Advocating on behalf of the largest employer within life sciences, HealthTech, the Association of British HealthTech Industries (ABHI) marked its 30th anniversary this year. In that time our industry has changed significantly, from being product-based, to delivering value-based service solutions and increasingly incorporating new fields of science, utilising digital data, artificial intelligence and robotics.
We represent 280 member companies, and as their devices, diagnostics and digital technologies have become increasingly sophisticated, treatment for the likes of cancer and stroke is now quicker and more targeted, supporting improved survival rates and life expectancy. Yet with the well understood demographic shifts comes a rise in chronic conditions, often perpetuated by factors such diet and lifestyle, and increased rates of diabetes and obesity, which are now the primary drivers of strain on what is already an over-stretched healthcare system. We must now identify, diagnose and treat patients in a holistic manner and as early as possible to manage or halt diseases.
Digitally enabled solutions and data driven products, that make the most of the NHS’ rich information pool, could be the answer we sorely need. There will always be a role for the hospital, but with the right use of technology, we can start to look at delivering care in alternative environments, such as the home or workplace. Through monitoring and predictive algorithms, we are positioned to manage our own health, with added focus on prevention and protection, thus alleviating pressures on the system. It’s not all apps, robots and telemedicine though.
There are currently over 10,000 HealthTech employees working in the UK; applying their trade to infrastructure projects, such as hospital and GP information systems. Programmes that will equip the NHS to deliver on what is arguably its prize asset: its data. As the world’s largest single health-payer system the NHS has a rich data pool. Large datasets, utilised effectively, mean three things for care: it can be more predictable, more personalised and more precise.
This data pool gives us the opportunity to deliver against the four Vs of data (Velocity, Volume, Veracity and Variety). However, this data pool cannot be constructed or utilised without the involvement of patients. Patient consent to data sharing must be the foundation for any revolution in digital health. We must engage citizens to have an informed public debate on the beneficial uses of health data. This is particularly the case when commercial entities form part of the data cycle. For this reason, ABHI is partnering with organisations to ensure we support the debate on informed patient opt-in.
Research suggests that the public does not, in principle, want their health records being shared with commercial organisations and several high-profile issues regarding the sharing of patient data outside of the health system have not helped perceptions. Regulation around data security is a must. The public must trust that their information is being used appropriately.
This underpinning principle must be supported by a regulatory framework that encompasses product, service and data regulation. Data protection legislation provides the framework for sharing data and further guidance has been provided in the code of conduct for HealthTech from the Department of Health and Social Care. Cloud-based services can help overcome this by providing a route to share anonymised data with entities outside of the consented area. Blockchain/distributed ledgers also have great potential to support sharing of health data, both at an organisational level, but potentially in the future as a basis for personal control of data. And so, whilst GDPR has enshrined the basics of data regulation into law, the sensitivity of health data and its sharing with industry may need further governance to build the trust and reassurance with the public.
Given the complexity of the digital landscape, collaboration is crucial. Developers, researchers, clinicians, users and funders all have a role to play. However, a great idea will remain an idea, if it is not given the necessary support needed to scale. This will require: access to capital, access to data on appropriate commercial terms, clear regulation and governance, and support to navigate and implement within the NHS infrastructure.
The UK invests heavily in research, and rightly so, however there is much less emphasis on implementation. ABHI are working to develop networks that promote communication and innovation with a strong direction towards implementation.
There is a role for companies, regulators, patients and the NHS to come together and design a system of transparency and privacy, that works for everyone. The prospect that digital technologies will make our health system more convenient, more coordinated, and more responsive to consumers’ needs is enticing. The opportunity for population health management with a focus on healthy living is even more exciting with a focus on engaged citizens preventing chronic disease and self-managing conditions.
Data is the fuel that powers digital technologies and the ability to collect, aggregate, store, and analyse “big data” is crucial to realise the potential advantages. It is perhaps not surprising, then, that in his first week in the job, the new Health Secretary Matt Hancock made technology one of his top three objectives, further tying the recently announced £20bn NHS funding uplift to the adoption of the latest technology and recently publishing his vision for digital technology in health and care .
As Hancock has stated: “The potential of cutting-edge technologies to support preventative, predictive and personalised care is huge.” This fourth industrial revolution, characterised by a fusion of technologies that blurs the lines between physical, digital, and biological spheres, offers the opportunity to radically change the long-term expectations, delivery, structures and outcomes from our health and care systems.
Andrew Davies is director of market access at ABHI.