Jas Singh, CTO, Medelinked, focuses on mHealth and the challenge of digitisation in the healthcare sector.
Most of us in the UK have reason to use the services of the NHS. And in doing so, it can’t have escaped our attention that the way services are offered and accessed have changed little since its foundation and are now very much out of step with the way that we lead the rest of our lives.
But we could be on the edge of significant change in this respect. The government recently announced that over £4 billion will be spent on improving the use of digital technology in the NHS over the next five years. This should create new opportunities for innovation in mhealth and digital healthcare in general.
The laudable aim is that the cash will help to get closer to the government’s vision of a paperless NHS, improving the speed of diagnoses and enhancing services across the country. Crucially, it should result in time saved so doctors and nurses can spend more time with patients rather than managing outdated systems and the administration that goes with that.
A digital healthcare system
The cash is expected to be spent on introducing systems that enable patients to book services and order prescriptions online, access apps and digital tools, and choose to speak to their doctor online or via a video link, very much like they consume services in virtually all other walks of life.
Yet many of the targets are still modest. As part of its digital drive, the government has a target of at least 10% of patients to use computers, tablets or smartphones to access GP services by March 2017.
Yet there is a big job to do. Recent research found that more than two‑thirds (68%) of UK citizens believe the NHS could – and should – use technology more in order to improve patient outcomes and the overall patient experience. Yet the NHS is currently struggling to meet its existing digital targets. The same research revealed that 96% of British adults either didn’t have online access to their records, or didn’t know if they did.
The growth of mhealth
The use of mobile phones has disrupted and transformed many industries in the past few years. While retail, travel and the media industries have been the first to adopt the use of smartphones to improve customer engagement, the healthcare industry has watched from the sidelines. Yet the ubiquitous mobile phone and mhealth technologies have the potential to transform many aspects of clinical practice and be a crucial part of systems that deliver healthcare more effectively and efficiently.
One of the main reasons for this is that the need to access information quickly and accurately is more urgent in healthcare organisations such as the NHS than in any other industry because the bottom line is that value of time here is associated with lives and not money (although its potential to make better use of the latter is also huge). And the ubiquity, ever increasing power and ability of mobile phones to transmit important information anytime, anywhere is leading to serious consideration of their adoption as
key technologies in clinical settings and revealing a huge potential for future implementations.
One of the areas where mhealth can have the greatest impact – assuming the healthcare system is ready to embrace real change – is in restructuring administrative processes.
One of the challenges in delivering joined‑up healthcare is that the working of hospitals is often highly dispersed because it involves the separate and joint functioning of various departments, for instance inpatient wards, outpatient clinics, emergency departments, pharmacies, operating theatres and labs.
However, the constant challenge is in getting these departments to collaborate seamlessly together and deliver timely patient care. The problem gets magnified when a healthcare provider such as the NHS may use different departments in multiple hospitals in any one treatment regime and certainly during the patient’s lifetime.
Mobile apps linked to open platforms can break down geographical and communication barriers and help patients, doctors and other hospital staff to communicate and collaborate with people in different locations. In case of emergencies, it helps in saving critical time and reacting quickly to the needs of the patient.
But clearly there are numerous hospitals today where the quality of care provided is not optimal and one reason for this is the lack of time available for healthcare professionals to spend with patients. The same is true for GP surgeries where consultation time is limited to eight minutes, once you have managed to secure an appointment, that is.
Manual admin slows down 21st century healthcare
One of the major reasons for this is that in the case of primary and secondary care from referral to registration to discharge, many parts of the process are executed manually. Sometimes aided by obsolete technologies and systems such as fax and post, this causes time to be wasted on administration, finding and retrieving documentation and fixing problems that could be devoted to patient care.
Clearly, there is an opportunity to invest in and build mobile apps that manage time and information more efficiently. Patients, as partners in their own healthcare, should be able to identify healthcare professionals, view doctor information, fix appointments and transmit relevant information to doctors and other health professionals directly through their mobile devices.
Individual doctors could use the same such apps to track appointments, meetings, call schedules and other clinical obligations and make themselves available in a timely fashion and even communicate with other clinicians and, with their patients’ permissions, share relevant clinical data.
Of course, one of the enablers of restructuring administrative processes is that of the introduction of more effective and efficient digital patient personal health records.
Documenting and accessing health records of patients and their relevant medical data is one of the most significant activities that underpins both primary and secondary healthcare. These are pretty much permanent and grow like topsy with additions are made to existing records time and again. But they are fundamental to the ability to deliver healthcare services.
Storage and retrieval of this information has traditionally been regarded as a huge challenge in clinical settings. But using cloud storage, secure mobile apps to file and retrieve relevant health records streamlines this process and can put the patient right at the centre of healthcare.
Using open platforms such as Medelinked, doctors and patients alike can access easily patient information such as medical history, vital numbers, lab reports and discharge summaries as well as DICOM imaging scans, x‑rays and a host of other potentially diagnostic information over a secure server.
This information can be augmented by a host of readily available wearable and fitness technologies that all help track the patient’s health state, and encourage better health state management from familiar vendors such as Apple, iHealth, Garmin, Microsoft, Fitbit, Jawbone, Nokia/Withings, Omron and Samsung, to name but a few.
The platform also enables physicians to transcend the thing which constrains their ability to act immediately or deliver best judgement in a case, by ensuring that access to information from any connected remote location is possible as and when needed and very quickly in case of emergency.
So the healthcare industry has pressing issues that need to be addressed in order to improve the quality of care for patients and quality of working life for healthcare professionals yet the NHS in particular is still in the very early stages of a true digital transformation.
But mobile devices, apps and open platforms will be the key to moving forward as they have the potential, serve as sensors, aggregators and displays, to enhance overall operational efficiency, streamline patient care delivery and lead the much needed transformational change where operational, clinical and financial benefits will flow throughout the system.
And helping make that happen is a challenge that any systems developer should relish.