Anne Blackwood, chief executive of Health Enterprise East, explains how using existing technologies or not yet adopted innovations can transform our healthcare.
As healthcare systems, we can be guilty of ‘re-inventing the wheel’ or designing what we believe to bespoke solutions, when in fact the technology we need already exists. This is due to a number of possible reasons - perhaps we either are not aware of what is already on the market, we do not have a good way of evaluating existing technologies, or we simply believe we can build a better mousetrap that fits our exact requirements. The latter approach can set us off on a costly and time-consuming exercise when a fully customisable off-the-shelf solution would work much better.
The global mHealth apps market, projected to be worth over $110 billion by 2025, continues to grow as adoption for mHealth apps tracking both health and vital signs expands further, partly thanks to social distancing measures brought in to control COVID-19. Whether for tracking patient data, enhancing patient education or providing diagnostic and treatment decision making, support mobile apps are here to stay, with a recent report showing that there are now over 165,000 mobile health apps available to download to mobile or tablet devices.
As a doctor or medical professional faced with prescribing a mobile app to help improve patient outcomes however, how do you approach selecting the right platform when many of these digital health tools have not gone through the same kind of rigorous testing and evaluation that other medical devices do?
The NHS has responded to this by creating an NHS Apps Library, where health apps and digital tools are assessed against a set of consistent national standards before being accepted into the Library. This ensures that only safe and secure apps that pass a combined assessment of technical stability, interoperability, usability and accessibility, data protection, clinical safety and some evidence of outcomes are published on the Library.
The NHS Apps Library provides the confidence commissioners need to prescribe solutions already on market that will help improve outcomes, support care pathways and provide an efficient and safe method of communication between patients and healthcare professionals. There are currently over 90 apps and digital tools in the library, covering everything from cancer to pregnancy and mental health.
So, are there equivalent initiatives for medical devices? To some extent, this is covered by the National Institute for Health and Care Excellence (NICE) medical technologies guidance that reviews new medical devices for adoption in the NHS. However, many small medtech companies struggle to generate the evidence required for a full NICE assessment and ‘lighter touch’ reviews are still in demand.
Sometimes, in our search for rapid solutions to new and dangerous threats such as COVID-19 help is already at hand. For example, recent clinical trials found that patients treated with steroids were found to recover quicker compared with patients who were not. The RECOVERY trial, which showcased the UK’s strengths in scientific and clinical collaboration, investigated dexamethasone, a cheap and widely available steroid, and reported to have cut deaths by a third among hospital patients who need ventilation and by a fifth among patients receiving oxygen only. Whilst not a cure, it provided a treatment option in the fight against the virus at a time when clinicians had no specific treatment choices available.
Recently, the success of the government’s Ventilator Challenge, to ensure the UK had sufficient stock of ventilators to deal with the surge in demand from COVID-19 patients, demonstrated the ability of industry and clinicians to come together and produce rapid prototypes based on designs which utilised parts already widely available in the NHS supply chain. Such invention, created from necessity, requires collaboration not just from engineers and doctors, but also from regulators, so these technologies can be safely accelerated through to market and save lives.
To respond to today’s pandemic, and tomorrow’s crises, we would do well to consider what we can already procure, evaluate or repurpose to provide affordable, rapid solutions for transforming our healthcare systems.
