Tobias Alpsten, CEO of health tech specialist iPlato writes
NHS chief executive Simon Stevens recently unveiled new plans to provide millions of patients with quicker access to health apps. Mr Stevens believes smartphones to be one of the ‘most powerful diagnostic tools now available’ and is hopeful that people already embracing apps including Uber and Airbnb would show the same willingness to embrace digital health technology which would help improve care and save the NHS money.
Without doubt the digital revolution, and in particular mobile technology, has transformed the way we all live our lives, but what are the barriers to NHS adoption of such services, which can help save money as well as improve and support a more patient-centric approach to care?
- Complex NHS culture
There is still a widespread nervous culture within the NHS that digital innovations are seen to be as nice to have ‘add-ons’ and the sector falls behind other industries in its adoption of digital technology and innovative solutions. This is in part due to:
- ancient and complex funding models and procurement issues; patient-facing digital innovations are part of the NHS ‘service delivery’ and not capital investment of IT hardware.
- fragmented pools of funding, innovations which are unable to deliver cost-savings within a required time-frame promote short-term rather than long-term strategic solutions.
In addition, for organisations to really embrace innovation and new creative advances they need to break down barriers, let go and refrain from dictating the minutia, and instead, focus on the essential criteria, in this instance – patient safety and improved outcomes.
Ultimately, if we are to drive real cost savings and efficiencies within the NHS, digital solutions need to sit at the very heart of service delivery and long-term strategy. While taking clinician views into account and ensuring safety, the focus should be on delivering what patients want and letting patients decide what they want to use. However, the question still lies as to why this is not happening, perhaps fear and a lack of trust plays a role in the reticence to embrace such technologies? Certainly, there is still an old-fashioned attitude and NHS tradition of ‘we know what is best for you’.
- A patient-centric approach to care-planning and prevention
Many GPs complain about their increased workload related to care planning, however digital systems exist with capabilities that enable patients to manage their own health which are accompanied by robust research and evidence of best-practice. Online patient services are able to deliver this by providing a facility for patients to monitor their weight, blood pressure, amongst others, and become involved and take responsibility for their own care for long-term conditions such as diabetes.
myGP securely automates the process of capturing important patient data which enables practices to tailor health information, alerts and reminders regarding health campaigns such as seasonal flu inoculations, NHS Health Check and cancer screening. Whilst this has initially focused on promoting ‘stop smoking services’, there are plans to provide other initiatives, all of which will alleviate long term pressure on the NHS. Over time, we hope the mobile service will help diagnose a range of conditions early, but, in the immediate term, myGP working alongside GP Principal Systems such as EMIS Health, allows practices to identify patients ‘at risk’, in order to easily engage with them and bring them in for check-ups.
With patients securely booking and cancelling appointments remotely on their phone, this also takes the pressure off GP receptionists at some of the busiest times of year, such as the winter flu season.
- Improving adherence to medication to keep patients out of the hospital
Broad, patient-led improved adherence to prescribed medication could have a significant impact on commissioning from both an outcomes and cost management perspective. Digital solutions and health apps promoting a patient-centric approach can help tackle the widespread issue of poor adherence. Currently, wasted medication costs the NHS a staggering £300 million each year1 with up to 50% of people not taking their medication correctly. In the EU alone nearly 200,000 deaths occur per year because of missed doses of medication.2 Currently, there are five million patients in the UK that take four or more medications, and around 200,0003 patients in the UK who require further support to take their medication correctly, above and beyond existing adherence packaging systems. We must never forget that behind these startling facts lie thousands of family tragedies.
In a recent – iPlato supported – medication reminder trial for people living with epilepsy 48% of the participants reported fewer seizures and significantly improved adherence to medication due to personalised reminders to the phone4. myGP allows patients to set up reminders for their medicines. This feature has proven popular with around 20%5 of the target patient group (those medicated for long-term conditions) currently receiving medication reminders from the service. These tools are designed to support patient self-care and require no GP practice intervention. Medication management apps are generally popular on App Stores but anecdotal evidence suggests that patients choose myGP for this because their medication details are kept within the ‘NHS domain’ with vital safety aspects such as encryption and data protection approved by the NHS.
If a fraction of the cost to better manage medication was invested in new innovative technology and intervention services, the NHS could save millions of pounds and potentially lives every year.
- Reducing pressures on A&E by improving access to GP services
Pulse Magazine recently released new research which revealed the average waiting time for a routine GP appointment is now 13 days, up three on 2015, and alarmingly, doctors have warned this figure could rise again to 17 days by next year6. A rise in demand, retiring staff and a shortage of GPs have been blamed for the increase.
And, if a poor patient experience with potential medical effects was not enough, the tax payer too suffers from this as, according to the NHS Patient Survey7, a national average of one in ten patients that do not get acceptable access to primary care attend urgent care services including A&E at a significantly higher cost. Transforming access to primary care offers obvious advantages to patients, but it also benefits commissioners and tax payers. As such, there is a push to ensure that the majority of GP appointments are used effectively to help reduce the burden on urgent care services.
As a healthcare community, we need to work collaboratively and appreciate that digital patient-facing technology may well be the answer to help save our NHS. We use our mobile phones to make over 18 million banking transactions per week, proving there is an opportunity to build a sustainable and modern NHS for future generations to come.
iPlato recently launched a new app – myGP – to help patients access GP services from their smartphone. myGP allows patients to book GP appointments around the clock on their phone and helps practices improve personalised patient care by automatically collecting patient data such as smoking status.
- Medi-voice Project http://cordis.europa.eu
- Omnicell UK 2015
- National Hospital for Neurology and Neurosurgery, (UCLH)
- iPLATO, 2016
- Pulse Magazine: Poll of 831 conducted by Pulse
- NHS Patient Survey: 2014