Rhys Little, director at Despark UK, discusses the increasing use of technology in the healthcare industry and why it can potentially transform the way in which the sector operates.
The majority of us are living longer but more unhealthy lives. Rates of obesity, heart disease, Type 2 diabetes and dementia are rocketing, sending healthcare costs spiraling and putting our creaking healthcare system under intolerable pressure.
Earlier this year, hospitals across England struggled to cope with unprecedented levels of demand which left thousands of casualty patients waiting for hours on trolleys. In January many hospitals and ambulance services declared critical incidents, even though most operations had been stopped for the previous month.
As a result, radical plans to shake up the NHS and drastically underfunded council-run social care are centred around changing the patient-doctor relationship by limiting “face-to-face” interactions. Some of the proposals include increased use of health apps, remote monitoring devices and “virtual appointments” to bridge the colossal £22bn funding gap over the next five years.
The need to innovate
All over the country necessity is driving innovation. NHS doctors and Essex University researchers are working with a private company to build a “virtual GP” app to deliver instant advice. The project has secured funding from the government agency Innovate UK, and it is hoped that it will save the health service millions of pounds. It is intended to help with minor ailments which can easily be treated at home but account for almost a fifth of GP appointments, costing £2 billion a year.
Under another scheme, 1.2 million NHS patients across north London are currently being given access to a free app which again means they will consult with a chatbot rather than a human being. When patients dial 111 they are prompted to try the app.
These products, along with several other online tools are all part of a drive to modernise and digitise the NHS with GP appointments and prescriptions being booked online – in the same way we can book a cab, do our grocery shopping online or order a takeaway. The key difference is of course, that when it comes to our health, the stakes are so much higher than if the chicken Jalfrezi takeaway we ordered turns out to be a Korma instead.
The response to the 111 scheme which has been developed by HealthTech startup firm Babylon Health, has so far been predictably negative. Patient groups have branded the prospect of having to type in your symptoms and wait for a result both “frightening” and “ridiculous” and have asked whether lives will be put at risk if either the patient or the app gets it wrong.
The British Medical Association claimed the system could add to the pressures on hospitals, rather than reduce them. “Owing to the lack of input from a trained professional, this simplistic system could, like NHS 111, result in more people being sent to overstretched GP or A&E services who don’t actually need treatment – or conversely, serious conditions being missed,” argued Dr Chaand Nagpaul, chairman of the BMA’s GP committee.
It’s a fair point but given that the scheme is only being offered on a trial basis to patients who find it more convenient to get the kind of instant response offered by an app, rather than going through a checklist with a non-medically-trained call handler, some of the criticism it has received so far seemed to verge on hysterical.
In any case, the much-maligned 111 telephone hotline it is intended to replace hasn’t exactly been a roaring success either. Since its launch in 2013, the NHS non-emergency helpline has been hit by a string of scandals including the death of one-year-old William Mead after a call handler failed to spot that he was seriously ill with sepsis. An official inquiry found that the boy could have been saved if the call handler had realised the gravity of his illness.
Nevertheless, the introduction of the Babylon pilot scheme does raise the important issue of public trust in digital health technology. Isn’t it an even greater leap of faith to ask patients to trust an algorithm over a medically-trained human being when it comes to diagnosing illnesses? Ali Parsa, the founder of Babylon Health, argues not, and has some evidence to prove it as a result of an in-house “live challenge” which took place last June. The results showed that the Symptom tracker was consistently faster and more accurate in triaging patients than its human rivals. It scored 92% accuracy compared to the doctor’s 82% and the nurse’s 77%.
Although the Babylon experiment may not have been the most scientific of evaluations – the point still stands. “I’d trust a machine over a human any day of the week – and I already do,” said Parsa, who points out that machines don’t get worked up or get angry as humans inevitably do. Even highly-trained and competent medical professionals are not infallible. They are human beings, like any other, who make mistakes either because they are tired, overworked or stressed.
It’s also important to remember that AI-driven technology learns every time it makes a diagnosis. A doctor might do 7,000 consultations but a machine can do thousands of times more than that. The speed at which it learns and everything it sees, increases.
Without realising it we already place our trust in technology to carry out all sorts of crucial tasks in the medical world, from scalpel-wielding robotic surgeons to machines that can remotely monitor patients in intensive care wards. When this type of technology works as it is supposed to do, we take it for granted, barely giving it a second thought. But it is often only the negative experiences and the instances where it fails us spectacularly, that we actually remember.
As with any innovation, it takes time for people to get used to new ideas and new ways of doing things. But a crucial, and often overlooked, factor in persuading patients and customers to accept new types of technology is their experience of actually using it.
This article is a shortened version of the ‘Prescription for success: The drive for more personalised care in the Digital Age‘ report produced by Despark.
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