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Topol Review highlights potential of digital technologies to address the big healthcare challenges

Published and last updated by Rahel Gerezgiher

Topol Review highlights potential of digital technologies to address the big healthcare challenges

Written by Anna King, Commercial Director at Health Innovation Network.

It is not often that an independent review for a UK Secretary of State gets held up for a book launch, but such is the case when you ask a world-eminent, California-based cardiologist to review the changes required in the NHS healthcare workforce to ensure preparation for the technological future.

Dr Eric Topol, probably best known for his book, The Patient will see you now, published his long awaited The Topol Review: Preparing the healthcare workforce to deliver the digital future last month. The report highlights how digital healthcare technologies have the potential to address the big healthcare challenges as well as tackle increasing costs. The report observes that innovation will “increasingly shift the balance of care in the NHS towards more centralised highly specialised care and decentralised less specialist care”. This shift in the pattern of need and services is aligned with much of the HIN’s work and our focus on out-of-hospital care. Flatteringly, Topol also supports the ambition that the UK has the potential to become a world leader in such healthcare innovations. This is particularly exciting to hear given the work the HIN has been doing locally with DigitalHealth.London building upon local strengths in clinical care, research, education and business to boost London as a world leader in digital health.

However, Topol also offers words of caution for those impatient for new digital healthcare technologies to reach their full potential. As he observed, “it can take up to 10 years to realise cost savings, investment in IT systems, hardware, software and connectivity, as well as the training of healthcare staff and the public”.  The potential benefits of genomics moving beyond rare diseases and cancers is a good example of this. Allowing better prevention and management of conditions that could reduce costs and disease burden in the 10 to 20 year timeframe will require the NHS to have completed the “digitisation and integration of health and care records if the full benefits of digital medicine (earlier diagnosis, personalised care and treatment) are going to be realised”.

Whilst much of the report focused on the longer-term revolutionary technologies, there was also an acknowledgement that some data-driven technologies can and are being deployed today. Particularly, those with the aim of improving ease of access or remote monitoring, designed to reduce unplanned hospital admissions and decrease non-attendance rates. This is an area that we see many solutions being developed by the innovators of the NHS Innovation and DigitalHealth.London Accelerator programmes. Companies like Transforming Systems and Dr Doctor use data to improve access and system efficiency, and companies like Lumeon and Health Navigator helping improve individual patient pathways. Topol is also refreshingly realistic about the issues we see many innovators face because of “uneven NHS data quality, gaps in information governance and lack of expertise”. Potential enablers to overcome the barriers to adoption, he suggests, include: an information governance framework, and guidance to support the evaluation, and purchasing of AI products.

In the report, genomics, digital medicine and artificial intelligence were all seen to have a major potential impact on patient care, but it also showed how digital will help improve the lives of the NHS workforce. There was a helpful introduction to a number of emerging technologies, including low-cost sequencing technology, telemedicine, smartphone apps, biosensors for remote diagnosis and monitoring, speech recognition and automated image interpretation, that are seen to be particularly important for the healthcare workers.

Topol also finally puts to rest dated concerns that technology exists to replace people working in healthcare. The report clearly responds to this fear confirming that technology is intended to ‘augment’ healthcare professionals, rather than replace; releasing more time to care for direct patient care. Whilst, some professions will be more affected than others,Topol finds that the ‘impact on patient outcomes should in all cases be positive’.

At the HIN we have been supporting the development of the NHS workforce as a necessary part of the journey to digital transformation. I was pleased that Health Education England’s involvement in the Topol Report means that training and education will be modernised, as it is still very dated both in its methods of delivery and syllabus. However, this education should not focus solely on just educating new NHS staff members – but we should also be digitally upskilling the workforce we have now, and at every level. And herein lies the real complexity of the digital revolution. What Topol finds undeniable is that the roles of healthcare staff will change and new skills will be required, and it is good to see Health Education England responding to this challenge – although, it was shocking to learn that radiologist are still be taught how to develop traditional x-ray films, despite them rarely being used in the NHS!

Learning from previous changes, implementation will require investment in people as well as technology. It bodes well for the exciting wide-ranging programmes of the AHSNs, that support a learning environment, understand the enablers of change and create a culture of innovation. Programmes of ours like the Graduates Into Health Fast Track IM&T programme and the DigitalHealth.London NHS Digital Pioneers programme will play an important role in developing an agile and empowered workforce to facilitate the introduction of the new these new technologies. The report is clear that it is an exciting time for the NHS to benefit and capitalise on technological advances, and the AHSNs are well place to support this. The observation that ‘within 20 years, 90% of all jobs in the NHS will require some element of digital skills, illustrates the need for digital education revolution perfectly, even if it did raise the question what would the 10% be doing!

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About the author
Anna has been Commercial Director at the Health Innovation Network since July 2013. Prior to her current role Anna was the Commercial Programme Director at the London Commercial Support Unit (Commissioning Support for London, NHS London and NHS Trust Development Authority).

HIN out and about in London

Published and last updated by Rahel Gerezgiher

HIN out and about in London

Find out what our HIN team has been up to recently, and some events we’ve taken part in or led.

Technology & Informatics

On 13 September, our T&I team visited Tameside and Glossop Integrated Care NHS Foundation Trust, just outside of Manchester. They learned about an innovation set up by the hospital called Digital Health Centre aimed at reducing the number of unnecessary attendances at Tameside Hospital’s A&E department through the use of Skype. The learning pilot, which has extended the number of local care and residential homes involved, focuses on when patients within the homes become unwell, staff will have the option to Skype a dedicated registered nurse at the Trust who will be on hand to give expert advice and guidance throughout a video conversation. This has already reduced the number of attendances to A&E. The team learned about innovative techniques being used in other parts of the country, and took on board the advice provided by the team to aid some of their projects.

Musculoskeletal (MSK)

Supported by Arthritis Research UK, the MSK theme successfully organised the annual ESCAPE-pain conference which was held on 11 September as Guy’s Hospital. Sarah Ruane, Strategic Lead at Sport England to our very Innovation Fellow, Andrew Walker took to the stage to present to a full room of delegates who were keen to share best practice and ideas. Read more on the event here.

Alcohol

Paul Wallace, Clinical Director for the alcohol theme presented a paper at the International Network on Brief Interventions for Alcohol and Other Drugs Conference in New York on “Use of SMS texts for facilitating access to online alcohol interventions – a feasibility study”. This is a presentation of the pilot project undertaken with three GP practices in Kingston.

Smartphones among digital tech transforming London’s NHS

Published and last updated by Simon Ellery

News

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Smartphones among digital tech transforming London’s NHS

Digital technologies – from smartphone apps that help people successfully manage their diabetes, avoid “no shows” at hospitals, to tools that save time for nurses and paramedics – are beginning to transform London’s NHS services.

For the first time, NHS providers in London have revealed the extent to which smartphones, the Internet and Bluetooth are improving patient care and look set to save the capital’s NHS millions each year.

Guy’s and St Thomas’ NHS Foundation Trust expects to save £2.5 million each year by reducing missed appointments through an app called DrDoctor which gives patients much more say in selecting a date and time of their choice, resulting in “no show” rates falling by 40%.

Health chiefs are also using smartphones to tackle a looming health crisis with London boroughs tackling type-2 diabetes.

Programmes run by the North West London Collaboration of Clinical Commissioning Groups, covering eight boroughs, are successfully tackling diabetes through digital technology. OurPath links an app to a fitness wristband and 3G connected weighing scales to provide clients with realtime updates that help tackle type-2 diabetes, and in studies has achieved an average 5.3kg weight loss, while Oviva has seen more than 200 people complete the online programme with an impressive 90 per cent completion rate.

Dr Tom Willis, diabetes clinical lead for the Collaboration, said: “GPS are by nature very busy, naturally sceptical and want evidence.”

The London Ambulance Service, which was praised for its speedy and high quality care to the victims of the recent London Bridge terrorist attacks, is a key adopter having helped adapt the Perfect Ward audit tool specifically for its ambulance stations. The city-wide service has also developed Perfect Kit Prep and cuts out medicines paperwork for faster ambulance care, these are being implemented across over 70 ambulance stations in the capital.

In Chelsea and Westminster another tool links a stoma bag, used to collect faeces and urine for more than 13,000 people who undergo surgery each year nationally, through Bluetooth to users’ smartphones. A discrete device called ostom-i Alert Sensor, developed by a patient innovator, provides alerts when the bag is full so users have more control over their daily life and, importantly, greater dignity.

A new report ‘Digital Leadership in London’s NHS’ reveals that within eight months the 31 start-ups and digital companies backed by an organisation called DigitalHealth.London have achieved strong uptake within the capital.

Download the report here