Health apps and smartphones: the ‘most-powerful diagnostic tools available’

How can digital patient-facing technology support a more patient-centric approach to care and support a future NHS? By Tobias Alpsten, chief executive of iPLATO

Tobias Alpsten

In this article, Tobias Alpsten, chief executive of health technology expert, iPLATO, talks about the future of digital health and how digital technology can support a more patient-centric approach to care management

There is still a widespread nervous culture within the NHS that digital innovations are seen to be as nice to have ‘add-ons’ and the sector falls behind other industries in its adoption of digital technology and innovative solutions

NHS chief executive, Simon Stevens, last month unveiled new plans to provide millions of patients with quicker access to health apps.

He believes smartphones to be one of the ‘most-powerful diagnostic tools now available’ and is hopeful that people already embracing apps including Uber and Airbnb would show the same willingness to embrace digital health technology which would help improve care and save the NHS money.

Without doubt the digital revolution, and in particular mobile technology, has transformed the way we all live our lives, but what are the barriers to NHS adoption of such services, which can help save money as well as improve and support a more patient-centric approach to care?

For organisations to really embrace innovation and new creative advances they need to break down barriers, let go and refrain from dictating the minutia, and instead, focus on the essential criteria, in this instance, patient safety and improved outcomes

Complex NHS culture

There is still a widespread nervous culture within the NHS that digital innovations are seen to be as nice to have ‘add-ons’ and the sector falls behind other industries in its adoption of digital technology and innovative solutions. This is in part due to:

  • Ancient and complex funding models and procurement issues; patient-facing digital innovations are part of the NHS ‘service delivery’ and not capital investment of IT hardware
  • Fragmented pools of funding, innovations which are unable to deliver cost-savings within a required time-frame promote short-term rather than long-term strategic solutions

In addition, for organisations to really embrace innovation and new creative advances they need to break down barriers, let go and refrain from dictating the minutia, and instead, focus on the essential criteria, in this instance, patient safety and improved outcomes.

Ultimately, if we are to drive real cost savings and efficiencies within the NHS, digital solutions need to sit at the very heart of service delivery and long-term strategy.

While taking clinicians’ views into account and ensuring safety, the focus should be on delivering what patients want and letting patients decide what they want to use. However, the question still lies as to why this is not happening. Perhaps fear and a lack of trust plays a role in the reticence to embrace such technologies? Certainly, there is still an old-fashioned attitude and NHS tradition of ‘we know what is best for you’.

Ultimately, if we are to drive real cost savings and efficiencies within the NHS, digital solutions need to sit at the very heart of service delivery and long-term strategy

Many GPs complain about their increased workload related to care planning. However digital systems exist with capabilities that enable patients to manage their own health, which are accompanied by robust research and evidence of best practice. Online patient services are able to deliver this by providing a facility for patients to monitor their weight, blood pressure, among others, and become involved and take responsibility for their own care for long-term conditions such as diabetes.

Digital apps can capture important patient data that enables practices to tailor health information, and while myGP has initially focused on promoting smoking cessation services, there are plans to provide other initiatives, all of which will alleviate long-term pressure on the NHS.

With patients securely booking and cancelling appointments remotely on their phone, this also takes the pressure off GP receptionists at some of the busiest times of year, such as the winter flu season.

Broad, patient-led improved adherence to prescribed medication could have a significant impact on commissioning from both an outcomes and cost management perspective. Digital solutions and health apps promoting a patient-centric approach can help tackle the widespread issue of poor adherence. Currently, wasted medication costs the NHS a staggering £300m each year with up to 50% of people not taking their medication correctly. In the EU alone, nearly 200,000 deaths occur per year because of missed doses of medication. Currently, there are five million patients in the UK that take four or more medications, and around 200,000 patients in the UK who require further support to take their medication correctly, above and beyond existing adherence packaging systems. We must never forget that behind these startling facts lie thousands of family tragedies.

If a fraction of the cost to better manage medication was invested in new innovative technology and intervention services, the NHS could save millions of pounds, and potentially lives, every year

In a recent iPLATO-supported medication reminder trial for people living with epilepsy, 48% of the participants reported fewer seizures and significantly-improved adherence to medication due to personalised reminders to their phones. Apps can now allow patients to set up reminders for their medicines. Features like this have proven popular with around 20% of iPLATO’s target patient group - those medicated for long-term conditions - currently receiving medication reminders from the service.

These tools are designed to support patient self-care and require no GP practice intervention. If a fraction of the cost to better manage medication was invested in new innovative technology and intervention services, the NHS could save millions of pounds, and potentially lives, every year.

Reducing pressures on A&E by improving access to GP services Recent research revealed that the average waiting time for a routine GP appointment is now 13 days, up three on 2015, and alarmingly, doctors have warned this figure could rise again to 17 days by next year. A rise in demand, retiring staff and a shortage of GPs have been blamed for the increase.

And, if a poor patient experience with potential medical effects was not enough, the tax payer too suffers from this as. According to the NHS Patient Survey, a national average of one in 10 patients who do not get acceptable access to primary care attend urgent care services including A&E at a significantly-higher cost. Transforming access to primary care offers obvious advantages to patients, but it also benefits commissioners and taxpayers. As such, there is a push to ensure that the majority of GP appointments are used effectively to help reduce the burden on urgent care services.

We need to work collaboratively and appreciate that digital patient-facing technology may well be the answer to help save our NHS

As a healthcare community, we need to work collaboratively and appreciate that digital patient-facing technology may well be the answer to help save our NHS. We use our mobile phones to make over 18 million banking transactions per week, proving there is an opportunity to build a sustainable and modern NHS for future generations to come.

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