By Dr Aleksandra Love, SETsquared Scale-Up Sector Lead for Health & Wellbeing
Rapid technological change within healthcare has happened since the start of COVID-19
The NHS and other providers had to adapt almost overnight, with many doctors starting to see patients virtually for the first time. This surge in uptake of technology has been very encouraging and right now there is a significant opportunity to transform the delivery of healthcare.
Dr Aleksandra Love, SETsquared Scale-Up Sector Lead for Health & Wellbeing chatted to two leading innovators to explore the future of healthcare technology.
Chris Robson, CEO of Living With, an award-winning platform that allows clinicians to distribute apps to patients and monitor their data remotely, believes this is the start of a new future for technology: “If you talk to healthcare professionals, there is a recognition that the technological change that has come about because of COVID-19 is permanent. You just don’t need to see every patient face-to-face and a lot can be done and monitored remotely and independently.”
Louise Morpeth is CEO of Brain in Hand, a digital platform for people with autism and learning disabilities agrees there’s been a big shift: “The technology available hasn’t changed but the attitudes towards it among people delivering services has. In the past they’ve been resistant to the use of technology, but it’s now proven as an acceptable way of doing things.
“Since the start of COVID-19, healthcare workers have become more receptive to incorporating technology into their delivery and I think we’ll see a continued natural acceleration of this.”
People from inside the healthcare sector are in the process of understanding what we need from healthcare technology and deciding what has to happen to make it work.
“I think we need to bring forward the debate about providing personalised support through technology rather than there being lots of standalone technologies and some in-person care as two separate entities,” said Louise Morpeth. “We need to discuss how we combine the human element with the digital software, rather than digitising everything and making it all automated.
“We work with people with autism or an anxiety-based condition and if we gave them the software and said here you go, and you can access it via a mobile – uptake would be very low. Instead we spend time personally onboarding and gradually helping them use our technology while also building the strategies that’ll assist them to live more independently. By doing this, users start to benefit from the technology and become less reliant on using services.”
Chris Robson agrees: “Personalised medicine is needed and the demand for this will grow. A generic delivery or package won’t work because every patient has specific needs or concerns. In some ways personalised care can be dealt with through technology but a large part of it will have to be face-to-face and I think we’ll get better at prioritising when we need to see a patient in person.
“I think it’ll have to be a hybrid model going forward. Doctors will still have to see people face-to-face because the technology just isn’t good enough and the quality of interactions needed is very difficult to replicate digitally.
“Technology has the capacity to streamline healthcare, be more cost-effective and efficient but will patients demand more? Doctors may only want to see their patients for a check-up every six months, but now that it’s possible to review patient data remotely in real-time; patients may start demanding feedback on their health or recovery monthly,” added Chris.
“Mortality has taken on a new meaning as a result of COVID-19. If people feel vulnerable and realise, they can be tested quicker or seen by a doctor faster they’ll become more demanding because there’s the opportunity to be checked out more easily and conveniently than before.
“People only tend to see a doctor if they feel unwell and often would leave it until their condition worsened but as monitoring technology progresses, it becomes possible to regularly check in with your doctor, pre-empt illness or when symptoms are going to flare up. Individuals will be able to check the status of their health more readily than ever before.
“But the pursuit of connected personalised care isn’t an easy journey. There won’t be a straightforward linear path to everyone using devices to track themselves all the time. An individual feeling unwell will think – I better track myself now so my doctor can see my data and tell me what’s wrong. Once the patient is feeling better, they’ll stop monitoring their health. Anyone who believes that people will track themselves all the time is fundamentally wrong and doesn’t understand human behaviour,” said Chris.
Among innovators there is a feeling that it is very difficult to get into the NHS. There is hope that this will have to change in the near future, because the pandemic isn’t set to ease any time soon and arguably the face of healthcare has already changed forever.
As Louise Morpeth explained: “In the NHS there are huge hurdles in place when it comes to purchasing technology and it’s become quite a barrier for innovators. A better dialogue is needed between commissioners in the NHS and providers of digital innovation so they can meet in the middle and establish how we can demonstrate our technologies are safe and going to be beneficial without having to meet incredibly unattainable standards that actually put a lot of innovators off providing the NHS with solutions.
“Given the acceleration of technology and the continued need for it, it’s likely that the standards and procedures for purchasing technology will change but there has been no announcement or guidance yet. That is quite hard for innovators who want to know what changes they need to make to their products to ensure it’s more acceptable to the NHS.
“Understandably the whole digital climate in the NHS is a state of flux and will take time to settle but for innovators it’s currently a period that’s quite difficult to read or predict.”
Another aspect that needs addressing is the role of research in determining whether the technology is good enough for the NHS.
Louise Morpeth says academia can be a disconnect in the industry’s pursuit of bringing new technology to market: “NICE published guidelines for digital technology which signalled changing attitudes to the types of research evidence that was acceptable but what we’ve not seen at the same time is a shift in the academic community to being able to work in a nimbler way to generate the types of evidence required by industry.
“I see academia as being rigorous and transparent because of the way they publish but very slow and quite wedded to set methodologies, and what we need in industry is a more agile response and pragmatic approach to innovation.
“It sometimes feels like we have three competing bodies; the NHS publishes lots of standards which are helpful but pretty tough to meet, academia is incentivised by publication in quality journals, and industry needs useful pragmatic research that quite quickly informs the development of their product.
“All three have quite different cultures and are moving in different directions. Some alignment or moving closer together for mutual gain in future would be hugely beneficial,” explained Louise.
Even if we can smooth the way for digital technology to be initiated, developed and brought to market quickly in the NHS and elsewhere, Chris Robson believes there are still obstacles in the way: “I think we have very inflated expectations about what the technology will be able to do. Many people talk about Artificial Intelligence (AI) in healthcare but there’s actually very little genuine AI going on. We’ve not adapted how we clinically evaluate new technologies like AI yet, and for good reason, so it’s not moving as fast as everyone wants or needs.
“The reality is that the technological transition will take longer than everyone realises. There’ll be some technologies that’ll develop very quickly, like smart technology for evaluating MRI scans will continue to evolve, but those personalised applications that require human behaviour and therefore adoption and adaption, will be slower to take hold.”
Then there is the age-old debate around the collection and storing of patient data. Western civilisation has been grappling with this for a long time and there is still no end in sight.
Chris Robson believes that unlocking data privacy concerns could hold the key: “One way to speed up the evolution of healthcare technology is to open the debate and establish the circumstances at which individuals are willing to share their data early and on a mass scale. Once we establish what is acceptable to our democracy, we can then supercharge technology innovation and the medical device and drug manufacturers to develop better treatments.”
The pandemic has made it clear that the healthcare sector needs to adapt and find more efficient and transparent platforms to share information. An incredible amount of healthcare innovation has occurred in a short amount of time, and it has changed how we perceive and access medical treatment. In many ways, the crisis has made the NHS and the health sector more robust, but it needs to develop technological platforms to help it fight the virus threat over the coming months and thrive post-COVID-19.