Technology-enabled seizure detection and reporting: The epilepsy network project

The traditional models of epilepsy care provision have not changed substantially in more than a century, despite rapid advances in computing, technology and materials science. One consequence of these advances has been the near universal prevalence of smartphones. Wearable devices with a complex sensor arrays are an emerging technology. These devices provide a coalescence of digital computing and communication tools that offer a new way to detect, report and communicate about seizures. The pilot of a smartphone-based application for patients and cares allowing real-time reporting of seizures securely to the relevant epilepsy care team is described. Wrist-worn devices were evaluated for their ability to detect epileptic seizures. Relevant information, such as seizure notifications and live alerts for notification of emergency attendance or admission to the hospital, are sent securely to the epilepsy care team in real time. Tailored specialist advice following notification is provided along traditional lines. Compared to the year preceding the pilot, the interval between seizure occurrence in the community and notification of the specialist team reduced, with faster response times in terms of advice. There was a 30% reduction in admissions for patients with epilepsy and 10% reduction in length of stay. Patients using the technology report an increased feeling of empowerment. This model of care has several challenges and requires modification of existing working practices if benefits for patients are to be fully realised. The benefits and challenges of technology-enabled care in are discussed from the perspective of the experience from development to clinical deployment.