Two years on: Can medtech innovation extend healthcare beyond the hospital?

We’ve just passed the second anniversary of the UK's national lockdown which began on the 23rd of March 2020. Two years on, healthcare professionals are reflecting on the Government's Living with COVID plan that’s set to define how we enter this new phase of the pandemic.

Interestingly, the plan emphasises the need for remote healthcare, underpinned by innovative models of care like Virtual Wards to be prepared for further resurgences and new variants. In fact, the NHS operational planning guidance sets out that, “by December 2023, systems should complete the comprehensive development of virtual wards towards a national ambition of 40 to 50 virtual beds per 100,000 population.” 

This would also help drive down wait times, improve access to clinicians by expanding the way healthcare is delivered and finally, create efficiencies for time-poor clinicians themselves who need to achieve more with limited staff. At the same time, the digital health landscape is evolving to make this possible. 

But how much closer are we to this reality? In this interview with Jon Payne, manager of sales, engineering and education, InterSystems, Ian Bolland asks whether the pandemic, the rise of medtech innovation and this guidance from the government represent the perfect storm to extend healthcare beyond acute hospital settings. 

Looking back at the last two years, what changes have you seen in the digital health landscape? 

It's interesting to reflect on how much has changed over the last two years, and it is clear to say the digital health landscape has not been left behind amid the widespread adoption of digital technology. One of the changes I have observed has undoubtedly been the shift towards using new and emerging technologies to achieve more efficient working methods. For example, AI and machine learning (ML) are increasingly being used by healthcare professionals to reduce risk and address a huge backlog of patients awaiting treatment because of the pandemic. For example, to reduce the staggering 15 million GP appointments that go to waste yearly, some healthcare professionals are exploring the use of ML to overbook appointments, in the same way airlines overbook flights intelligently. These systems read and learn from patient data to determine who is likely to miss their appointment, enabling practices to overbook and see someone else if a patient is a no show. This is just one example of the new and intelligent ways technology is being embedded in day-to-day healthcare operations.

More broadly, in 2019, the NHS Long Term Plan outlined the ambition to improve digital transformation efforts, recognising the potential of connected systems to optimise healthcare in an increasingly digital world. The vision was to enable greater access and transfers of data across care settings to give providers the relevant data to improve the agility and quality of care. It is evident that the pandemic has facilitated more integrated and efficient care, and I've certainly seen a lot of evidence of this as part of the work we do with NHS trusts across the UK. Looking into the future, Sajid Javid's recent ambition for 90% of NHS trusts to have an EPR by December 2023 is also likely to play a key role in transforming and accelerating transformation across the healthcare sector.

I think this is just the beginning of a long digital transformation journey in the healthcare sector, and I am excited to see what the future holds.

What do you think about the Government's Living with COVID plan, and what challenges will this present for healthcare?

Over the last two years, our personal and professional lives have been transformed by COVID, and it is a welcome development to see the Government lay out a plan for this next phase of recovery. 

I am pleased to see remote healthcare technology cited as one of the many ways the healthcare sector coped with the overwhelming number of hospital patients during the pandemic, with the plan pointing to virtual wards and other forms of remote healthcare technology as crucial ways the UK will be able to 'Live with COVID. For example, during the pandemic, clinicians used virtual wards to remotely monitor COVID-19 and non-COVID-19 patients while conveniently communicating with them at home rather than in the hospital. Virtual ward technologies can include apps, technology platforms, wearables, and medical devices such as pulse oximeters.

It would have been even better to see more guidance on the broader role technology could play in assisting people to get back to their everyday lives, particularly in the face of various ‘waves’ of infections impacting NHS demand. COVID-19 continues to pose a public health risk, and the ease of restrictions can potentially increase the number of hospital patients. This will only add to the existing backlog of hospital patients and create longer waiting times. 

How can medtech innovations support trusts in delivering on the Government's plan? 

Medtech innovation can support the Government's plan through a range of solutions. For example, telemedicine plays a significant role in managing healthcare demand amid the pandemic. According to McKinsey, overall telehealth use for office visits and outpatient care was 78 times higher in April 2020 than February 2020. The widespread adoption of Telehealth in Trusts can enable greater and safer access to healthcare, supporting the Government's plan by significantly reducing the number of patients in the hospital.

Telemedicine enables patients to continue to receive treatment from healthcare providers, even remotely, while in lockdown or isolation. Beyond things like virtual GP appointments, telemedicine can also encompass, for example, technologies that allow patients to be safely monitored in their home environment, using remote health solutions that provide care teams with relevant and real-time data.

For example, medtech innovations can assist with managing long COVID symptoms and other impactful long-term conditions such as Multiple sclerosis (MS). In this case, telemedicine can monitor and measure people's progress at home. Over time, these solutions can go on to improve the value of data collection for the population's health, where the population can gain significant knowledge from better monitoring, information collection, and applying AI to identify others who may benefit from a change in the way their condition is managed. Or even where some manner of early direct intervention may be appropriate.

Sajid Javid has recently announced the Government's plan to roll out electronic patient records by 2023 to 90% of trusts in England. How will this help foster further medtech innovation?

Electronic Patient Records (EPR) allow trusts to exchange health information electronically and provide higher quality care with unified information. The benefits of EPRs for the health sector is limitless and involves providing accurate, up-to-date, and complete information about patients at the point of care, securely sharing electronic information with patients and other clinicians and reducing costs and environmental impact through decreased paperwork. 

EPRs can help foster medtech Innovation by providing a clean database for remote consultations, enabling trusts to deliver more care in the community. This paperless system also reduces the patients' carbon footprint by discouraging paper use when filing out clinical records. EPRs further provide clinicians with coordinated information which enables access care records on urgent situations. For Instance, Coordinate My Care, is an online service that allows people with long-term conditions in London to share their notes and wishes electronically with all NHS services, including ambulance staff, in real time. This database contains information about where they keep their medicines, or who to contact in an emergency, the full knowledge of a patients care record only leads to better outcomes for both the patient and their healthcare professional. 

Reflecting on this new phase of the pandemic – and as we all learn to live with COVID – will we see healthcare offered in new ways and settings?

Definitely! Healthcare is already being offered in new ways through remote technology. Reflecting on the last two years, COVID made us realise that there is no reason patients should not be able to access healthcare where and when they need it. Interoperability has played an instrumental role in helping thousands of healthcare professionals’ access and securely share medical records, enabling them to act decisively from any part of the world. Suppose we can embed interoperability into the very fabric of our NHS. In that case, we could facilitate a more integrated care system where care is being offered in new ways and settings beyond the hospital's four walls.