Technology in healthcare

March 2015

Doctor checking phoneGareth Baxendale FBCS, Head of Technology, Clinical Research Network, at the National Institute for Health Research, discusses all things technology-related in the healthcare arena.

It seems an obvious statement that technology in healthcare is a good thing, and there are some genuinely amazing innovations that have made a real difference to people’s lives;. Consider the improved quality of life an artificial pacemaker can offer or the difference that the simple hearing aid has made to millions of lives.

I work for the NHS Clinical Research Network, a part of the wider National Institute for Health Research. For me, technology, and its application in healthcare, is one of the most important and exciting areas of innovation with its noble quest to improve our health and save lives and, yes, perhaps make a profit on the way for some.

The game of life

Innovation in healthcare technology often comes from indirect and even unexpected applications. Take, for example, the Xbox Kinect, a brilliant piece of technology allowing a game player to interact with a game using body movements; no controller or physical touch is involved.

Not long after its launch Microsoft Research and surgical staff at St Thomas Hospital in London began trialling its use in surgical theatres as it allowed surgeons to quickly view 3D images without any form of contact, keeping the environment sterile.

It could be said that technology for gaming is now being adopted in situations where life and death are quite literally at play. We have all heard about Google Glass and this too has found its way into the surgical theatre and trials are underway to consider its use.

Recently a doctor in Madrid used Google Glass to stream a live surgical procedure to doctors located at 300 universities and hospitals on five continents. A remarkable ‘use case’ for Google’s Glass, it must be acknowledged.

So you would imagine that in 2015 we would already be seeing cutting edge technology being rapidly adopted across the healthcare spectrum. Sadly though, we see areas where technology appears to be ‘dragging its feet’ so to speak.

The ‘telemedicine’ approach and mobile monitoring of patient stats has been on the go for many years, and where we should be seeing this as a field of mature technology that has reduced costs, as well as re-admissions, it is really still in its infancy with many projects still in the early stages or simply stalled.

To be fair though, perhaps our own personal and social views on the use of technology in healthcare may be partly to blame. It’s only in recent years that people feel more at ease with a simple telephone consultation with their doctor as opposed to sitting endlessly in a waiting room reading a crumpled edition of House and Home magazine from 2009.

The NHS reported, in August, that: ‘around 12 per cent of GP consultations are now done over the phone - representing a four-fold increase over the last 20 years.’ Now, of course not all consultations can be completed over the phone and will require a physical examination to enable a doctor to make a conclusive assessment. But what if a doctor could take your vitals while on a telephone consultation?

Wearable health technology

So it’s at this point that we entertain the latest buzz phrase ‘wearable tech’. Wearable tech of course has the ‘look at me! I have the latest gadget’ (obligatory pose for selfie) tag, but it also has huge potential in the healthcare space.

Monitoring of a person’s vitals in a manner that is non-intrusive, and in a way that is not just ‘cool’, but also ‘reliable’ can go a long way to drive innovation and accelerate adoption. Apple has just released IOS 8 with their new in-built app called ‘Health’ and a new developer kit called ‘HealthKit’.

The new app is not just another pedometer/calorie counter. In fact as Apple states: ‘You can allow the data from your blood pressure app to be automatically shared with your doctor.’

Combined with Apple’s new watch which has a built-in heart rate sensor we could just start to see the beginning of more interactive and detailed telephone consultations with GPs.

The somewhat less glamourous bodyworn patch may not have the same kudos as sporting the latest must-have Samsung or Apple wearable, but they are still key areas of innovation.

Many of these devices rely on a smartphone to collate the data and there will no doubt be many arguments over the security concerns and how these will be regulated in a healthcare setting.

These matters must be addressed quickly though in order to maintain people’s confidence and for wearable tech not to be consigned to the annals of history as simply a novelty item. It really is an opportunity not to be missed.

Have you taken your medication?

As our population ages and lifespan increases, healthcare becomes a programme of continuous treatment and monitoring, especially as we enter our twilight years.

I recall Dr Phil Hammond (writer and broadcaster) saying that while doing a home visit on an elderly lady he noticed that she had put all her many prescribed pills into a bowl on the sideboard, when he asked her about it she said that she ‘couldn’t remember which ones to take and when’ so it seems her solution was to have a pick-n-mix approach.

It’s on this subject I was interested to read that PA Consulting, as part of their intelligent healthcare objective, has announced a body-worn patch that will not only monitor vitals, but also monitor if a patient has taken their medication, alerting their healthcare worker or doctor. It seems even remembering to take our pills will soon be a thing of the past!

Supporting innovation

Innovation of course requires funding and often corporate heavyweights are happy to put money into new initiatives to claim the IP and patent the idea for profit. This is not wrong in itself, as businesses must profit, and without them some innovations would not even see the light of day.

However a different approach to this was presented at a seminar I attended earlier this year, where we were told about some interesting approaches to supporting innovation.

The example given was that of Johnson and Johnson who are taking a very direct approach with their aptly named ‘J&J Innovation Centres’. Located in California, Boston, London and Shanghai these centres allow a ‘partnership approach’ for those with new and exciting ideas to share and be supported by those with a background and experience that can genuinely help drive the idea forward.

A key principle behind this initiative is to accelerate the time it takes for an idea to become reality. The centres will focus on innovations in pharmaceutical, consumer products and medical devices and diagnostics. It will be interesting to see what new innovations come, hopefully sooner rather than later.

Med-tech and clinical research

The Clinical Research Network (CRN) supports many med-tech trials for new innovations. Medical device companies must provide evidence of clinical effectiveness, generated by clinical research in accordance with the NICE medical technologies evaluation programme (MTEP).

The role of the CRN is to make the process of starting and delivering a clinical trial in the NHS efficient with a focus on the highest levels of performance and quality. Med-tech research studies in our portfolio are seeing significant increase year-on-year, and the work we do supporting all trials, not just med-tech, contributes to quicker evaluation and results.

This reduces the time it takes to move into the adoption stage, which means that patients can benefit from new and better treatments sooner. Like a car with no fuel, innovation on its own is really of no use if it does not have the support and direction to quickly and efficiently become a reality that will ultimately benefit people.

We stand on the threshold of the so called ‘internet of things’ which could usher in major advances in healthcare innovation with a proliferation of low-cost, always–on devices designed to improve and manage our health and wellbeing.

Let’s hope that these new innovations, whatever they may be, will quickly move from theoretical ideas to tangible outcomes that will bring real benefits for us all.

Image: iStock/520245153

Comments (3)

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  • 1
    David Thickins MBCS wrote on 30th Mar 2015

    Yes, these certainly are exciting times with regard to new and exotic technical innovations in health care. However, I still have some reservations about there still being a lot that could be done at the more mundane, data processing end if you like, such as in routine Care Home management. How many Care Homes I wonder, both within and outside the NHS have a custom-built database application to help as regards managing its day-to-day affairs?

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  • 2
    Phil wrote on 9th Apr 2015

    Having tried to implement a couple of IT applications in this space, one of the issues I faced was the resistance to change from the nursing staff of the ground. They were just too busy with their day-to-day jobs to be responsive to something that would actually ease some of this pressure. Unfortunately, another example of the blinkered, short term views some people take.

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  • 3
    Christine Arrowsmith wrote on 16th Apr 2015

    As an IT professional with a life long medical problem I would welcome any device which helps me maintain my health. I have used a very simple mobile phone for years to remind me that I need to take a drug at 4 pm. It rang, and rang until I turned it off. I now have a more complex modern phone. This one rings just once. Result I miss the ring and realize that I've missed the drug Rats!
    Telephone consultations with GP's. As a small person I remember the GP holding my wrist (Pulse) and checking my finger nails (anemia). this has not happened for many years but I suspect that we could do with something which would do that check while on the telephone.
    I had 2 telephone consultations recently, I had a fall while out and realized that I had damage in my rib cage (pain when breathing and coughing - ouch!). The first call was a 'sounding out'.
    No I was not going to A&E, the damage was some days earlier, I was sure the rib problem was probably a pulled muscle but how long would it last. As a precaution I was told to start my emergency medical supplies. I pointed out I would need replacement which resulted in the second call.
    This was basically a check up and replacement. I was told I could look forward to some 6 weeks before the pain would go. The information was right. The antibiotics, without instruction I would not have started them but perhaps the potential problem was nipped in the bud!
    So yes telephone consultations do work but some how I just felt isolated!

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