Marcus Vass and Jane Whitcombe consider the future for digital health and some of the key tech collaborations that will start to make a difference to patients over the next year
Technology is transforming the health sector and will continue to do so throughout 2019 and beyond. We are already seeing a number of key technologies that are having a fundamental impact on the way in which healthcare is accessed and provided. Here we highlight examples of collaborations that are already, or on the brink of, transforming the landscape.
Artificial intelligence (AI)
The potential for AI in healthcare is established, and governments, tech companies and healthcare providers continue to invest in technologies such as AI-assisted robotic surgery and AI to diagnose certain conditions. AI is already being used to detect diseases such as cancer more accurately and at earlier stages, and to objectively track symptoms for diseases such as Parkinson’s, where human monitoring proves inconsistent. Baidu Research recently claimed that its AI algorithm outperforms humans when identifying breast cancer metastasis, thereby reducing the need for patients to undergo unnecessary biopsies. AI is also being used to great effect in processing and analysing the health data of large numbers of individuals to diagnose the presence of or propensity to illness. This has the potential to be a game changer, provided that systems designers give due thought to the regulatory and societal context, most notably in relation to sufficiently safeguarding individuals’ rights and freedoms.
China’s Ping An Good Doctor, a one-stop healthcare ecosystem platform, recently debuted its unstaffed clinic that uses AI algorithms. The AI doctor chats with the patient and gathers medical history to generate a diagnosis, which is then passed on to a specialist consultant at Ping An Good Doctor’s in-house medical team via telemedicine. There are also plans to include a smart medicine cabinet that allows patients to receive their treatment following a diagnosis. Founder Wang Tao has announced plans to build hundreds of thousands of these AI clinics across China in the next three years.
Virtual reality
Use of virtual reality in the healthcare sector to date has primarily been in the context of education and training, such as virtual surgery. As virtual reality moves towards more mainstream use, we are now starting to see the potential for direct use by patients themselves.
VRHealth announced a partnership with Oculus in 2018, allowing use of its Oculus Go and Rift virtual reality headsets to provide technology solutions for a variety of therapeutics, including pain management in cancer treatment and alleviating patient anxiety before and after surgery.
Also, Oxford VR has been trialling use of VR technology to help mental health patients. The group is currently working on VR therapy packages for psychosis and social anxiety. Oxford VR is funded by The National Institute of Health Research in the expectation that the funding will help to create a VR product which will be taken up by the NHS.
Wearables and monitoring apps
Use of wearables such as the Apple Watch and FitBit and fitness monitoring apps is widespread; their popularity is spreading. Healthcare providers are increasingly embracing these technologies as a cost-effective way of managing the rise in lifestyle diseases, such as diabetes and heart disease, by engaging service users to monitor and control their conditions themselves in place of management by clinicians in a clinical setting. The benefits of this approach cut both ways, with individuals being empowered to take ownership of their own health and care.
Last September, Apple received US regulatory clearance for its EKG feature and irregular rhythm notification feature on the Apple Watch Series 4. The increase of wearable technologies and related apps achieving medical device status, as exemplified by the Natural Cycles fertility tracker and Omron’s blood pressure monitor, is also set to continue at pace.
Wiser policymakers are keen to break down any unnecessary barriers to the use of innovation within healthcare, driven by the dual incentives of increased efficiencies and improved outcomes. There are, of course, ethical and practical issues that must be considered in this move towards self-management in a clinical context. The most obvious is that individual healthcare service users are not medically trained, so the extent to which they can – and should – be expected to accurately monitor their health conditions is limited. It is a matter for clinical service providers to ensure they retain an appropriate level of overarching management whilst not balancing face to face services too much in favour of electronic intervention.
Equally, care must be taken to ensure that any efficiencies realised in using this approach are not unduly undermined by individuals’ misidentifying output as a problem needing medical intervention. In practice, ensuring that use of technology is properly trialled and tested in a controlled environment before mass roll-out, and that procurement processes are designed to ensure that solutions actually address the issue at hand, would go some way to minimising these risks.
Blockchain in healthcare
Potential for the use of digital ledger technology (blockchain) in the health sector will continue to be explored. For example, MyHeathMyData aims to implement one of the first blockchain biomedical information networks connecting organisations and individuals. It is encouraging hospitals to make anonymised data available for open research and prompting patients to both own and control their health data. DHL and Accenture have developed a blockchain based serialisation prototype which tracks medicines from their point of origin to the consumer to prevent tampering and reduce counterfeiting.
The NHS operates with huge volumes of continually growing data on over 30 million patients. Following the failed UK IT centralisation programme, the National Programme for IT, this data continues to be transferred between entities largely via paper records, resulting in time and cost inefficiencies. Blockchain could offer a way of decentralising data without compromising on security or accuracy.
A permissioned ledger for medical data could change the relationship patients have with their medical data. Patients would have the ability to control who has authorisation to hold a copy and combined with the time-stamping, verifiable identity, efficient data sharing, transparency and inability to alter, blockchain could be valuable to the NHS in addressing some of the current inefficiencies.
A new digital platform could allow patients to access a timeline of their lifelong medical records and prescriptions and enable patients to be in control of their own healthcare records using their smartphone. Concurrently, GPs would be able to see a full picture of patients’ medical history at primary and secondary care level and can make more informed decisions.
Widespread use of blockchain in health and other sectors will depend on increased awareness and understanding of the technology, how it works and the advantages it provides, as well as breaking down other practical issues that are currently acting as barriers to widespread use: the issue of storage of what is an ever-increasing volume of data, and with it, the ability to apply blockchain technologies at a large scale.
2019 promises ongoing rapid growth and development in health tech innovation in the areas discussed above and beyond.
Marcus Vass is partner and co-head, Digital Health, at Osborne Clarke, while Jane Whitcombe is a senior associate at the firm
