The digital revolution, which began several decades ago, has completely transformed how we access, collect and transmit information. In the last decade the 'internet of things' and the increasing capacity and capability of smartphones, tablets and more recently wearables, have had a profound impact on society as a whole. Changing consumer expectations, behaviours and demand. In response, businesses are constantly adapting and innovating from contactless and online banking services to smart energy meters and now the 'connected homes'.
Indeed many industries have transformed themselves. For example, today's car has the computing power of 20 personal computers, features about 100 million lines of programming code, and processes up to 25 gigabytes of data an hour1 – it alerts the driver when a service is due or a part needs attention, or even calls emergency services if the air bag is activated. Few drivers are aware of the full functionality, nor do they need to know, rather all that matters is the knowledge that the car's reliability has increased significantly. But can this high reliability approach be applied to healthcare? One area where this is starting to happen is in the adoption of digital health. As our recent report Connected health found, there is increasing evidence that healthcare may in fact be approaching a tipping point in its digital revolution.
One important aspect of this is harnessing the power of connectivity, so that healthcare (or aspects thereof) can be monitored and managed remotely, in real time. One example, with independent evidence providing a testament to its effectiveness, is the Philips Hospital to Home enterprise based approach to care delivery. Powered by data visualisation and decision support tools, it is enabling hospitals in the US to realise workforce efficiencies, increase reliability of interventions and improve outcomes as part of a whole system clinical transformation. Specifically it is:
- Transforming critical care and helping to reduce mortality and length of stay in Intensive care units. The eICU clinical programme also helps address the issue of clinician and nurse shortages by blending medicine with technology and leveraging clinical expertise, patented processes and cutting edge technologies. The eICU programme can monitor multiple patients across a number of hospitals. A five year study of the eICU programme (118,990 critical care patients across 56 ICUs and 32 hospitals) found that patients receiving critical care from a Philips eICU were 26 per cent more likely to survive the ICU, 16 per cent more likely to survive the hospital intervention and be discharged 20 per cent faster from the ICU and 15 per cent faster from the hospital.2
- Monitoring and managing the care of patients in medical /surgical hospital units using telehealth aimed at improving the efficiency and effectiveness of healthcare resources utilisation. The eAcute clinical programme comprises bidirectional audio and video services located in patient's rooms and a centralised remote clinical team to augment in-hospital expertise. It helps detect deteriorating patients and make better use of constrained resources, with tools that address re-admission, patient wellbeing and satisfaction and clinical best practice. Research shows that compared to standard care this telehealth-based model delivered 17 per cent reductions in length of stay, 16 per cent reduction in cost per case, 26 per cent reduction in deaths or discharge to hospice care and 36 per cent reduction in falls.3
- Expanding reach, by enabling providers to care for patients over great distances. For instance, the Veteran's Administration (VA) in the United States is able to deliver critical care for patients across 2,000 miles, from Florida to North Dakota, from 2 eICU Centres in Ohio and Minneapolis. The technology supports the VA in delivering best standards-based care for patients at their local VA facility, rather than requiring the patient to be transported to a facility far from their home. This also minimises disruption on the patient's family.4
Another example, closer to home, is a UK based company, Babylon, which has developed a digital health app primary care transformation model or virtual primary care system aimed at putting the patient at the centre of healthcare delivery while improving access to primary care. The Babylon medical app provides patients with virtual consultations with doctors utilising a one-tap appointment booking service, and arranges for prescriptions to be delivered, as well as monitoring a range of health metrics to help doctors with diagnosis.5
The app is free to download to a smart phone or tablet and is available to members who, having signed up for the service, can then book virtual consultations (over the phone or via video calls) with a range of Health Care Professionals (including GPs, Specialists and Nurses). This service was the first app based service to be registered by Care Quality Commission (on 17 April 2015) but has yet to be inspected by them. It has attracted much media attention and in April was announced as the winner of the BT Infinity Lab SME Award: Digital Innovation for the Public Sector competition, a joint venture between BT, TechHub and the Cabinet Office.6
The above examples are two of a number of good practice examples highlighted in our Connected Health report. While they illustrate just some of the potential power of digital healthcare, the report also highlights some of the concerns and barriers to its use. Including the ability to properly diagnose patients remotely without physical examinations, the loss of important emotional support provided by face to face interactions and data privacy/ ownership and liability.
In the primary care example, the jury is still out as to whether access can be improved and the cost of primary care reduced by the use of the technology, with as yet limited evidence of its effect on demand for traditional primary care services or secondary care services. Meanwhile, and despite the evidence from the US hospital to home services, for various reasons, both technical (lack of interoperable systems) and cultural, the use of digital hospital services described above has yet to get a foothold in the UK.
Nevertheless, the idea of a virtual healthcare service is gaining traction across the UK, for example, the Chief Executive of NHS England has indicated publicly that virtual healthcare has a strong future in the UK and plans to launch a number of pilots.7 As explained in our report, and for the reasons described above, we believe that we are now at the tipping point in healthcare's digital revolution and that the technology will be instrumental in delivering the right care in the right place at the right time.
Footnotes
1.http://www.mckinsey.com/insights/manufacturing/whats_driving_the_connected_car
2.http://www.hospitaltohome.philips.com/pdfs/CHEST-paper_Approved-copy_Dec-9_2013.pdf
3.http://www.hospitaltohome.philips.com/programs/eAcute
5.http://www.babylonhealth.com/
6.http://www.cloudpro.co.uk/cloud-essentials/general/4945/babylon-wins-bt-accolade-for-app-innovation
7.http://www.ft.com/cms/s/0/53f89f00-91ce-11e4-afd2-00144feabdc0.html?siteedition=uk#axzz3O30A9D3Z
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