As the NHS, like all health systems around the world, struggles with the challenges of caring for our aging population and the growing epidemic of chronic disease, the opportunities for innovative, technology-based solutions to bridge the gap are stronger than ever.
Whether it's to avoid time in hospital, allow earlier intervention, or enable remote monitoring of patients, technology can play a key role.
In fact, health technology is already stepping up to the mark in many areas, by improving our ability to monitor, measure and record symptoms, medication compliance and patient outcomes. Combined with the power of advanced analytics and patient-friendly interfaces, these technologies promise major benefits.But at the end of the day there are two key questions we need to ask of any new technology:
- Will it lead to a better health outcomes?
- Will it provide a more cost-effective way of delivering care, reducing the burden on our health systems?
If we're able to answer 'yes' to both of these, it's likely that this new technology is the answer.
Diabetes is one chronic illness where technology has the potential to benefit patients and is already capturing the interest of technology innovators.
For example, Google X has partnered with Novartis and lens maker Alcon to license its smart lens technology. Microscopic sensors in the lens use the patient's tears as a fluid sample to monitor blood sugar levels.
With the benefits of remote monitoring in mind, another company, Senseonics is developing a continuous glucose monitoring system including an implanted sensor, wireless transmitter and a smart-phone app. This means glucose levels can be measured remotely every few minutes, and accurate alerts sent to both the user and their clinician about impending hyperglycemia or hypoglycemia.
A lesser known and very challenging illness is Parkinson's disease. Difficult to diagnose and with no cure, Parkinson's affects approximately 127,000 people in the UK. A high proportion of patients suffer disabling, uncontrolled symptoms that can lead to unplanned and expensive hospitalisation. It's a difficult condition, but one where technology can play an important role.
Until recently Parkinson's disease symptoms could not be objectively measured. Clinicians relied on observation, clinical assessment and patient recall during a short office consultation to assess the frequency, severity and duration of symptoms. Problems with this model of care are confounded by the fluctuating nature of the disease which makes it difficult for patients to tell their clinician exactly what they are experiencing.
The Parkinson's KinetiGraph™ system (PKG™) is providing a solution to this. A patient friendly, wrist worn device, records symptoms continuously over seven days as people go about their daily lives. The data is then analysed in the cloud using proprietary algorithms to produce a detailed report for their clinician, providing an accurate, representative view of the person's Parkinson's symptoms.
So how can medical technology make a difference?
Similarly to diabetes, Parkinson's patients often end up in hospital because their symptoms become uncontrolled. Using the PKG, clinicians can more accurately identify patients whose symptoms are becoming uncontrolled and assess the impact of changes to dose or timing of medications in bringing symptoms under control. Patients are also empowered to take charge of their illness with features such as medication reminders encouraging greater compliance with medication routine. The interim results of a 2016 study even suggested that the PKG could help identify patients whose symptoms were not controlled, yet would have otherwise gone 'under the radar' of clinicians. The remote monitoring capability of the PKG also opens the door to telehealth opportunities for people living in remote areas who otherwise do not receive adequate care or who have to travel long distances to see a clinician.
We live in an age of personal fitness trackers and wearable technology, but if we want to encourage uptake of medical technology by the NHS and others, the economic benefit must be measurable. On the Parkinson's frontier, the case is clear. Research has shown that the cost of care for patients who have uncontrolled Parkinson's symptoms is more than double those who are controlled. By adding the PKG to a patient's therapy treatment, patients with uncontrolled symptoms saw significant improvements in their Parkinson's symptom scores.
Ultimately, prevention is always better than the cure, and medical technology also has an important role to play here. The PKG is currently participating in two clinical studies looking to identify the early warning signs of Parkinson's, with the hope that treatments that delay or avoid the onset of the illness will be developed faster.
Today and in the future, for innovations in medical technology to be successful whether they're classified as digital health, mobile, remote monitoring or any other kind, they need to make a fundamental difference to patients' lives as well as allow our health systems to be sustainable and accessible.