue’ of data that can unite applications, enabling the intelligent collection, interpretation and use of data, coupled with a flexibility to accommodate the growing and ever-changing needs of a UK city.

Another important aspect of the scheme is its breadth of participation - with Manchester Science Partnerships, the University of Manchester, Ordnance Survey, Cisco and BT, as well as smaller tech SMEs (20 partners in total).

So much for the promises, but what’s happened? Advanced Nurse Practitioner Julie Harrison has some of the answers. A nurse, not a technologist, Harrison is a key player and Project Lead in the health project side, a plan to set up a ‘biometric sensor network’ to help improve responses to patients’ conditions and improve how local healthcare services work in the area of COPD (chronic obstructive pulmonary disease), a catch-all for a group of lung conditions that cause breathing difficulties.

It is also worth noting that the project has placed a high value on community engagement from the outset, which Harrison says has been true on the ground in her project (“All CityVerve use cases are being developed through a ‘bottom-up’ approach to ensure its applications are real and relevant to its citizens”).
On the plus side, Harrison says that despite stiff early resistance, communities she and her team have been working in actually turned out to be much more tech-savvy than might have been expected.

Everyone has a smartphone now - even one of my 92 year olds.

She doesn’t actually use it for anything but calls, but she has one, as well as a desktop that she uses for talking to her family and shopping.

The point is that patients are very relaxed about using some sort of technology, if it’s familiar to them.

Another good thing to come out of the work, she says, is that awareness and mutual understanding she’s seen evolving between NHS and social care professionals and folks who seem to be in very different worlds, like the technology companies she’s worked with.

There have been some very useful interactions there and I think both sides have learned a lot - I certainly have.

Another gold star has been for resident interest in specially developed apps for the project, such as ‘BeActive’, which offers a gamification approach to encouraging health and fitness activity, such as earning ‘rewards’ as one progresses and does more, she adds.

That’s been a very popular app and we’ve got some great data on its impact.


Now for the less straightforward part. It does need to be stressed that the project is a Demonstrator, and so is all about exploration and testing of ideas and technology - but the reaction of Harrison’s COPD patients is nonetheless striking.

What we are finding is that people are very suspicious of any idea they are being monitored and their data collected. They just don’t like the idea that there’s someone ‘spying’ on them in their homes.

But what’s really interesting is that once they see that this could help them, their attitude completely turns around. They said there were too many apps to bother with, and they were initially quite disengaged.

Yet I have had the same patients telling me adamantly they didn’t want any technology in their homes later on demanding that I give them a smart inhaler!

Harrison says that mirrors her own perspective on technology in the NHS.

We have had similar experiences in our telehealth projects and pilots I have been involved in. But there are so many advantages in better tracking of medication, which can pile up in patient homes and can be costly for GPs and CCGs, remote consultations, smart logistics so nurses aren’t driving round all day picking up supplies but seeing patients, other features that we do find patients can come round and see value.

The problem may be that that just isn’t true with sensors. But if patients see value in tech in their care, they want more of it than the NHS than we’re currently providing.

What her part of CityVerve are deciding, it seems, is that patients will come round to see the positive sides of technology, but there does seem to be a sticking point around unobtrusive remote monitoring that seems to be - at least for now - pretty intractable.

And given how central sensors are to any practical IoT plans…

That could be a problem.