Transforming the health of the nation
Government plans to give the NHS a digital overhaul will rely heavily on innovative start-ups, writes Joe Crewther for the BVCA Journal.
On 28 December 2018, as much of the UK recovered from the onslaught of unhealthy Christmas food and drink, Matt Hancock, the new Health and Social Care Secretary, announced grand plans to overhaul the nation’s healthcare system and bring it into the digital age. “Too often the IT used by GPs in the NHS — like other NHS technology — is out of date,” he said. “It frustrates staff and patients alike and doesn’t work well with other NHS systems. This must change.”
The minister went on to declare his love for the NHS but shared his ambition for turning it into “the most advanced health and care system in the world — so we have to develop a culture of enterprise in the health service to allow the best technology to flourish.” Part of these efforts will be down to entrepreneurs and start-ups, he added. “I want to empower the country’s best minds to develop new solutions to make things better for patients, make things better for staff, and make our NHS the very best it can be.”
Mobile monitoring One of the most exciting innovations in healthcare will be the projected rise of mobile and wearable healthcare devices. Many of us already monitor our health using wearables, be it through smartwatch devices like the Fitbit, which can promote exercise and accurately monitor heart rate; apps like MyFitnessPal, which help users monitor and improve their diets; or apps like Calm, which aim to address issues like stress and anxiety through mindfulness meditations.
In Germany, the medtech startup DiaMonTech is making major breakthroughs with regards to diabetes. The firm has developed technology that can directly measure glucose levels in the bloodstream using an invisible infrared laser. It is a breakthrough that could transform the lives of diabetics around the world (there are approximately 422 million sufferers worldwide): eradicating the need to draw blood and avoiding the additional health risks that come with that process. DiaMonTech is currently working on numerous devices containing the technology, including a phone-sized pocket device and a smart wristband.
Another start-up that’s further ahead than most is Sleepio, an insomnia treatment app created by UK company Big Health. The company was partbacked by JamJar Investments, the venture capital firm started by the founders of Innocent Drinks. The app aims to tackle the need for pharmaceutical and mental health services among insomnia sufferers by offering users a full cognitive behavioural therapy programme of weekly sessions through their laptop or mobile device. They are provided with ongoing reports and advice regarding their sleep patterns, and severe sufferers can have their plan tailored by virtual experts. In 2017, it was granted NICE (National Institute for Health and Care Excellence) accreditation and is now recommended by the NHS as a firstchoice intervention for a range of issues.
Digital doctors
Wearables aren’t the only thing on the horizon. Artificial intelligence (AI) is set to revolutionise healthcare in 2019 and could have a huge impact on filling the void left by health worker shortages and bringing global healthcare to an altogether higher level. Babylon Health has been one of the key players in this so far. The app (which has more than 2.5 million users) essentially acts as an AI doctor by assessing medical symptoms and advising on actions. It has already been rolled out by the NHS, through a service called GP at Hand, to ease the pressure on GPs. Matt Hancock himself has said he uses the app, and investors include the original founders of Google’s DeepMind (Demis Hassabis and Mustafa Suleyman).
However, in the summer of 2018, the Financial Times ran a story in which numerous doctors warned of the danger of the app, stating that it can often miss symptoms of serious illness such as cardiac arrest or deep vein thrombosis. It was a reminder that, while the potential of AI doctors for global healthcare is colossal, these technologies are still very much in their early days.
Perhaps the biggest concern in British healthcare right now is the consequences of ever-increasing life expectancy. Last summer, a report from the Office for National Statistics projected that by 2066, a quarter of the UK population would be aged 65 or over. The proportion of those aged 85 or over is projected to rise to 7%. With this comes what has been dubbed the ‘looming dementia crisis’ as the social care system continues to be put under unmanageable strain.
One novel way of easing the burden has emerged in Ireland. Researchers at Trinity College Dublin have developed Stevie, a prototype care robot that is designed to take on some of the more mundane work of looking after elderly and disabled people, as well as those with conditions such as dementia.
“Stevie can perform some of its jobs autonomously, for example reminding users to take medication,” wrote project leader Professor Conor McGinn in The Independent. “Other tasks are designed to involve human interaction. For example, if a room sensor detects a user may have fallen over, a human operator can take control of the robot, use it to investigate the event and contact the emergency services if necessary.”
Stevie — who has arms, wheels, and a screen for a face — can talk, make phone calls, regulate lighting and room temperatures, make gestures, show facial expressions and display text. “None of this will mean we won’t need human carers anymore,” says McGinn. “Stevie won’t be able to wash or dress people, for example. Instead, we’re trying to develop technology that helps and complements human care. We want to combine human empathy, compassion and decision-making with the efficiency, reliability and continuous operation of robotics.” The researchers hope to have Stevie ready for the market by 2021.
Personalised medicine
While AI and assorted health apps will make a considerable difference to healthcare, there are even more significant plans under way that could have a far more dramatic impact on people’s health. Gene testing is where the DNA of people is studied to show the level of risk of ailments such as Alzheimer’s, dementia and cancer. Already, private organisations such as Google-backed US firm 23andME have emerged that allow people to pay for their DNA to be sequenced. The potential benefits of predicting how likely a person is to develop certain illnesses are clearly vast, with preventative treatment able to be offered well before symptoms develop.
However, there are some who have raised concerns over the ethics of sharing such information with private companies, as well as the accuracy of the tests many of these firms provide. Nevertheless, the direct-to-consumer gene test industry is seen as one with considerable potential, with a recent Global Market Insights study suggesting it would be worth US$2.5 billion by 2024. In April 2018, UK start-up DNAFit was acquired for £10 million by Hong Kong competitor Prenetics, which is backed by Chinese e-commerce giant Alibaba.
In January, Hancock announced plans for the NHS to provide gene testing, albeit for a few hundred pounds per user. The Health Secretary believes it could transform medicine in the UK, saying: “There are huge benefits to sequencing as many genomes as we can. Every genome sequenced moves us a step closer to unlocking lifesaving treatments.”
As technology advances — from robots and virtual reality to wearable tech and gene sequencing — the possibilities within the world of healthcare are seemingly endless. “This is the crest of a wave,” said The Telegraph in a special report conducted last year and funded by Samsung. “In the coming years, 5G will enable surgeons to perform robotic operations from other continents. Augmented reality will change our understanding of the human body. AI will help us fight illnesses that have defeated even the best caregivers. Everything is changing, and it’s all down to those little ones and zeroes flying through the air.”
