Technology
Radical change in health and care Given the pace of change in the technology sector, Dr Philip Scott discusses how technology is radically changing the way the NHS provides services The NHS is a beloved institution and its staff Supporting the triple aim always feature as the most trusted professions The high-level goal of quality improvement in – so why does it need radical change? Since health and care services is often characterised its inception in 1948, the NHS has faced everas the ‘triple aim’: (1) improving population increasing demand. Innovations in healthcare health, (2) reducing per capita costs and (3) mean that previously untreatable conditions improving the patient experience of care. can now be cured or prevented and now Digital technology has the potential to help in we are experiencing the ‘demographic timeeach of these. bomb’ of an ageing and unfit population. Reducing costs is one of the goals of largeThe NHS Long Term Plan calls out urgent scale pathology and radiology networks public health issues that add to the drain on – achieving economies of scale by centralising resources: obesity, alcohol abuse, smoking, services and sharing diagnostic test workload. antimicrobial resistance and air pollution. Likewise, the increased use of 111 (online or On top of all this, we have changes phone) to divert people away from in the workforce with declining unnecessary GP or emergency numbers of experienced department visits should general practitioners, have financial benefit Digital challenges in recruiting (though that is not yet techno and retaining staff, proven). Electronic health already logy has increasing numbers records have been used d o for hea ne much of people with by OpenSAFELY to l t hcare a has the multiple long-term achieve rapid low-cost n d potenti health conditions clinical research in the a f a l to do pandemic. r more. and no sustainable SMS text we are However, financial model for reminders are widely right social care. And then used to reduce healthcare cautiou to be we have a pandemic appointments being wasted s and the gigantic project by non-attendance. to get routine services back Improving population health to normal! How can digital is the aim of online guidance on technology support radical change nhs.uk and personal health apps for longfor the better? term conditions like diabetes or dementia.
Other apps exist to help people with repeat medications keep to their prescriptions, and innovative clinical decision support helps doctors to reduce overuse of antibiotics. Better patient experience is the purpose of the NHS App. It enables patients to access their primary care record, book appointments, request repeat prescriptions and give proof of their Covid vaccination status. An innovative technology that was very helpful in the pandemic was Oximetry@home, which enabled ‘virtual wards’ of people to be supported by hospital clinical teams while remaining in their own home. Innovation with artificial intelligence There are high expectations, not always realistic, of what artificial intelligence (AI) can do for healthcare. Numerous AI innovations have come to nothing, but in fairness that is inevitable for ground-breaking new technology. One aspect of the problem is that there is no single definition or taxonomy of ‘artificial intelligence’ that is universally accepted. Broadly speaking, AI includes rule-based systems, where human knowledge and expertise is hard-coded into software; natural language processing (NLP), where software extracts meaning from or generates text or speech; machine learning, where analytic techniques determine patterns of association in source data; and intelligent E Issue 21.4 | HEALTH BUSINESS MAGAZINE
13
