The co-founder of NetDoctor and medical director of Liva Healthcare on how digital health could change patients’ lives
What does your day-to-day work involve?
I conduct research on digital health and collaborative e-health tools, develop e-health solutions to be used with patients, teach medical students and doctors in endocrinology and communication and work as a GP one day a week. I have also recently founded Liva Healthcare, a platform to facilitate ongoing personalised interaction through an intuitive app, building a strong bond between a healthcare professional and their patients. Its main focus lies in scaling back chronic illnesses, such as Type 2 diabetes, obesity and heart disease, by driving behaviour change. The platform is currently being trialled by the NHS.
Why the interest in empowering patients online?
The key reason I became a doctor was my desire to help and empower patients to lead healthier lives on their own terms. New research shows that 19 out of 20 people want to change their lifestyle rather than taking medication. As a doctor, I always look at how this can be achieved.
You have been involved in numerous research projects assessing the impact of online digital interventions on health – what does the evidence generally show?
The evidence is clear: lifestyle interventions, relating to diet and exercise, are more powerful than medicine.
In addition, research has shown that collaborative e-health solutions are the most effective. This is where digital health platforms are used alongside behavioural change theories and empathic counselling. For patients, having a trusted relationship with a healthcare professional is key to making lasting lifestyle changes. As a result, digital health tools shouldn’t look to replace healthcare professionals with an algorithm. Instead, these tools should be used to facilitate their work.
What are the advantages and disadvantages of e-health for patients?
The advantage is that e-health can assist and guide patients in living a better and healthier life which can roll back their diagnosis of a lifestyle disease. In addition, through e-health, patients can have a personal health coach in their pocket to help support them daily. The disadvantage is that in order to use e-health tools patients need to have a smartphone and be able to use the app. We have found however those that are not used to this type of technology find it very simple to use and get to grips with it quickly!
In your opinion, could the pharma industry be paying more attention to this area?
Yes, digital health is bypassing traditional medicine as a result of patients’ demands for personalised treatment. By offering a digital health platform to patients, the pharma industry would be giving them the best of two worlds.
Pharma companies could also use digital health to manage patients who have been prescribed medication. The digital platforms can help encourage patients to take their medication at the appropriate times, helping to lower dropout rates.
What about the NHS?
The NHS is beginning to embrace digital health. For example, the NHS last year launched the digital stream pilot of the Healthier You: NHS Diabetes Prevention Programme which is trialling digital health tools across the UK to tackle type 2 diabetes.
Going forward, if the programme proves the effectiveness of digital health intervention to combat type 2 diabetes, there’s no reason why digital health tools couldn’t be used to tackle a whole range of lifestyle diseases.
Does the NHS have problems with access to digital health innovations?
I believe the main obstacle is that healthcare professionals need to change their mindset on what is possible when you involve patients in their own health. To date, it seems the healthcare industry has little faith in what patients are capable of when you guide them and instead opts for passive treatments such as medicine. Research has shown, for several years now, that digital health can change the health of millions, but we are just getting started.
What is a key frustration of your job?
The lack of trust in the healthcare system of patients’ ability to make lifestyle changes and improve their health.
What do you hope to achieve in the future?
My hope is to improve the relationship quality between patients and healthcare professionals. GP-patient bond is a key driver of efficient treatment. This is particularly true for the treatment of chronic diseases, which require patients to make lifestyle changes. What would be ideal, is to increase GP-patient contact by at least ten times. I believe this could easily be achieved through digital health.
What keeps you awake at night?
That the implementation of collaborative e-health solutions is a slow process even though evidence to support its use has been around for over seven years.
What are your passions outside work?
Live music, travel and a variety of active sports.