7 minute read
Creating a digitally integrated health system
Healthcare World’s Steve Gardner speaks to Richard Oakley, Neil Mason and Jodi Carter of Methods Analytics about the intricacies of developing and building a fully digitally integrated health system
Over the past 40 years, technology has changed the world in a way not seen since the industrial revolution. If you told someone in the 1980s that we’d be watching television on our phones, and have the ability to shoot studio-quality videos accessible to everyone around the world in just a few seconds, all from a device the size of your wallet, they wouldn’t believe you. HD TV would be jaw-dropping. Cryptocurrency? Artificial Intelligence? Virtual Reality? Don’t even try to explain.
But it’s not just smartphones that have had a profound impact on the world. The digital age has completely revolutionised every sector of human interaction both in business and our day to day lives. Yet, within healthcare, the sheer potential of this new age has not been realised - not even close.
Consider the health systems that you may have on you as you read this. A smart watch, for instance - which can not only monitor your pulse and oxygen saturation, but also detect atrial fibrillation. Steptrackers which record your daily exercise without even thinking about it. Continuous glucose monitors that can notify diabetics at a moment’s notice of their blood sugar levels. These are only a select few of the multitude of personal health devices we can now access. The technology today enables people to take charge of their own healthcare like never before.
Yet, this itself is an issue. While the benefit of personal digital health solutions, and the data from them is potentially profound, how can we apply this to health systems at large? Obviously, the data collected from just one person’s digital health profile alone would be huge so from a few thousand individuals? Astronomical. Then how do we bring this data together and produce meaningful and actionable insight to improve the health of individuals and populations?
This is why I spoke to Methods Analytics’ Richard Oakley, Head of Data Science and Artificial Intelligence, Neil Mason, Head of Healthcare Strategy, and Jodi Carter, Head of Healthcare Sector, to understand how we can build a digitally integrated healthcare system.
If all the current apps, technologies, websites and more were merged together, would we have everything we need to create an end to end digitally integrated health system?
Neil: I’d say no - but we are on our way and getting close. We’re fortunate, particularly in the UK, to have a National Health Service that collects a huge amount of data, but it is very disparate. If you could pull it all together, you would have a wonderful resource. It’s the quantified self that is still nascent - all the personal data that people are amassing now. How easy it is to share the data is a big question, yet in the relatively near future we will be at a point where you could begin to think that you might have su icient to start transforming the way we deliver and think about healthcare.
Do we have all the soft ware and apps that we need but just don’t know how to connect? Or do the technologies still not exist? Jodi: Somewhere there is an app or a piece of so ware that covers most parts of the system - the problem is that not everybody is using that one bit. So there may be one provider who is really good at the front end delivery of consultations, for instance, and they have great data or a great app for that, but then they don’t do anything a er that point. There will certainly be many use cases with no current visibility, let alone solution.
So is it a question of language then? Is it about getting all the diff erent technologies to talk to each other?
Richard: I don’t think it’s a simple integration or interoperability question. It’s more of a problem of transforming a health service. Simply having an app doesn’t make people behave di erently. For instance, fitness trackers are a great example – there’s a huge amount of virtue in having one for people who are looking to improve their fitness and lose weight as they can be a really good way of monitoring their progress.
However, it doesn’t change the fact that individuals have to make a conscious personal decision to engage with their device for that purpose; the concept of ‘patient activation’ comes in here. That’s the missing piece – all these apps etc are great, but is it in the best form for it to work for individuals and the health service?
For these services to work, people have to choose to engage with them, and I don’t think we’re there yet. For instance, in the UK at the moment GP’s are overloaded. As a result, people think the only way they can access the health service is via the emergency room, so they go there to see a human being, despite the fact that emergency rooms are over-capacity too and are actually not remotely optimised as settings for non-urgent care.
In this instance I don’t think apps are going to help. It’s a much bigger challenge than the integration and interoperability problem, which can be solved with improving standards and good collaboration between companies. It’s a system problem, a behaviour problem and a question of ambition.
Richard Oakley Director of Data Science & AI Methods Analytics
Is it about driving cultural change and getting people to accept the idea that their healthcare can be delivered digitally through apps and wearables? If so, how can it be achieved?
Neil: Sticking with the example of the UK, the capacity in the NHS is strained right now, and I don’t see that changing any time soon. Apps certainly can alleviate some pressure in particular areas if people accept digital solutions, such as a remote consultation with a GP that results in a treatment that is monitored remotely. We do need to see people accept that more. The fundamental missing link is a ubiquitous solution or app that everyone knows. For example, the COVID-19 NHS App has driven people’s awareness of the national NHS app. As people have started to use it, more are starting to self-service prescriptions and access services via the app though this is relatively limited in scope. Most importantly, we need it to be trusted, and I’m afraid people don’t necessarily have that trust in digital health solutions just yet. When they do, you start to see channel shi s and certain types of healthcare being delivered truly digitally.
Will we look back in 20 or 30 years and realise that the idea of sending ill people to places full of other ill people might not have been the best idea?
Jodi: COVID has highlighted many things that people knew but weren’t talking about. GP’s probably shouldn’t be seeing dozens of sick people every day and should be using digital solutions where they can. But there’s been no push to force people into that conversation until now, so if some of these changes stick, that will be positive in terms of digital care. How digital do we need to be? Richard: The UK is not unique in the way we set up our care system by any stretch of the imagination. The role of the GP 100 years ago was to visit people at home, even if there was little they could do for them. Nowadays, there is so much we can do for people with a body of medicine that has far exceeded the capabilities of any one individual. So the GP became the foundation of the NHS, treating most people and signposting those that needed specialist care, and that’s how we choose to use them in the UK.
The same is true of technology. We started with virtually no apparatus, and it’s become more about digital, more about data. Take patient records. They went from paper to digital, and the benefit was clear. Now all administration at a surgery is digital so doctors can do more work than before. But is this the right way to run the system today or will it compound issues or reduce value from something which is, relatively speaking, already optimised?
So the question is not so much how digital do we need to be, but are we digitising the right thing? For me, across the world people should be talking less about digitising health systems and more about totally rethinking how we approach healthcare in the light of the technologies available to us. That will move us on in ways that we can’t imagine right now, but I guarantee that proactive digital-led care rather than reactive physical care will be a huge part of the story.
Conclusion
So there you have it. This group of experts thinks we already have some of the answers, but they are not properly aggregated, nor are they always used or trusted. The answer appears to be a completely new way of thinking that uses digital in totally innovative ways. If we start thinking about new approaches to healthcare as a whole, we may actually end up with a system or systems that work in today’s interconnected world.
Contact Information
analytics@methods.co.uk
