We were pleased to be able to attend Future Shock – the trends, technology and movements that should be defining the 2015 election (but aren’t), held by Nesta at Millbank Tower, London.
Siegfried and Roy?
This event, when advertised, felt like quite a smoke and mirrors affair, with the location and more specific information not being released until months after initial sign up. But it delivered on its promise of a solid discussion, with an array of panellists from the Financial Times, Channel 4, University of Oxford and Movement for Change.
Giving us their visions of the future was nothing like Tomorrow’s World (what we remember to be robot arms and hover cars) but more how economics could/should look (plus Paul Mason’s ideal – ‘Nationalise all grid infrastructure and introduce a universal basic income’); That it isn’t anything new to be afraid of change (just look at Orwell’s thoughts back in 1972) courtesy of Izzy Kaminska; That only the creative jobs won’t be automated in the future with a staggering 35% of jobs at high risk of automation (Thanks Dr Mike Osborne!!) and that the only way we can effect change is by closing the gap between people and politics from Kathryn Perera from Movement For Change.
They obviously all spoke a lot longer than the one point that I have credited to each them, but the overall feeling was that we need change, and we need it happen soon, but rather unfairly (I think) this won’t happen before next year’s elections or for some time yet. And that while we shouldn’t be afraid of this change we should approach it cautiously.
We were very lucky to be given the option of one of three sessions in the morning and three sessions in the afternoon to choose from (and I would have loved to have gone to them all!) but being from a digital agency with a strong focus on health, I chose “The Big Shift for Health: How technology can empower patients and stop the NHS going bust.”
How do we empower patients?
First up we heard from John Loder, Senior Programme Manager for Nesta who said “In Healthcare we expect technology to make things more complex, not easier…”
So why do they expect that? It could be because the current structure of the NHS worked when it was first set up in 1943, but today, with patients having the information they want at their fingertips, the hierarchical structure doesn’t work. The next more confounding problem is, what should this new structure look like? Surprisingly, no one’s actually sure, but the technology available and currently being developed should help us to frame it.
Take for example the work Apple is doing with its app ‘Health’, when the tech is there it will effectively aggregate all the important data that can be presented to a doctor to give a longer term picture of someone’s health, not just a quick test in a 5 minute appointment.
Three people/companies making a difference
1. Also take the work of Dr Vanessa Diaz, who we met at the IBME event at UCL earlier this year. She is part of a team building a model that becomes a virtual version of you. This helps physicians to test scenarios on a patient’s virtual self without being subjected to anything physically. This way they can work out the best outcome and tailor a patient’s treatment to the person, not the condition.
2. And this is precisely what Geneix (pronounced Gene-iks) is all about too (we saw Mark Bartlett, their CEO, talk at Future Shock), matching treatment to the individual not the condition using DNA and data. Using this method they can improve the overall efficacy of the medication along with patient adherence, because they are taking a medication that works for them. This can also reduce hospital readmissions, adverse reactions and reduce the cost of medications unnecessarily prescribed. Using data from your genes they can see if certain medications would work well for you, and where they wouldn’t alert the doctor before prescribing them, so you, the patient, suffers no adverse reactions, and hospitals or Doctor’s practices don’t exert their resources on fixing a situation that could have been avoided.
3. Finally, Proteus Digital Health want to use your insides to get accurate data (we heard Barnaby Poulton, their regional director, talking at Future Shock). Using ingestible sensors, and powered by your stomach fluids, you can receive information; like when your medication was taken (you take it at the same time); heart rate; activity and rest. Sounds gimmicky? You’d think so, but actually when patients are given accurate real time data about themselves it empowers them to make changes to their behaviours, like the time they take their medication or their overall adherence. It also helps HCPs see in real times how the medication they have prescribed is working, and whether the patient is taking it at the optimum time for them.
These all sound good, but how do we work towards this change?
Well, therein lies the rub. Before we can get the NHS to use technology more freely in order to help patients, we have to look at three factors.
1. Patients need access to their own data – this is so true, and so necessary to help people to make the right lifestyle choices and changes to their behaviours. They need to have something tangible they can access to track their health and see the difference, first hand that these behaviour changes make. This isn’t just the likes of wearables, but also seeing what decisions have been made when and how in their care. There is a huge disconnect between patients and their data, and that data following them from NHS trust to NHS trust. Given the technology we already have, it is surprising that we still don’t have access without making a data protection request.
2. Doctors need the data too – not just HCPs, but researchers too, and we’re going someway towards this with the NHS care.data programme. Essentially anonymising data that is accessible to HCPs and medical researchers (and potentially pharma companies for a fee) so they can see overall health impact data. While the NHS has been collating data since 1980 about hospital admissions, they haven’t been able to follow the full care path, including items like test results and prescriptions, which are essential to HCPs to see what works and what doesn’t. However, people have the option to opt out of their information being shared (which is obviously their right), but in doing so it could damage the accuracy of information collated on wider issues, like public health issues. Also with the anonymisation of data, it means that researchers cannot contact the patient whose data they have, which is fine in terms of privacy, but if they found an actionable way of helping that person, or found evidence that the treatment the patient had was not the best for them, they could not help that person.
3. The NHS/government needs to accept that they are not moving as fast as the exponential rate of change that the technology industry is moving at. They also need to accept that patients and HCPs will adopt technology more freely, be more willing to share their information (I’m talking millennials here, not baby boomers or older) and will want information faster, easier and more accurate than ever before.
With the election coming up in 2015, inevitably changes won’t be as fast as we would like and it is unlikely that the technology and data reforms we need for an effective NHS will form part of any party’s policies. With MPs today debating whether to repeal parts of the 2012 Health and Social Care Act – debating whether to further privatise the NHS or not – we’ll be waiting a while for a real health technology bill to be enacted.