From stethoscope to CT scanner, technology and healthcare have long been inseparable. But the challenge, especially in an age of tight budgets and digital innovations proliferate, is deciding which technologies will provide the greatest public health benefits.
These are not necessarily cutting edge innovations. An important step is simply to replace existing analog systems with digital ones, says David Maguire, senior analyst on the policy team at the King’s Fund health think tank.
This year, Maguire co-authored a report that analyzed the evidence on digital technology in healthcare and social services. Among the most promising areas identified was communications, both internally and in patient relations.
This assessment is corroborated by the success of accuRx, a communication platform for general practitioners combining text messaging, video consultations and the possibility of sending documents and photos. Today, the software is used by over 98% of GP practices in England, up from 50% in March 2020.
While this rapid adoption is due in part to the momentum given by the coronavirus pandemic, it also reflects the targets set by the NHS one year before the pandemic in its long-term plan. Developed by health experts, including frontline staff, it sees “better use of data and digital technology” as essential to improving patient care within a decade.
“One of the biggest challenges in the healthcare system is the fragmentation of care, felt by patients in almost every healthcare system around the world,” says Katie Halfhead, communications manager at accuRx. “Simple infrastructure is needed to improve communication between care teams, which will translate into integrated care and better patient outcomes. “
However, organizational inertia can be difficult to overcome. Just three years ago, Matt Hancock, then UK Health Secretary, set April 2020 and end 2021 deadlines for the NHS to phase out the use of faxes and pagers respectively. A report from the National Audit Office in mid-2020 on the NHS’s progress towards ‘digital transformation’ complained of ‘slow delivery’.
The challenge is not only technological but managerial, argues Maguire. “Providing clinicians and industry managers with the skills and time to engage in implementation processes will help every project that uses digital technology,” he says.
Patient trust is also needed, especially when it comes to the use of data – as the NHS found the hard way this year, when a public outcry forced it to backtrack on its plan to ” record the medical histories of 55 million patients in a database to be shared with third parties. .
But not all data is equally sensitive. For example, artificial intelligence startup Kortical applied machine learning to logistics data to predict demand for different types of blood.
COO and co-founder Barbara Johnson says the software is able to take into account “the dynamics and uncertainty inherent in such a complex system”, with the result that, in a live trial, it has shown that it could reduce wastage of blood products by 54 percent.
Drug discovery is another promising area for machine learning, as start-ups bet AI can find unsuspected potential in overlooked molecules. Healx, based in Cambridge, is one such company. Its AI platform, Healnet, aims to find drugs for rare diseases, for which only 5% have an approved treatment. Tim Guilliams, co-founder and managing director, said the company has 21 programs in its pipeline.
In the coming months, she is also launching a clinical trial in fragile X syndrome, which causes learning disabilities.
Healnet integrates content, including biomedical research and patient group data, and analysis to find potentially useful relationships between diseases and compounds. The Healx team then selects the most promising compounds for further study.
There is, according to Guilliams, the potential for “real breakthroughs” in drug development. “I think there are huge opportunities to improve preclinical validation and clinical trials – for example, using AI to improve molecules to reduce toxicity, or to predict the effects of molecules on patients, or even identify the most relevant people to recruit for the trials. “
Yet even advanced technology may depend on more modest innovations. “You can’t start using AI systems, for example, until you’ve moved away from paper files,” says Maguire.
He adds that a conceptual shift from responsive healthcare to disease prevention may be needed before the full potential of the technology can be realized.
“One of the big challenges for the sector is trying to create real models of population care that meet the needs of people where they are now, and not a need that grows as their risk factors increase. ‘aggravate,’ he says.
This could be achieved through the use of wearable devices that track indicators such as heart rate and body temperature – although policymakers may find issues of privacy and digital inequality to be more difficult to resolve. .