1. Connected health:
empowering consumers, reducing costs,
building data & insights
Bob Gann
Head of Business Development – International, NHS Direct
Visiting Professor – Health Informatics, Plymouth University
United Kingdom
September 2013
M2M Middle East Forum, Dubai

2. Connected technologies can meet today’s health
challenges
Global health
challenges
•Inadequate access
•Unsustainable costs
•Increasing burden of
chronic illness
•Increasing customer
expectations
Connected
technologies
•Mobile devices
•Cloud computing
•Decision support
•Social networks
•Big data
Impact on health
•Remotely delivered
care
•Chronic disease
management
•Peer-to-peer support
•Targeted wellness
•Personalised care

3. Significant
consumer
demand for
connected
health
People now manage
bank accounts &
travel bookings
online – we can do
same for health
records &
appointment
bookings
Other industries
have cut costs &
improved customer
experience through
digital self-service –
we can provide
online consultation
& self management
Millions of online
communities, reviews &
ratings – we can share
experience & insight
between clinicians &
patients
Businesses understand
their markets – we can
build & use big data to
target health
communications

4. Digital first
Opportunities to transform
healthcare through:
•Telephone & online triage
•Remote video consultations
•Digital notifications – appointment
reminders, test results
•Mobile enabled health staff
•Connected devices for telehealth

5. NHS Direct – pioneering multi-channel healthcare
NHS Direct has
provided remotely
delivered health
services, via
telephone, web and
app, since 1998

6. Driving down cost while improving quality & access
Ambulance
£250
Accident &
Emergency
£100 Minor
Injuries
Unit
£70
Out of
hours
family
doctor
£50
In hours
family doctor
£36
Telephone
NHS111
£7 - £9
per call
Web
£0.12
£
Cost
Channel: Emergency Urgent GP Telephone Digital
Our goal is to improve access, support
patient choice and shift demand to lower
cost services, whilst improving quality and
maintaining patient safety

7. Reduce unnecessary
referrals – 22%
Teach patients to cope with
recurring illness - 15%
Prevent worsening
conditions – 3%
Recommend lower cost
care - 60%
How digital symptom checkers save costs
In a year…
•0.7m ambulance & emergency attendances
•1.5m family doctor consultations
•0.6m other face-to-face appointments
avoided through patients using NHS Direct telephone
& digital services
Saving £148m

8. NHS Direct symptom checkers: channel shift
to self service
NHS Direct has both shifted existing users to lower cost
digital channels & reached new audiences who prefer digital
Why are health care interventions delivered over
the internet? J Med Internet Res 8(2) e10
Consumers want to use digital
health because:
•Cheaper to use
•More convenient
•Access when needed
•More anonymous (reduces
stigma)
•Increased sense of personal
control

9. Remotely delivered telehealth
Telehealth services enable
patients to use connected
devices to monitor their own
vital signs & communicate
these to monitoring centre
for review by clinician
Image from www.tunstall.co.uk

10. Telehealth for 3 million lives
Companies involved: 02 Health, Air Products, BT Health, Care Innovations,
Cisco, CSC, Harmoni, Invicta Telecare, Medvivo (formerly Telehealth
Solutions), MSD, Peaks & Plains Housing Trust, Pfizer Health Solutions,
Philips, Qualcomm Life, Robert Bosch Healthcare, S3 Group,
Solutions4Health, Technology Strategy Board, Tunstall Healthcare
In UK government & industry are
working together to deliver the
benefits of telehealth to
three million people
living with long term
conditions

11. Mobile revolution puts health in hands of consumers
• In future, transformation in health
will increasingly be led by
consumer devices
• 6.8bn mobile subscribers
worldwide – 300m in Middle East
• 40,000 health apps - downloaded
40 million times a year
• Wireless health market will reach
£60bn by 2018 – with mobile
health apps the biggest
opportunity
Wireless health market: global trends
Marketsandmarkets.com

12. Monitoring me
How’s
my heart
rate?
What’s
my
oxygen
intake?
How am
I
sleeping
?
How
much
exercise
? Am I
eating
healthily
?
What’s
my blood
sugar
level?
How’s
my
posture?
“The average person
looks at their mobile
phone 150 times a day
so it’s ideal for health
monitoring”
Dr Eric Topol

13. Apps for everything
Send pictures of skin
conditions for diagnosis
Measure heart rate by
pointing at face
Monitor sleep patterns
Save & share health
records
Test & map DNA
Increasing numbers of
Arabic health apps

14. Wearable M2M devices
Wristbands monitor activity,
synchronising to mobile phone
Wearable, washable
baby monitors
Temporary tattoos
measure sweat lactate
levels for athletes
Under clothing sensors
transmit real-time
biometrics to monitoring
health professionals
By 2016 sales of
wearable health
devices will reach
100m a year
(ABI Research)
Digital pills text doctor to
say you’ve taken them
7 out of 10
Americans
monitor their own
health
(Pew Research)

15. Connecting digital devices
• Digital devices provide data output and
connect in various ways.
• Some enable wearers to monitor their own
readings using a mobile phone and website.
• Some allow data to be downloaded and
viewed by third parties such clinicians who are
watching trends that merit medical
intervention.
• Some devices encourage wearers to share
their fitness progress with work-out buddies
and friends via social media sites.

16. Regulating & recommending digital health tools
European Union & US
Food & Drug
Administration regard
some apps as medical
devices which need
regulation
Doctors are starting to prescribe apps & digital
health devices from recommended catalogues

17. As consumers control their own data they can share
with others
Example: PatientsLikeMe
• Patients provide detailed, structured
information about their condition & treatment
(including symptoms, medication, side
effects)
• They can share their experiences with
others, including clinicians & other patients
• They can link up with other patients like
them
• Builds into voluntary provided, big data for
research & clinical trials

18. Wisdom of crowds: individual consumer experiences
combine to build rich data & insight
• In US cities multi-channel
311 service allows citizens
to report problems - &
services (& other citizens) to
respond
• Builds rich knowledge base
of citizen concerns
• Now implemented in
England as Care Connect
• Twitter knows first – early
alert to emerging health
problems

19. Challenges of connected health
• Privacy: security of
highly sensitive
personal data
• Quality assurance of
digital tools &
products
• Technical
infrastructure
• Business models
• Creating
cyberchondria?
The Arab digital generation may have more concerns
about connected health that UK & US consumers

20. Connected health recommendations for the Arab
digital generation
Connected digital services can drive
significant improvement in quality,
access & affordability in health care in the
Middle East – with three priority areas
1.Credible, high quality information
delivered via web portals & apps to
encourage healthy lifestyles
2.Improved access through remote
consultations & shared health records
3.Big data: consistent, large scale data
gathering on medicines, patient histories
& public health Digital health information initiatives
in Middle East are meeting
challenge

21. Supporting connected health: locally & globally
Licensing digital
symptom checkers
to other countries
Providing
professional advice
& consultancy
Enabling digital
health innovation
locally in UK

22. Thank you
For more information contact:
Email: bob.gann@nhs.net
Twitter: @bob_gann
September 2013