The future of medicine?

By Clive Flashman

I recently attended the 3rd Annual Future of Medicine event, jointly run by the IET and RSM. This year's panel of speakers was as eminent and varied as previous years and showcased a range of innovative thinking across the Healthcare continuum. 

Dennis Gilhooly  gave a truly global view on what is happening in digital health, and the policy initiatives and taskforces being established on regional and national levels. He mentioned a new Commonwealth initiative for digital health that is being led (interestingly) by Sri Lanka. He explained how in the Caribbean, mobile telecoms companies have joined forces with health agencies so that together they can track the vectors of pandemics such as Zika. 

Professor Tony Young (National Clinical Lead for Innovation at NHS England) spoke about the NHS Clinical Entrepreneurship programme and the success it has already had. He spoke about the digital doctor's bag that is already starting to be used by GPs, and it was gratifying to see ORCHA singled out for praise in that part of his presentation. One of the things Tony said that I strongly agree with is that the current model of healthcare is broken, and that there is a huge and urgent need for disruption. He went on to say that the patients will do this themselves if the clinicians don't do it first. He also explained how the NHS was now starting to 'mass purchase' innovative solutions for the whole of the country, ensuring that innovation was nurtured and that the NHS leveraged its scale to get the best prices possible.

One of the Cardiologists who spoke said that there had been research to show a strong link between air pollution and heart disease. He was starting to use wearables with his patients to monitor levels of air pollution and issue warnings based on a model he had created.

A GP called Keith Grimes  gave a very entertaining and thought provoking presentation, talking about the range of technologies starting to become available to clinicians and patients, and the challenges he saw for Healthcare in 10 years time (an increasingly elderly population supported by a smaller number of working people, higher prevalence of chronic disease, more antimicrobial resistance and climate change).

Then, possibly the most inspiring presentation of all was from a London-based surgeon called Shafi Ahmed. He started talking about the (much needed) disruption in medical education, and spoke about how medical students don't buy books any more, they find all the content they need on the web. He spoke about how chat bots are supporting global peer to peer learning, and how he has used live streaming social media to train thousands of surgeons at a time in Bangladesh. He showed us an animated timeline of the @NHS twitter account which he curated for a week, including the first surgical procedure, streamed via twitter and explaining all the supporting processes and activities that went along with it. It was viewed by 54 million people - that is digital disruption on a massive scale.

I have seen Ali Parsa from Babylon Health give his demonstration of the new AI capabilities of the Babylon app before, and it was still impressive the second time. It takes users through a series of questions (like the 111 service) to arrive at either a diagnosis, recommendation, or some other suggested action. I suggested that the App would be even more powerful if it understood your context as a patient, and Ali said that while he completely agreed with this in theory, in practice, Healthcare organisations and EHR vendors were highly protective of their data and made this almost impossible to achieve.

There were a number of other speakers too, but for me, these were the highlights of the day. One of the things that became clear was that there are lots of very smart algorithms and models already looking to find meaning and value in the data generated by clinicians and patients. However, if that data is of poor quality (and it often is) then the intelligence in the AI will have been wasted.We have to ensure that we have strong foundations for the evolution of digital healthcare:
1. Appropriate and secure sharing of data
2. Effective data governance
3. Good quality data
4. Improved interoperability of systems
5. Information Standards that everyone understands and signs up to
6. Strategies that focus on the value for the patient (and clinician), not technology for its own sake
7. Reimbursement models that support digital service delivery

If we can build the foundations properly, then digital healthcare has a real chance of success.