An ageing society requires AI
Our life expectancy in the UK is now older than the NHS itself. While last month, we celebrated the NHS turning 70, it wasn’t until 1963 that we were expected to live until 70 too. Life expectancy has since buoyed with the average person now expected to live until 81.
While this is a huge triumph for modern science and healthcare, it poses huge pressures for our provision of services. Society is changing, and institutions need to not only respond to, but anticipate change, and that’s a huge ask for one as complex and enormous as the NHS.
While much has been written about why an ageing society is a ticking timebomb for our society and economy – it’s most pertinent in health. Because how do you manage the health of a population that includes millions of people over 100?
It seems the time is right for looking to technology for help. Last month, health secretary Matt Hancock, unveiled a £487m cash injection for technology to help achieve better services and, crucially, cost savings.
The medical sector has already been the testbed for innovation, whether it’s use of 3D printing or surgical robots – but what is missing so far is a change in our focus for how digital can really help the NHS become sustainable and help citizens get better access and quality of care. Because it means shifting our focus from learning from experience to forecasting the future.
Consumers in the UK are crying out for digital in their healthcare, and we are seeing more evidence that people would be open to healthcare coming out of hospitals and into their homes. In our recent survey of 1000 adults in England, the majority of consumers were open to artificial intelligence, virtual clinicians or home-based diagnostics – for example with the use of virtual health coaches and nurses and AI-based clinical services for diagnosing illnesses at home.
But only 13% of consumers have used these kinds of services in England (likely down to lack of availability) – significantly fewer than those who have received virtual care in the U.S. (at 25 percent). While use of virtual care is low, consumers are fundamentally attracted to the benefits of 24-hour availability and the time saved in travel. There is also strong willingness to use it for applications such as medication reminders, healthy activity reminders and daily support for ongoing health issues.
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We are all taking healthcare matters into our own hands, and even in our phones, when we think about it. Consumers are increasingly using a variety of digital self-service tools for managing their health. The use of mobile and tablet health apps has tripled over the past four years, from 13 percent in 2014 to 48 percent today.
Similarly, the use of wearable devices has grown five-fold over the past four years, from just 6 percent in 2014 to 31 percent today. More consumers are turning to health wearables — such as those that monitor glucose, heart rate, physical activity and sleep — and seeing these as beneficial to understanding their health condition and monitoring the health of a loved one. Consumers would also be open to seeing their health information, say on a patient portal, and viewing their electronic health records or prescription medication history.
This increase in the number of devices means a wide range of data will have to be absorbed, analysed and converted into diagnosis and treatment support. Pathology reports will need to be combined with data from wearable sensors, home-based pathology tests, diet and exercise data, and heart rate and blood pressure information.
Based on this data, patients could be warned of necessary lifestyle changes to avoid the onset of chronic conditions, or prevent existing conditions getting worse. And here lies an even better efficiency, there is a huge opportunity for the NHS to use data and digital to prevent illnesses rather than treating them – and consumers are willing to engage with these services.
My firm belief is that the only way we will be able to have a sustainable NHS going forward is through harnessing the power of technology to help to us to be well and stay well, particularly when we think about the challenges an increasingly ageing society will bring.
Many people are avid users of consumer grade technology and, as we can see from the survey, they are very open to bringing this to the clinical setting as well. I don’t envisage a future where consumers turn to robots for their care, but a future where machines can help doctors and healthcare workers in relieving administrative burdens and leaving humans to do what they do best – be human. Doctors, supported by machines, can be even better doctors. But robots on their own can never be doctors.
Patients and machines are joining clinicians to be a collaborative healthcare delivery team and the world seems ready.
Getting ready for cloud data-driven healthcare
As healthcare continues to recognise the value of data and digital transformation, many organisations are relying on the cloud to make their future-forward and data-centric thinking a reality. In fact, the global healthcare cloud computing market was valued at approximately $18 billion and is expected to generate around $61 billion USD by 2025.
At the forefront of these changes is the rapid adoption of cloud-based, or software-as-a-service (SaaS), applications. These apps can be used to handle patient interactions, track prescriptions, care, billing and more, and the insights derived from this important data can vastly improve operations, procurement and courses of treatment. However, before healthcare organisations can begin to dream about a true data-driven future, they have to deal with a data-driven dilemma: compliance.
Meeting regulation requirements
It’s no secret that healthcare is a highly regulated industry when it comes to data and privacy – and rightfully so. Patient records contain extremely sensitive data that, if changed or erased, could cost someone their life. This is why healthcare systems rely on legacy technologies, like Cerner and Epic EHRs, to manage patient information – the industry knows the vendors put an emphasis on making them as secure as possible.
Yet when SaaS applications are introduced and data starts being moved into them, compliance gets complicated. For example, every time a new application is introduced into an organisation, that organisation must have the vendor complete a BAA (Business Associate Agreement). This agreement essentially puts the responsibility for the safety of patients’ information — maintaining appropriate safeguards and complying with regulations — on the vendor.
However, even with these agreements in place, healthcare systems still are at risk of failing to meet compliance requirements. To comply with HIPAA, U.S. Food and Drug Administration 21 CFR Part 11 and other regulations that stipulate the need to exercise best practices to keep electronic patient data safe, healthcare organisations must maintain comprehensive audit trails – something that gets increasingly difficult when data sits in an application that resides in the vendor’s infrastructure.
Additionally, data often does not stay in the applications – instead healthcare users download, save and copy it into other business intelligence tools, creating data sprawl across the organisation and exposing patient privacy to greater risk.
With so many of these tools that are meant to spur growth and more effective care creating compliance challenges, it begs the question: how can healthcare organisations take advantage of the data they have without risking non-compliance?
Yes, healthcare organisations can adhere to regulations while also getting valuable insights from the wealth of data they have available. However, to help do this, organisations must own their data. This means data must be backed up and stored in an environment that they have control over, rather than in the SaaS vendors’ applications.
Backing up historical SaaS application data directly from an app into an organisation’s own secure cloud infrastructure, such as AWS or Microsoft Azure, makes it easier, and less costly, to maintain a digital chain of custody – or a trail of the different touchpoints of data. This not only increases the visibility and auditability of that data, but organisations can then set appropriate controls around who can access the data.
Likewise, having data from these apps located in one central, easily accessible location can decrease the number of copies floating around an organisation, reducing the surface area of exposure while also making it easier for organisations to securely pull data into business intelligence tools.
When healthcare providers have unfettered access to all their historical data, the possibilities for growth and insights are endless. For example, having ownership and ready access to authorised data can help organisations further implement and support outcome-based care. Insights enabled by this data will help inform diagnoses, prescriptions, treatment plans and more, which benefits not only the patient, but the healthcare ecosystem as a whole.
To keep optimising and improving care, healthcare systems must take advantage of new tools like SaaS applications. By backing up and owning their historical SaaS application data, they can do so while minimising the risk to patient privacy or compliance requirements. Having this ownership and access can propel healthcare organisations to be more data-driven – creating better outcomes for everyone.