How technology will revolutionise the health service

19 Oct 2018 Nick Garbutt    Last updated: 2 Nov 2018

Pic: Franck V, Unsplash

A fascinating survey published by PwC this week shows that people in Northern Ireland are more receptive to Artificial Intelligence in health care than any other part of the UK.


 

This contrasts with a similar report published two years ago which showed us to be the least receptive. The difference is probably largely due to spiralling waiting lists. Respondents said that speed in being treated and ease of access were the main attractions.

It’s not necessarily that people here are more advanced. The report mirrors global research which suggests that the poorer the existing health infrastructure in a country, the more willing its people are to embrace new technology. Nigeria tops the global list.

The report also states that Northern Irish women were also the most receptive to having children delivered by robots. Given that the number who are is 3% as opposed to nobody at all in the rest of the UK and that such an option is not yet available, this statistic might be a nice line for the newspapers  but is not really one for serious discussion.

But the survey is important nevertheless. It will provoke a broader discussion on how technology can improve the performance of the health sector; what AI based devices are already in use, what is to come, what difference they can make and, how the voluntary and community sector can get involved.

In the future the focus is likely to be on robotics. Right now it is all about wearable technology that can either stave off ill health in the first place, or else help to treat existing conditions. And what is especially exciting is that there is so much already developed and momentum across the world is growing.

This is very big business. According to analysts MarketsandMarkets the total US IT health market will be worth more than $100 billion by 2020 and a good slice of that will be from wearable devices. There is an enormous amount of research underway and we can expect a continuous flow of new products.

These come in many forms from wristbands and watches to clothing, headbands eyeglasses and necklaces. There are some that can be implanted and others, currently under development, that can be swallowed.

Most contain sensors that gather data which is then fed to either a database or an app for analysis. Responses can be triggered. For example the analysis might prompt a doctor to contact a patient who is experiencing abnormal symptoms, or it might send you a congratulatory text for achieving a fitness goal.

There are three obvious and equally important implications of this revolution in health care. The first is that it marks a shift from treatment to prevention; the second that it allows personalisation of health care (ie specific to you rather than one size fits all) and thirdly it helps improve medical standards by allowing doctors to interpret the constant flow of data from multiple people.

Public attitudes are critical to this process. The tipping point comes when enough people want to be more active participants in their own health and welfare. The most important aspect of  the PwC survey is that it suggests we are already there. It states that “56% of NI patients would be willing to access advice and information from an intelligent healthcare assistant via a smartphone or similar device in preference to any contact with health professionals.”

In effect this means that healthcare starts to shift from the hospital or doctor’s surgery into our day to day lives, everywhere and anywhere and all the time.

It is useful to divide wearables into two categories: those designed to promote fitness and wellbeing and those that are for treatment of conditions.

We are all familiar with fitness watches, such as fitbit. Northern Ireland has the highest uptake in the UK of them. They allow people to track their exercise, weight and heart and sleep patterns and to set goals to improve them. Not as well known is the Smart belt which has a built-in mechanism to alert people when they have overeaten!

Their increasing usage and sophistication is recognition of the vital role that exercise, sleep, diet and general wellbeing has on our health. It is evidence of people taking more interest, and therefore control. Whilst the technology companies have an obvious interest in investing in this area, it should also be of interest to the Third Sector. There are many opportunities to work with the health sector to promote healthy lifestyles, and as social prescribing takes off, it will bring increased funding opportunities with it.

There are many examples of devices being used for direct medical interventions: they are already available to monitor early-stage heart disease to alert clinicians about potentially life-threatening episodes so that they can be addressed at an earlier, more treatable stage. In a previous Scope piece we explained how tech companies were developing means by which people with long-term conditions were being helped to stick to their medication. There are also people with type one diabetes who are using open source technology which shows you how to make an artificial pancreas.

And for older, vulnerable people, with dementia for example, necklace devices are being developed which would monitor pulse, the user’s whereabouts and alert carers if the person were, for example, to suffer a fall.

There are, of course, two caveats to all this. The first is that medical data needs to be secure. Absolutely secure. The NHS suffered a hacking incident last year. We need to be  reassured that records can neither be accessed or, even worse, altered from outside the system. There is a lot of focus in the tech community to produce sufficiently robust systems.

The second is that medical monitoring is potentially intrusive. Individuals and their families need to be convinced that the benefits of such devices outweigh any potential impact on privacy. So strong ethical frameworks need to be put in place.

These considerations are important and need to be resolved. However there is no question that  embracing technology both to boost prevention and treatment has enormous potential to help transform a faltering health service. This report suggests that Northern Ireland is ripe for progress. We just need politicians in place to debate and progress it.

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