DiagnosticInnovationService Delivery Changes Minder and MinderCare: digitally enabled dementia care

Dementia care in the UK costs an estimated £42 billion a year, projected to rise to £90 billion by 2040. Around one in six hospital beds are occupied by someone living with dementia, and analysis of electronic patient records shows that around half of these admissions follow infections or falls that are potentially preventable.

Researchers at Imperial, funded by the UK Dementia Research Institute (DRI), developed a secure digital platform to enable better dementia care. It integrates data from in-home technologies collecting continuous behavioural, physiological and environmental data. Applying artificial intelligence to seven years of data, the team developed and validated algorithms to predict risk and characterise health, e.g. predicting infection risk from heart and respiratory rate measured by an under-mattress sensor. Results are sent to clinicians through reports co-designed with community geriatricians, occupational therapists, community matrons, GPs and specialist nurses allowing earlier treatment.

The Imperial BRC has established and sustained the Hammersmith and Fulham testbed for Minder research and development, in partnership with the local Primary Care Network. This testbed provides the clinical partnership, governance and data infrastructure of Minder, as the foundation for MinderCare, a translational study run with Imperial College Healthcare NHS Trust and funded by LifeArc. MinderCare provides a clinical service model that integrates Minder into direct patient care to establish feasibility for scale-up. Health economic evaluation is embedded using
routinely collected primary care data, and work with the Imperial Clinical Trials Unit and Imperial College Health Partners has refined the primary outcome, Days Alive and Out of Hospital.

MinderCare has demonstrated the acceptability and accessibility of digitally enabled dementia care. The service is embedded within the NW London virtual hospital and we have recruited a diverse and vulnerable cohort with significant frailty and advanced dementia, over 40% of whom live alone. Minder reports are integrated into the electronic health record and shared with community teams through the London Care Record. Proactive care is being provided by our nurse led team, who respond to the daily health reports.

Continued BRC support, alongside investment from ICHT and the UK DRI, is extending this work and developing sustainable commissioning models with the NW London ICB. This work underpinned a successful bid to the UKRI NHS Dementia Challenge, building on our partnership with Pears Cumbria School of Medicine with a work package adapting and testing MinderCare in rural and coastal settings.