Last year, the Wellcome Foundation inaugurated a programme at the Edinburgh Festival called The Sick of the Fringe (#TSOTF16) to explore some of the boundaries and synergies between the worlds of medicine and the arts. Healthcare is a major issue in Scotland; barely a day goes by without an article in the national press about the impending obesity, stroke or heart attack crisis and the effect it will have on healthcare provision. In the second year of TSOTF it was interesting to see whether it had started to have an effect. There certainly seemed to be some progress in the way new writing tackled healthcare issues.
It’s over forty years since the first personal wireless telecare products came to market. Over the years, along with many others, I’ve been writing about their potential and the opportunity they present to save healthcare costs and by extension, our healthcare systems. Five years ago, many of us got excited when the Tricorder Prize was announced, with the promise of a Star Trek-like device that would diagnose multiple conditions being demonstrated by 2015. That deadline has now slipped to 2017, but it’s not stopped a plethora of new healthcare devices being announced in the meantime, helped along by the twin vogues of crowdfunding and lifestyle.
So where are all of these digital health devices? If you visit a hospital or GP, they’re mostly noticeable by their absence. Startups are coming and going with ever greater rapidity, whilst healthcare costs grow relentlessly. What is stopping digital health devices fulfilling their potential? At the recent Future of Wireless International conference, I chaired a session with speakers from within the medical device community and working at the sharp end of healthcare, who shared their views about the challenges. It was one of the most brutally honest and candid discussions I’ve come across, which deserves to be heard by anyone entering this market. So here is a precis of their essential advice for any digital health startup.
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.
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.
While most of the world was scratching its head about the London Olympics’ opening ceremony, Danny Boyle managed to do something that successive UK Governments have failed to do for over sixty years. The world watched as he promoted the NHS as a Global Brand. For five years we’ve had debates about what the lasting legacy of the London Olympics would be, a lot of which has concentrated on what to do with the buildings. The rest has been about whether it will persuade more people to become more active. Whilst I’m not belittling the positive effects that it may have in reintroducing people to sports and providing renewed support for sporting facilities, I’d like to put forward a much more important legacy – we should follow on from Danny Boyle’s tribute and start making the NHS a Global Health Service.
Readers of this blog will know I’ve been espousing the need to turn the NHS into a Global Brand for many years. But with the Olympic coverage disappearing from the front pages of our papers, that idea seems to be catching on. Recently the Independent ran the headline that the Government was considering a Global NHS. We now have the best opportunity to make that a reality – quite possibly a once in a lifetime chance to transform healthcare in theUK, and improve access to it around the world.
So Jeremy Hunt, here’s a challenge for you. If you want to go down in history, here’s you chance. Take this opportunity to show the world that the UK is great at healthcare as well as sport by making the NHS a truly global brand.