I’ve just sat through Tim Cook’s Apple announcement, and amongst the shiny stuff was something really important – ResearchKit. Most smartphone users probably don’t realise how much data their devices are capturing all of the time, or that some of it is quietly being used to influence apps such as the games they play. The point is, that for the first time ever, aspects of our health and lifestyle can be captured easily. For medical researchers, access to this personal data could transform the way we perform research on disease and aging. Even where research projects are able to monitor patients today, the sensors are often unwieldy and it’s difficult to get volunteers to sign up and stay engaged. To be effective, medical research needs data – not just from ill people, but from those at all stages of the continuum of health and illness. The issue has always been how to get hold of it.
Every year I get to sit through a large number of presentations from people who have developed new products or applications. Whilst lots of them are interesting, it‘s rare to see one that jumps out. This year I was fortunate to sit through one of those. It was given by Andrew Bastawrous from the London School of Tropical Medicine, describing a smartphone adaptor and application he and his colleagues had designed to help diagnose sight problems. It was a master class in how to make decisions about hardware and application development.
Andrew has now set up Peekvision – a company planning to make and distribute their product. They’ve started an IndieGoGo campaign to fund it, which will let them supply them to community workers around the world who have been selected by their partners Médecins sans Frontières and the International Agency for the Prevention of Blindness. For £60 you can pay for a device to be given to a healthcare worker. I can’t think of a better Christmas present to give.
What was so good about Andrew’s talk was the pragmatic approach to product design. It started by identifying a real problem that needed to be solved and then addressing the challenges of rolling it out in a way that made sense to patients, the local community and health workers. So many developers would have just reached for their iPhone and started to write code. This brilliantly demonstrates why that would have been the wrong approach.
There’s a lot of hype around the first Google Glass operation, performed last week at the Clinica Cemtro in Madrid. Although Glass was used in this instance for training purposes, it doesn’t take much imagination to see its potential for guiding a surgeon. That’s a step which fulfils much of the original promise of remote robot surgery, which we now see in a somewhat emasculated form in the Da Vinci robots, which are arguably adding more glamour than technology to routine procedures.
If we take that mental step towards guiding and assisting surgeons through Google Glass, it leads us to ask the more important question of how we select and train surgeons, and what patients should expect of them. If we want the best manual technicians we may not want to retrain our current surgeons, but look for a new breed. That resonates with George Brandt’s play Grounded, which won awards at Edinburgh this year. It looks at the issues in reassigning fighter pilots to operate drones. It has a magnificent performance from Lucy Ellison and has relevance to many other areas, particularly the brave new world that Clinica Cemtro are letting us glimpse. If you’re in London before 3rd Oct, go and see it at the Gate Theatre.
Let’s look at how those three things come together.
Over the past few years I’ve been working in the mHealth and smart energy sectors. Both have a common belief, which is that consumers will do things that are in their own interest – namely spend time and effort in order to save themselves money and keep themselves fit.
That mantra has seen a raft of new companies appear in each sector, directly targeting the public with products that attempt to change consumer behaviour or lock them into a brand. In the mHealth sector most have realised that medical or clinical approaches are too difficult, so have euphemistically renamed exercise and dieting as health and fitness. Meanwhile, energy utilities are attempting to improve their image by rolling out customer engagement programs, whether that’s in the form of green button apps in the US, or in home energy displays in the UK. Both hope that this will result in customer loyalty for their brand, attracting new customers and retaining existing ones.
In recent months both sectors have latched onto gamification, often as a result of hiring strategic marketing people from web and mobile phone companies. They’ve taken to gamification like enthusiastic bricks to water, hoping it will change the way consumers value their products and buy from them. I think they’re sadly mistaken. As proof, I’d cite the success of Viggle, which illustrates exactly what the average consumer wants from gamification. Viggle let’s you win points by watching TV. It’s nothing to do with better health or savings on your energy bill – it’s the couch potato dream of free pizza for mindless inactivity.
If you’ve been following the UK health pronouncements on telehealth, you’ll be aware of the policy of recruiting 3 million patients to become telehealth users by 2017. And if you’ve been following the industry analysts you’ve probably spotted the recent report by InMedica, suggesting that by 2017 there will be 1.8 million patients using telehealth worldwide. In other words, the UK’s program will be responsible for around 200% of telehealth patients. I know we did well at the Olympics, but that’s setting the bar rather high.
It suggests that either our ministers in the Department of Health are doing a Chris Huhne, or else the analysts are being uncharacteristically understated about the future.
A couple of years ago I wrote a somewhat tongue-in-cheek article about how much the NHS could save each year by implementing some fairly basic mHealth initiatives. Nothing very complicated – mostly simple stuff like appointment reminders, but with the help of some silly projections from NESTA I reckoned there was potential to save almost £13 billion a year from the NHS budget.
A few weeks ago I came across a much more sensible proposal in the form of Transform’s Digital First report for the NHS. Whilst my effort was largely based on fanciful numbers from corporate PR departments and think tanks trying to get noticed, the Digital First report uses real examples of current practice within different parts of the NHS. It looks at ten easy-win initiatives which, if they were to be implemented across the wider NHS, could release funding of £2.9 billion per year.
These are not high tech; they don’t require massive capital investment, they’re just ten good ideas which have been developed and deployed locally and which can be copied throughout the country. Most are centred on GP practice. In each case, the report describes the current implementation, the degree of difficulty (or in many cases the ease) of attempting each project, and details of how to do it. There’s even a Digital First website “designed to help NHS staff implement Digital First”. The report is essentially an instruction manual for every GP surgery. I’d recommend downloading and reading it. And the next time you see your GP, give them a copy or ask them how they’re getting on with it.