By Deborah Rozansky
This July, the NHS turns 70 years old. Amidst the well-deserved celebrations of the service’s countless life-saving achievements have been calls for securing the NHS’s future. Much of the media attention has focused on the sizeable public investment needed, but NHS leaders, politicians and pundits have also stressed how the service must adapt to assure its future.
It is increasingly clear that innovation from new technologies offers substantial scope for shaping the future of the NHS, from improving access and care quality to tackling cost pressures. But will technology help keep the NHS alive and healthy? How ready is the NHS to innovate and adopt leading technologies?
Recently, Optimity Advisors and the Economic Research Council jointly hosted an event where we explored this question. The event’s three speakers covered distinctly different perspectives about the potential for technology-driven improvements in delivering better health and care. They shared innovations and personal experiences to illustrate:
- The role of technology in the delivery of personalised care
- How technology can support our quest for better value care – high quality care that is effective and affordable
- The application of new technology into clinical settings, both to improve access to care and to improve care outcomes
Our first speaker was Tom Miller from GreyBird Ventures, which invests in companies that are developing diagnostics for personalised medicine. An industry leader and international expert in sustainable healthcare and scientific research, Tom shared some cutting edge developments in diagnostics, and he explained how these emerging technologies are expected to personalise medical care and treatment. “Medicine is a data business,” said Tom, as he described the conundrum of the explosive growth in our knowledge about biology and both chronic and infectious diseases. People with the same symptoms may have different underlying biologies. Technologies offer unique propositions for precision treatments. So, what’s coming? Tom showed a video of a pill with a camera that can be used for non-invasive gastroenterological evaluations. He also shared an example of repairing damaged heart muscle with stem cells and computer modelling. A third example used machine learning to observe and measure the motion of patients with neurological disease, and from “thousands and thousands of data points”, the technology is identifying patients not responding to treatments or conditions that are deteriorating. For cancer, technology is being used to identify which medications are best for “patients like you”.
Will the NHS be capable of taking on these emerging technologies? The science is quickly advancing, and “we are on the verge of a revolution.” Tom predicts that systems which can mine information across institutions will advance the personalisation of medical treatment and care. As he put it, doctors want to say to their patients: For patients like you, these are the medications they were given, and these were their outcomes.
Professor Sir Muir Gray of Better Value Health Care spoke about his work to deploy best value interventions in healthcare. These are the services and treatments that improve health and provide high quality care within available resources. “The future is here, just not evenly distributed,” he said, noting that “the problem is a lack of clarity and thinking, not lack of technology.” Unwanted variation and overuse of treatments are significant problems. So is the underuse of high value interventions, such as those that prevent disability and disease. Sir Muir stressed a future NHS must maximise value, especially the changing dynamic between the patient and the provider, i.e., recognising the patient’s own agency along with the clinician’s expertise. Empathy was key to making this work. He advocated thinking of healthcare as population-based, complex adaptive systems, encompassing a wider range of local services and incorporating technology. As an example, he proposed the idea of a National Activity Therapy Service as a means to keep people healthy and fit, incorporating simple tools like apps and personal assistant devices.
What would it mean for the NHS if the concepts and approaches for Better Value Health Care were widely adopted? Imagining, designing and building a new system would start with a different way of thinking – from organisations to systems. By focussing on the health of the patient and years of healthy living, we would shift the emphasis of services – and resources - from treatment to prevention. Technology would enhance and facilitate patient involvement, and it would help promote best value interventions which assist people in staying well.
Our final speaker of the evening was Dr Nadine Hachach Haram, who is a surgeon and the CEO of her own company Proximie. She inspired us all with her front-line clinical innovation: the application of Augmented Reality to surgery. Through Proximie’s AR solution, remote support from senior consultants can now be offered to surgical theatres anywhere in the world, extending opportunities for the spread of technical skills and clinical excellence. Patients directly benefit from better surgical outcomes. Nadine demonstrated how the technology works - a virtual “hands on” collaboration between clinicians in different places – and how Proximie’s technology is “hardware agnostic”, meaning it can be used on the computers and mobile devices everyone uses now. Initial UK studies are showing clear benefits to the NHS as well, from quicker discharge and fewer patient transfers to overall cost savings.
What would it take for the NHS to realise the benefits of AR? Nadine shared that she benefited from important support, such as the NHS Clinical Entrepreneurs Programme, and the collaboration with a number of well-known institutional partners. The main barrier to the spread of innovation is culture. “Showing impact is a ‘must have’ to changing hearts and minds,” said Nadine.
From the three enthusiastic speakers on the night, it was evident that technology might not save the NHS, but if we really are on the verge of a revolution, it will re-shape how healthcare is delivered in the future. Technology promises exciting new benefits for patient care, such as less invasive and more effective treatments. By emphasising systems, networks and connectivity, It also puts patients truly at the heart of care and in control of their own health.