Patients are set to become active players in a technology revolution which could improve their health and revive the NHS

1. CONNECTED HEALTHCARE
LORENA TONARELLI
Smartphone
apps are key
to dialling up
innovation
Patients are set to become active players in a
technology revolution which could improve their
health and revive the NHS
I
ncreasing patient expectations,
chronic disease prevalence and
budget constraints are placing un-
precedented pressure on the NHS.
This is paving the way for technology
to transform radically care pathways in
the UK. Giving people greater control
over their health and wellbeing through
digital innovations is a crucial part of
this process.
At the Nuffield Trust Health Policy
Summit, Health Secretary Jeremy Hunt
said: “Patients are ready to take on the
challenge. We need to give them the
chance to sit in the driving seat.” He
added that, although technology is
key, it is also important “to change the
cultural relationship between doctors
and patients, from master and servant,
to partners”.
A review of the research conducted
globally on the digital self-management
of asthma concluded that this can im-
prove self-care, life quality and medica-
tion use. In a US budget impact model for
diabetes, self-management technology
delayed complications and generated
health. In particular, mobile phones are
helping people lead healthier lifestyles
with immediate and relevant personal
support through new apps and websites.
They have the potential to be the single
most important channel through which
we can help improve the nation’s health,
address health inequalities and alleviate
pressure on the NHS.
“Public Health England already has
a range of apps available for free from
the NHS Choices website, many being
among the most downloaded apps in
the country. We are keen to develop this
whole area and, through our Health X in-
itiative, we are working with leading tech
startups to bring the most innovative dig-
ital thinking to health improvement.”
The Health X initiative, which was
launched last year, has already produced
groundbreaking ideas for products that will
help consumers conduct healthier lives.
“Whether helping people follow a
simple programme to get them off
the couch and in a few weeks running
5km, knowing how many calories are
in foods or aiding smokers to quit for
good within 28 days, we are looking
for mobile phones to play a significant
role in improving the health of the
savings to the health system. Remote
monitoring of blood glucose, alone,
saved $326 million over ten years.
Telemedicine, wearable technology
and online resources are all crucial in
creating efficient services, potentially
saving the NHS money that could be
spent elsewhere. But mobile phones are
considered the key driver.
“Mobile-phone subscriptions exceed
the world’s population of over seven bil-
lion. It is no surprise that this is helping
shape some of the innovations we are
seeing in healthcare,” says Dr Mutaz Ald-
awoud, a GP in Bradford, West Yorkshire,
and digital clinical champion at NHS
England. We are beginning to realise the
benefits of using mobile phones and apps
for medication reminders and communi-
cation of vital-sign readings, which helps
reduce unnecessary visits to the GP.
There are some 40,000 health-related
apps available today. Flurry Analytics
reports that, between December 2013
and June 2014, daily use of health apps
increased by 62 per cent, compared
with a 33 per cent rise for mobile apps
in general.
The NHS Choices Health Apps Library
has many clinically safe products for
managing health on the go. They include
apps for booking GP appointments and
understanding laboratory tests, and
cover conditions such as autism, diabe-
tes, stroke and cancer.
Professor Kevin Fenton, national di-
rector of health and wellbeing at Public
Health England, says: “We recognise
that digital technology is revolution-
ising the way people get personalised
information and interact with their
nation over the coming years,” says
Professor Fenton.
Marple Cottage Surgery, Stockport,
Cheshire, has been using interactive
self-management plans for asthma
and diabetes for years. “Together with
advice from our nurses, they help pa-
tients control the condition without
having to come to the practice,” says
GP Dr Andrew Johnson. “We are now
about to embark on new areas, includ-
ing live video appointments.”
Dr Arvind Madan is a GP and chief
executive at the Hurley Group, a net-
work of NHS practices in London. With
colleagues, he created webGP software
enabling patients to self-care, check
symptoms and consult with their
doctor online. “Patients can educate
themselves, take control over their
health and choose the most appropriate
service,” he says.
They can expect improved outcomes,
thanks to comprehensive history-tak-
ing and early-symptom detection and
treatment initiation. Practices use
their resources more efficiently, and
commissioners save money as a result
of reduced complications from de-
layed treatment and attendance at ur-
gent-care centres.
In a pilot funded by the NHS Tower
Hamlets Clinical Commissioning
Group, webGP had 36,000 visits in six
months. Some 60 per cent of the pa-
tients who visited were managed re-
motely and 18 per cent did not need the
doctor. This saved 400 GP hours.
Dr Stuart Bingham, lead GP at the Bar-
kantine Practice in London, highlights
the importance of online self-help in-
formation and consultations. He says:
“Technology needs to advance along-
side services, to enable primary care to
develop and meet demand. However, IT
governance and patient confidentiality
issues could delay the process.”
Crucially, practitioners must be will-
ing to engage with technology and ad-
vocate its use among patients. Bradford
GP Dr Aldawoud concludes: “We need to
get the technology to those who need it
most, embed it into care pathways, and
convince healthcare professionals and
decision-makers that, if such innovations
are allowed to flourish in a supportive en-
vironment, care can be delivered closer
to home, saving time, avoiding waste and
ultimately improving health outcomes.”
Telemedicine,
wearable technology
and online resources
are all crucial in
creating efficient
services, potentially
saving the NHS
money that could be
spent elsewhere
APPLICATIONS
rise in daily use of health apps,
December 2013 to June 2014
62%
Source: Flurry Analytics
GLOBAL MOBILE HEALTH MARKET FORECAST
Percentage share of overall market, 2017 estimate
US/Canada
Latin
America
Africa
Asia-
PacificEurope
$23bn
28%
7%
5%
30%
30%
Source: PwC
06 | FUTURE OF HEALTHCARE 23 / 03 / 2015 | RACONTEURraconteur.net