The turn of every new year brings with it a barrage of resolutions and a surplus of best-intentioned gym-goers.
The new year also has another health-related tradition, that of the “Dry January” challenges. This is a campaign designed and promoted by Alcohol Change UK to raise awareness of the effects of alcohol.
The event started back in 2004 and the idea is as the name suggests — to go alcohol-free for the full 31 days of January. This can be done in promotion of the charitable organisation or simply as an acknowledgement to your own wellbeing.
The subject of alcohol and health is quite extensive, so I’ll break this up into two parts and will try to cover the majority of the topic within these. First of all is the effects of alcohol on physical activities. Read more
William James, an American psychologist was a leading thinker of the late nineteenth century and one of the most influential U.S. philosophers. Labelled as the “Father of American psychology” he wrote back in 1890 —
“The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character, and will.”
Social skills are formed through face-to-face interactions with others from birth, such as infants with their parents and siblings, and children with their peers at nursery and school. But there is a growing concern that the use of social media is effectively displacing the way the new generation is developing their peer to peer social skill-set throughout adolescence. The question is whether these digital stimuli have the potential to influence the risk of behavioural addiction.
University College London psychiatrist Dr Michael Bloomfield states: “Adolescence is a critical period for a person’s development, particularly as our brains go through important changes during our teenage years.”
Neuropsychiatric Disease and Treatment, which is a peer-reviewed medical journal covering research in psychiatry and neurology, released an in-depth article into the Maturation of the adolescent brain. It stated:
“It is well established that the brain undergoes a “rewiring” process that is not complete until approximately 25 years of age… The nucleus accumbens, a part of the brain’s reward system located within the limbic system, is the area that processes information related to motivation and reward. Brain imaging has shown that the nucleus accumbens is highly sensitive in adolescents, sending out impulses to act when faced with the opportunity to obtain something desirable.”
Part of the appeal for these attention-seeking businesses are the ‘rewards’ they offer; push notifications of the number of ‘likes’ on the user’s post for example. These are types of rapid reward cycles which reinforce the habit-forming actions of their users, guaranteeing they keep coming back time and time again.
An opposing opinion is that perhaps it is not the general use of digital media but more the content and context that is influential since some uses of digital technologies actually do improve multitasking skills, working memory, and fluid intelligence- which is one’s problem-solving ability.
Whether we use the technology to connect with loved ones throughout the day for that familial interaction and support, or if our usage is related entirely to our curiosity and inclination to compare our lives to the often highly filtered and sheltered lives of others, there is a stark contrast to the online environment we expose ourselves to. With the more astute and measured perspective of an adult, these potentially negative factors may not be such an ‘influence’ (as these ‘influencers’ are named). But for younger, less pragmatic users, these issues will have a much greater impact on their self-esteem and value.
A study into the issue was conducted by University at Albany psychologist, Julia Hormes. She led a team of three researchers in assessing the addictive nature of social media — specifically Facebook. She states that-
“New notifications or the latest content on your newsfeed acts as a reward. Not being able to predict when new content is posted encourages us to check back frequently,”
The big players profit from their user-base through targeted advertising which means this genuinely becomes an economy driven by control over our attention. The value of our attention is enhanced by its finite availability, thus the demand and need for those in this market to compete.
With the emergence of these critical communication technologies, there is bound to be some fraction of users who will show addictive behaviour. If someone is displaying unbalanced behavioural habits, whose responsibility is that?- It would certainly be in the platform provider’s interest to afford some safeguarding within their services since they know exactly how much you are using their product and the detrimental effect of reliance on them.
Alex Marshall CPsychol, Forensic Psychologist, provided an overview of the subject when he observed-
“There is a lot of research into adolescents being vulnerable to entrenchment in a particular lifestyle that otherwise would be adolescence-limited, but failure to integrate (amongst other factors) prolongs behaviour or steers them off onto a trajectory that they otherwise weren’t destined towards biologically or socially.”
Ultimately, nobody knows the consequences these digital media phenomena will have on modern life and to some level, we are all part of a long-term social experiment to find the answer.
Since its foundation, Medicalchain has been growing rapidly and we are delighted to announce the official opening of our new office in Switzerland. We have a global vision and geographical expansion is necessary to achieve this.
MyClinic.com continues to improve and we are working to our timeline for version 2 which is eagerly anticipated for the end of Q2 2019.
We are working extra hard to confirm contracts and are hopeful that our services will be available within the NHS as well as the private sector soon.
MyClinic.com will also be available on Android very soon.
Considering how difficult it can be to keep up with our progress, especially product development — we have created an interactive timeline on our website to update you clearly on our road to achieving our goals.
Want to help? Give us feedback!
Please continue to download our iOS version of the MyClinic.com app and let us know your feedback on version 1.0 by sending us your comments to — [email protected]
Our Communications Manager, Tim Robinson has been working on a new blog about the problems in healthcare and how to address these. Check out some of his articles below:
Faxploit: Read about the security dangers healthcare systems have by using fax machines— read here
Lifestyle Intervention: Read about how the NHS plans to help patients at risk of developing diabetes with “lifestyle interventions” to curb the demand the health service is under — read here
Curiosity killed the…Trust?: Trust is especially valuable when it comes to our intimate health data, read about how that ‘trust’ is being handled today — read here
E-Prescribing for NHS Trusts: Read about the benefits of “E-Prescribing for NHS Trusts” — read here
Youth Turning to Apps for Mental Health Needs: Read why our youth are turning to health tech and apps to care for their mental health needs instead of existing conventional options — read here
Snail Mail in the digital age: Read how using ‘Snail Mail in the digital age’ to inform patients about their vital NHS healthcare services has caused serious delays in tests and screenings for thousands of patients — read here
Our COO, Mo Tayeb has been busy this month in Switzerland, Italy and Taiwan, speaking at various events and forums that showcase the latest in technology in healthcare. In Switzerland, he attended the Life Sciences Leader Forum. In Italy, he spoke at the Futureland event, which highlighted the companies and technologies that are going to make an impact in 2019. Finally, in Taiwan, he presented Medicalchain at the Healthcare Expo at the end of November. This event marks the principal display of solutions and connections for medicine and healthcare in Asia.
Back home, Mo has been just as busy speaking in London at the Healthcare Unblocked event, the UK’s first conference dedicated to advancing blockchain in healthcare.
More in London this month as our Head of Business Development, Dr Amina Albeyatti attended the Giant Health Event 2018 at Stamford Bridge, home to the Chelsea Football Club. We received a warm reception and presented Medicalchain and MyClinic.com and its application in our health, to a very excited audience.
Dr Amina Albeyatti was interviewed by Disruptive Live. Check out the interview below:
We were also interviewed by Jessica DaMassa, health blogger for WTF Health.
As one of the UK’s technology startups and the first UK-based company to bring blockchain technology to healthcare, we were delighted to be invited to the 11th Annual GovNet Parliamentary Awards, hosted by Rt Hon. Baroness Golding. It was an enjoyable and relaxed evening to set off the Christmas season.
Our founders will be holding an AMA on December 24th at 7:30 am GMT, a link to the event on YouTube will be shared via our social media closer to the date. Please start posting your questions from now to Communications Manager, Tim Robinson. [email protected]
London January 9th 2018
Designing a Central Bank Digital Currency and Building Healthcare on Blockchain
Medicalchain’s COO, Mo Tayeb, will be speaking at this event. Find out more and how to join us
Thank you to everyone who has taken the time to ask us questions and engage with our communications team. If you have not had the chance to say hello yet, please click on one of the links!
Don’t Forget To Sign Up For Your Free Health Passport
The Medicalchain Health Passport signup is live! Prospective patients and medical practitioners can register their interest now, by clicking here.
Partnerships within the NHS and private sector
New website reveal — coming soon
This month marks the end of an eventful year for Medicalchain. With the conceptualisation and delivery of the first rendition of the MyClinic.com application, to the plethora of events all around the world that members of the team have presented at.
We appreciate all the support we have received for what we are trying to achieve, from our loyal community members to representatives we meet at our events — including the wider public at large.
Overall this year we have represented at over 52 events in over 25 cities around the world!
We look forward to the new year and all that we have in line to achieve in keeping with our roadmap. Notably, the updated versions of the MyClinic.com application and the release of the Health Passport, which will truly enable patients to hold their own data. With more good news on the way with exciting partnerships close to being announced.
Again, we thank you for your support and wish you all a Merry Christmas and a Happy New Year, from all at the Medicalchain team.
Thanks for reading the seventh newsletter of Inside Medicalchain. For more information on where to purchase our tokens (MTN), click here.
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Although patented back in 1843 — about 30 years before the telephone — the Fax machine did not become widely used until around the 80s.
This is around the same time as the Nintendo NES, Boomboxes, Sony Walkmans, pocket TVs and the Casio C-80 Calculator Watch. Yet the fax machine seems to have outlived all of these.
But the reality is that this technology was in use back in the days of the French Emperor Napoleon III when the ‘pantelegraph’ was used over state-owned telegraph lines for sending signatures.
So the joke goes something like this-
In the modern day, the risk associated with using these devices is that all computer systems are prone to infiltration. A fax machine is no different, but not only are they connected to your network; they are also connected to the outside world via a phone line, so essentially there is no firewall!
A research team has proven that the only information required to infiltrate a system, is the organization’s fax number, which could be part of an all-in-one fax, copier and printer- something which is often publicly available on any employee’s business card or company website.
How is this done? —
It is even more alarming when it is historically the industries that hold the most protected data which are still using these technological relics the most. But who really does use these the most? DeepMind Health Independent Review Panel Annual Report states- “The digital revolution has largely bypassed the NHS, which, in 2017, still retains the dubious title of being the world’s largest purchaser of fax machines.”
The other main users are the legal, banking and real estate sectors. Imagine an attacker using an exploit to forward copies of each of your bank statements to themselves, now that is a sobering thought.
It comes as good news then that the NHS has announced plans to abolish the use of these devices. NHS hospital trusts in England own a whopping 8,209 fax machines. Just one of these, Newcastle upon Tyne NHS Foundation Trust relies on an astonishing 603 fax machines!
A statement by Mr Richard Kerr, RCS Council member and chair of the Commission on the Future of Surgery sums up the situation — “The advances we are beginning to see in the use of artificial intelligence and imaging for healthcare, as well as robot-assisted surgery, promise exciting benefits for NHS patients… NHS hospital trusts remain stubbornly attached to using archaic fax machines for a significant proportion of their communications. This is ludicrous… As digital technologies begin to play a much bigger role in how we deliver healthcare, it’s absolutely imperative that we invest in better ways of sharing and communicating all of the patient information that is going to be generated. The NHS cannot continue to rely on a technology most other organisations scrapped in the early 2000s.”
The NHS will be banned from buying fax machines from next month and has been told by the government to phase out the machines entirely by 31 March 2020.
Whenever you hear the word “intervention” you may automatically think of an ‘addiction intervention’’, or a ‘surgical intervention’, as these terms have almost become synonymous with the word. But how about a lifestyle intervention?
Currently, the NHS England spends around 10% of its budget on treating diabetes, with recent projections showing that the growing number of people with the condition could result in nearly 39,000 people suffering a heart attack and over 50,000 people suffering a stroke by 2035.
There is progress within the sector to redress the prevalence of type 2 diabetes (T2DM) in particular, through a prescription of- lifestyle changes.
There are plans proposed by the NHS to roll out a national Diabetes Prevention Programme (DPP) in the form of ‘lifestyle interventions’ to curb the demand the health service is under. The evidence shows that diabetes prevention programmes significantly reduce progression to T2DM compared to traditional care by ~26%.
The approach will involve GPs prescribing a liquid diet of just over 800 kilocalories a day for three months, then a period of follow-up support to ultimately help achieve remission of their Type 2 diabetes. NHS England’s chief executive, Simon Stevens, announced the program on 30th November. It will first be offered to 5000 patients before being rolled out nationally.
The announcement followed a series of recent studies that have overturned the widely held view that type 2 diabetes is incurable and must be managed with medication.
Large population-based studies in China, Finland and the USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). With these studies leading to the conclusion that even moderate reduction in weight and only half an hour of brisk walking each day reduces the incidence of diabetes by more than fifty percent.
The objectives for the DPP are:
To support more people at high risk of developing diabetes to receive lifestyle interventions to help them lower that risk.
To slow down the increase in the incidence of type 2 diabetes compared with current predictions.
To reduce the incidence of heart disease, strokes, kidney, eye and foot problems (and associated mortality) related to diabetes compared with current predictions.
The benefits include not only saving the NHS money by alleviating the demand diabetes puts on numerous services within the sector, but the money and resources will then be reallocated and reinvested into providing more essential frontline care.
Chris Askew, the Chief Executive of Diabetes UK states: “Plans to double the size of the NHS Diabetes Prevention Programme is excellent news. The programme is already the largest of its kind globally and shows England to be a world leader in this area. The ambition being shown by the NHS needs to be matched across all government policy — we need stronger action on marketing to children, and clearer nutritional labelling to support people to make healthy choices.”
There are even plans for online versions of the DPP, involving wearable technologies and apps to help those at risk of Type 2 Diabetes better self-manage. These will also be provided to those who find it difficult to attend regular sessions due to work or family commitments.
The aim is to better integrate the available solutions and help patients feel more in control of their treatment. This will hopefully stop the chance of patients withdrawing from their therapy and in feeling more accomplished with short-term goals- by achieving a certain number of steps for instance. This move by the NHS brings us one step closer to achieving a patient-centric health service, a more integrated solution.
Trust is a valuable commodity and in the words of American business magnate, Warren Buffett — “It takes 20 years to build a reputation and five minutes to ruin it.” The greatest issue is not so much the fact that you have been lied to, but that it then becomes so much more difficult to trust.
Trust is especially valuable when it comes to our privacy, and what is more private than our most intimate data — our personal medical records. In May, Sir Alex Ferguson, Britain’s most successful football manager was admitted to Salford Royal hospital after suffering a brain haemorrhage. After emergency treatment and less than a month in the hospital, Sir Alex made a good recovery.
After an audit of the Trust’s computer systems however, it became evident that a number of staff members- Two doctors, a senior consultant, and two nurses allegedly gained unauthorised access to Sir Alex’s private data.
Doctor Chris Brookes, chief medical officer for the Northern Care Alliance NHS Group, which runs Salford Royal, said of the incident- “We can confirm that a number of staff who work at Salford Royal are currently subject to investigation in relation to an information governance breach… All of our patients have the right to expect that their information will be looked after securely and accessed appropriately. We take patient confidentiality extremely seriously.”
Human error is not the issue here, curiosity shouldn’t be a variable in the privacy of our data since ideally, this shouldn’t even be a possibility. The Information Commissioner’s Office (ICO) is the UK’s regulatory body charged with enforcing data protection legislation and bringing regulatory action against those found to have breached data laws. It regularly deals with health-related cases and states that within its figures for Q2 of 2018/19 alone, there were a total of 4,056 data security incident reports within the sector.
What can Hospital Trusts do to earn our trust? Doctor Chris Brookes, chief medical officer at the site responsible for Sir Alex’s breach also stated — “We take patient confidentiality extremely seriously and will take the appropriate action to ensure staff understand the seriousness of unauthorised access.” Does that mean staff were not previously aware of the seriousness of unauthorised access? Does that statement guarantee this won’t happen again?
If hospital sites and CMOs wish to redress the issue they should reconsider their solutions, since trust is built through actions, not words. Successful relationships, including doctor-patient relationships, are built on the foundation of trust. This isn’t automatically awarded to someone due to a title, but earned, and as each Doctor and healthcare professional represents the sector as a whole, their reputation affects the NHS’s reputation.
Advising someone not to be curious is not enough, we should have firm and robust measures to protect patient data. Around the world, companies are considering using blockchain technology to help with privacy and data safety as they have done for the financial sector. it is time to block unwarranted access so that we can rebuild some trust.
The UK’s Department for Health and Social Care has announced this week, that it will be providing £78 million to establish electronic prescribing and medicines administration (ePMA) systems in NHS Trust sites. There will be an initial share distributed to 13 selected NHS trusts, with a total of £16 million funding for 2018/2019 between them.
The reason for this decision is to move away from handwritten prescriptions which cause many issues within the system. Health Minister Stephen Hammond said, “As part of the long-term plan for the NHS, we not only want to harness technology to make it one of the most advanced healthcare systems in the world but crucially to improve patient care… The funding provided for these trusts will help to drive these changes to the patient experience, but will also aid our hard-working and dedicated staff… The introduction of electronic prescribing is not only known to reduce medication errors but also frees up time for staff by moving away from archaic systems.”
The benefits of ePMA systems include:
The reduction in potentially deadly medication errors by up to 50% when compared with the old paper systems.
The creation of a more complete electronic health record.
Dispensers can reduce use of paper, have improved stock control, and provide a more efficient service to patients.
Patients can collect repeat prescriptions from a pharmacy without visiting their GP, and won’t have a paper prescription to lose. In turn, freeing up GP time.
This is a great move to advance the UK’s health system for the benefit of service providers and patients alike.
A research body conducted by university academics from Manchester, Sheffield and York, identified more than 230 million medication errors a year that took place in the NHS. The report also stated that an estimated 712 deaths result from avoidable adverse drug reactions (ADRs). Furthermore, these ADRs could be a contributory factor to between 1,700 and 22,303 deaths a year.
Fiona Campbell, Research Fellow from the University of Sheffield’s School of Health and Related Research, said: “Measuring harm to patients from medication errors is difficult for several reasons, one being that harm can sometimes occur when medicines are used correctly, but now that we have more understanding of the number of errors that occur we have an opportunity to do more to improve NHS systems.”
A personal case in point occurred recently. On a weekend away within the UK, I became aware that I’d forgotten to bring my inhaler with me. Usually, the asthma is not a problem, but there was a lot of heavy walking and a log fire involved which seemed to exacerbate the issue.
Upon attending a local pharmacy I came to an abrupt roadblock as the pharmacist refused to sell me an inhaler over the counter, instead insisting I give her a paper copy of my prescription.
If I didn’t have my inhaler I certainly wasn’t going to have my prescription with me, so I asked if she could make a discretionary judgment as I had no means of providing the prescription and I mentioned the NHS website, which says:
“If you urgently need medication, contact your prescriber immediately to arrange a prescription. If this isn’t possible, you may be able to get medicine from a pharmacist in an emergency, subject to certain conditions.”
This is when she also quoted the NHS website and relayed to me:
“You must have been prescribed the medicine before by a doctor, dentist, nurse independent prescriber, optometrist independent prescriber or other healthcare professional, who is registered in the UK.”
Here was the alleged issue – I had no evidence that I had been prescribed Salbutamol previously, other than knowing what it is and wheezing at her over the counter.
The next step was to call up my home GP and ask them to send evidence of my repeat prescription to the pharmacy. The GP uses a system called EMIS, the Pharmacy I attended used a rival software, TPP. Therefore both could not communicate with each other to verify my need for this inhaler whilst I became more breathless and wheezy as time went on.
The solution to the issue? (although it is perfectly legal for the Pharmacist to make a judgment call on a solitary inhaler to a wheezing patient, they are registered health professionals for a reason you know):
I needed to register with the local medical practice
Meaning I needed to consent to the medical practice obtaining all my previous medical records
To then book an appointment to see the doctor
To then wait another 2 hours to get to see the doctor- taking up her lunch time
To obtain a prescription I already have on repeat
To go back to the pharmacist that turned me away to get an inhaler
The entire process took over 3 hours all the while physically no better off, which proves the point even though anecdotally. The current system is archaic and not in harmony with the times we live. Almost everything is digital – even the local old man I bought wood to build a fence from accepts online purchases and Google Pay.
The utilisation of electronic prescribing will streamline the present health system and save the NHS financially, by limiting cases of litigation as a result of ADRs and wasted appointments at GP practices (inhaler). Patients will benefit by being able to avoid unnecessary trips to their GP and in having quick access to their medication upon a visit to any cooperative pharmacy.
According to the Office for National Statistics (ONS), in 2014, a total of 6,122 suicides were recorded in the UK for people aged 10 and older (10.8 deaths per 100,000 population), with suicide being the leading cause of death among young people aged 20-34 years of age. This equates to approximately one death every two hours, with around 75% of these being male.
Suicide is not a mental illness in itself, but rather a desperate attempt to control the overwhelming symptoms of the underlying mental health disease; making it the ultimate consequence for many mental illnesses. The Adult Psychiatric Morbidity Survey found that young people aged 16–24 were more likely to report suicidal thoughts than any other age group, with females in this age group having the highest levels of suicidal thoughts than any other demographic.
It is easy to rattle off a long list of statistics to prove a point, but there is a greater issue involved here, 72% of people who died from suicide between 2002 and 2012 had not contacted their GP or a healthcare professional about these feelings in the year leading up to the event.
There are a multitude of reasons to why patients are not reaching out for help. Severe depression and anxiety can make simple tasks such as going outside or calling your doctor too difficult. Simple everyday processes become a barrier to accessing help. It may be difficult to get access to a GP or a Doctor they trust, they may lack faith in the system to help them or are poorly informed about the help available, and the general stigma associated with mental health.
Although society and the media is trying very hard to change perceptions of mental health and the stigma associated with it, it remains a part of the problem. Stigma comes from multiple fronts. There is the social stigma inherent in a society, which can be localised due to the demographic disparity. Then there is a self-imposed stigma from the perception of the sufferer, at the possibility of being labelled as perhaps self-absorbed, their symptoms self-inflicted or unimportant. Either way, the fact that stigma exists around mental health compounds the suffering. Sufferers may feel it is a personal weakness or failure on their part, but the reality is that it is a disease that needs treatment and is ultimately not their fault.
If stigma, isolation and lack of availability of help compound the issue, the converse must also be true. People who receive support from caring friends and family, and who have access to mental health services are less likely to act on their impulses, however those impulses manifest.
According to the Care Quality Commission, evidence suggests that the number of children visiting A&E for mental health treatment has more than doubled since 2010. Many services are even failing to meet NHS guidelines for an out-of-hours crisis service.
Dr Nick Waggett, Chief Executive of the Association of Child Psychotherapists commented on the current state of the sector – “We do hear stories of children and young people having to have attempted suicide on a number of occasions actually before they are seen within the service… The problem is that then they’re very ill and it actually becomes increasingly difficult to offer them an effective treatment.”
I started this article to break the ice, stating the worst case scenario, but these points are just facts. Just as it is a fact that mental health is a continuum, the extremes are quite distinct, but the variations in between are gradual. If the number of fatalities represent one extreme, even though so prevalent, there will be so many more who are affected along the scale.
Everyone has mental health and just as everyone has different states of physical fitness, everyone has varying states of mental health. The two should not be thought of as separate since mental health plays a major role in your ability to maintain good physical health. Mental illnesses, such as depression and anxiety for example, affect your ability to participate in healthy behaviors.
Clearly there is a need for mental well-being to have the same prominence as physical well-being. Not to compare mental health disease with physical disease, but to appreciate that they coincide. Clinical depression is an illness that should be treated by a health care professional or a mental health professional, in as much as diabetes, arthritis or hypertension needs treatment.
Since the openness and access to sources of care and support can mitigate the risks associated with mental health issues, especially the prevalence at which these issues affect the young, we should publicise any available resources.
Tom Madders, Director of Communications, Campaigns and Participation at Young Minds, an organisation dedicated to tackling the issues around mental health in youth states- “Most young people spend much of their time online, and it can feel easier for them to communicate through messaging and online services than face-to-face”, this is where services such as Kooth come in. Kooth is a platform which offers online counselling and emotional well-being support for children and young people through a community of peers and a team of experienced counsellors.
It would seem that the use of health apps is an indispensable convenience and even preference which should be more widely adopted by local health organisations, including the greater health and social care system as a whole.
Many services are failing to meet the demands of those in need and the last thing which should happen if they have been able to reach out; is for young people to be rejected from a service they believed could help them. Whether there be a top-down, or bottom-up dissemination of these resources, it doesn’t matter, so long as access is made available. Anyone can download an app.
A helpful summary of available apps to support mental health well-being can be found here:
As the Digital Revolution gave rise to the beginning of the Information Age, the control of data became the defining characteristic in human civilization. Data is everywhere, and informs most of the decisions we make on a daily basis.
This advancement has been progressing at a rapid pace in every aspect of modern day life, except perhaps within the health sector. The need for evidence based technology is so ingrained in NHS culture, that anything new is often viewed with suspicion and cynicism. This leads to a scenario where tradition reigns and innovation effectively plateaus.
Within this sector, medical professionals use data collected from groups of patients to identify issues associated with certain conditions, which is then used to develop more effective treatments and management techniques. Having the right data at the right time (and knowing how to use it), not only improves quality of life, but can save it. It is logical then that barriers are broken down to make way for greater use of data in the health sector.
A step in the right direction is the newly formed ‘HealthTech Advisory Board’. This board is made up of IT experts, clinicians and academics. They will report directly to the Secretary of State for Health and Social Care and its roles will include:
Assisting in policy creation.
Challenging decision making.
Acting as a sounding board for new ideas.
Health Secretary Matt Hancock said: “I want the UK to have the most advanced HealthTech ecosystem in the world. That starts with improving the technology and IT systems in the NHS and creating a culture of innovation so patients can benefit from cutting-edge treatments while reducing the workload of staff… The new future-focused HealthTech Advisory Board will bring together tech experts, clinicians and academics to identify where change needs to happen and be an ideas hub for how we can improve patient outcomes and to make the lives of NHS staff easier.”
Chair of the board Ben Goldacre said: “I am delighted that Matt Hancock has created this board to inject challenge and diverse expertise around better use of data, evidence and technology in healthcare… I hope we can bring positive change for staff and patients, and realise the Tech Vision with a cutting-edge 21st century NHS. Medicine is driven by information: better use of data can revolutionise health care.”
We are unlikely to see an instance of metamorphosis with the NHS becoming a paragon of health and social care given its capacity for change. But we are now in a position to ask the right questions, to evaluate the status quo, and start to break down some of those systematic barriers.
Many will be familiar with the impromptu visit to the local hospital. That anxious rush to arrive at the reception desk to register your arrival with the admin staff on hand, to then need to sit and wait with the other attendees until you are eventually called in for assessment, then after no short while finally on for treatment, transfer or discharge. Or perhaps you have entered the system more subtly, via a referral from your GP to an outpatient appointment.
Either way, this is the most many of us will ever experience of this healthcare juggernaut. To filter through the various departments when the need arises. You will have noticed however the timescales involved between appointments, that oftentimes they seem to take longer than we’d like. This is something we might not appreciate.
A fitting analogy to help us see the overall picture is traffic flow. Each leg of a route can be thought of as an individual ‘process’ in the overall journey. As variations in speed at different legs of a journey can equate to delays, each ‘process’ affects the efficiency of the entire journey as a whole.
Just as the flow of traffic is improved by controlling the variation in the speed of cars and the havoc stop-starting causes in the endless lines of caterpillar-esque traffic, the flow of patients can also be improved by understanding the causes of variations of processes within the healthcare system.
Whole healthcare systems have been analysed: from GP practices, to ambulance services, secondary care, tertiary care, and including social services. This work has shown that improving patient flow across health and social care systems is beneficial to patients and staff alike in many ways, such as: • improving the clinical outcome and experience of patient’s journey. • eliminating waits and delays. • saving time and effort by avoiding duplication of work. • saving money from the cost of overtime, waiting list initiatives, locum and agency fees. • improving the trust of the healthcare organisation.
The need to apply Quality Improvement shouldn’t be viewed as a box ticking exercise either, but rather, as healthcare organisations dedicated to the welfare of the general population and the NHS, they have a responsibility to identify and review these processes with statistical accuracy so improvements can be implemented and audited. That should mean taking into account all the costs related to any process, including the loss of income to a patient attending an appointment and the impact of transport on public health. The inefficiencies of our health system impact on the general health of our society as a whole.
In order to deliver high-quality healthcare, establishments must start to think in terms of value and sustainability; this means the need to identify a balance between cost and outcomes (value) and long-term impacts (sustainability). There is no ‘one-size fits all’ solution to the inefficiencies we encounter in the current healthcare system, but there are innovative solutions to address many of these sticking points; healthcare organisations need to acknowledge these deficiencies honestly and utilise new technologies to advance care for all.
A case in point is whether there is a legitimate need to physically attend a consultation. If there is not, are we not then forcing a one-size fits all solution to a legacy issue without taking advantage of the modern day tools at our disposal?- As Apple’s trademarked slogan goes, “there’s an app for that”.
Outpatient appointments and the sheer number of users flowing through a system may be the bread and butter of many establishments, but the reality is that cost is borne out in more than how taxpayer contributions are expended.