Helen Marsden, founder of consumer blood testing company Medichecks and its new business-to-business arm Plasma by Medichecks, explores how remote testing is spearheading innovation in digital health.
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Medical Technology Concept
Ten or more years ago, when I talked to people about at-home diagnostic testing, it was common for them to say, “why on earth would I want to pay for that, when I can just go to my GP?” But we’re in a very different world today, where remote testing is at the forefront of change and progress in modern healthcare, and new markets for these services are expanding.
Being able to monitor your health or find information in relation to a range of symptoms and concerns without attending a doctor’s surgery, and perhaps without even leaving your own home, is increasingly in demand.
There are several reasons for this change:
- Ten or 20 years ago it was considerably easier to see your GP, but today, with overwhelmed services and less availability, it can be challenging to even get an appointment.
- Many people simply don’t want to “bother the doctor” with what they may consider to be more of a lifestyle related check-up than an acute diagnostic need.
- People are leading increasingly busy lives, which can make finding time to see a GP a chore.
- There has been a gradual acceptance that people can and should take responsibility for their own health.
- People are far more informed about their health than ever before. 1 in 14 Google searches are health related, and people are far more proactive about their health, seeking to prevent disease rather than wait until symptoms appear.
So, it’s easy to understand why there is a growing appetite for personalised information from an accurate and reliable source that can be conveniently obtained on demand.
One million more health checks
It’s a swing that has informed government policy. In June this year, health and social care secretary Steve Barclay announced a new digital health check will be rolled out across England from spring 2024.
It will operate alongside the existing in-person NHS Health Check, with an ambition to deliver an additional one million checks over four years. The hope is that tens of thousands of cases of high blood pressure will be identified, and, through identifying those at risk of high cholesterol or diabetes, hundreds of strokes and heart attacks prevented.
While this sounds promising, our decades of experience in remote blood testing has highlighted challenges that the government will need to navigate if it is to be successful. After all, providing the technological know-how is just one piece of the puzzle. There is a need to design into the process where things many go wrong and have a robust plan to troubleshoot effectively and deliver seamless service delivery in the face of unexpected issues.
The system will need to account for hard-to-reach groups and support a range of languages so that it is truly accessible to all. It will need to be easy and simple to use too. If an individual experiences difficulty using a finger-prick collection kit, or if the sample fails, there needs to be a means in place to deal with that and provide a second test.
Crucially, the government must find an effective way to encourage those people who are not inclined to look after their health, to actually take the tests. Our data indicates that when a test is provided for free, people feel less motivated to do it, whereas even a nominal contribution can inspire people to take part.
But when the motivation is there, remote blood testing can be a hugely successful means of testing a large population quickly. A successful project we completed for the NHS with volunteers completing a finger-prick blood test saw an 83% sample return rate, which should be considered outstanding. This was down to a robust plan with ongoing communication throughout the diagnostics journey. In fact, across three months, more than 250,000 emails were exchanged, with 37,000 kits sent to volunteers. The good news is that 94% of those involved rated their experience of remote blood testing as good or excellent.
A timeline charting demand for diagnostics-as-a-service
A transformation has taken place in remote diagnostic testing in recent years.
Central to this was the development and validation of finger-prick blood testing in December 2011, although it remains a consumer misconception that venous samples are more accurate.
This innovation allowed the possibility for people to carry out a blood test themselves at home, quickly and conveniently. Yet remote diagnostic testing is so much more complex than simply posting a testing kit to a customer and having a UKAS-accredited laboratory to process the sample.
At Medichecks, we were the first direct-to-consumer blood testing company in the UK, having started more than 20 years ago. And over those years, our experience has taught us that ensuring everything goes smoothly requires considerable innovation and support behind the scenes.
We have seen tech companies enter the market only to flounder because they have not understood that complexity of remote capillary blood testing. There are some biomarkers that a GP would routinely test for that simply can’t be performed on a finger-prick sample. And there are others that degrade in the post which can’t be included in a test panel. Human error also accounts for test failure, squeezing your finger so hard it damages the blood cells or just forgetting to attach the sample labels to the tubes. Having systems in place for those occasional yet inevitable situations where the process may not be straightforward is vital, so that each customer gets the service they require and have paid for. That’s why we partner with more than 200 clinics nationwide so if the finger-prick test is not suitable for the customer, blood can be taken by a phlebotomist.
As more health and wellness brands enter the marketplace, the demand for remote testing is increasing. And the range of companies who can see the potential in it is expanding.
From nutritionists to private doctors, fertility clinics to supplement brands, there are many businesses that want to offer testing to their customers either as a product to sell or as an adjunct to their main offering. For example, by using a remote blood test to determine vitamin levels, a supplement brand can offer personalised supplementation plans that will deliver tailored results to their customer, increasing the value of the transaction.
The reality for many businesses is that developing their own remote testing system from scratch is not viable – and there are a whole range of financial, logistical, and regulatory considerations.
These include what do you do if you have a failed sample and need to retest? What if the test produces critical results that mean the customer should attend A&E? What about CE marking and ISO? What checks and balances are in place to reduce sample failure?
And aside from all of that, setting up a diagnostic service can be a massive distraction from the core business of say, a nutritionist or a pharmacy – it’s simply not their speciality.
That’s why Medichecks established Plasma, our direct-to-business arm, so that companies requiring remote diagnostic testing, can commission a ready-made, trusted service. Importantly, Plasma set-up is bespoke with a range of technologies to support organisations, from the nutritionist working alone in their own practice to a large-scale tech company.
The explosion in health and wellbeing businesses presents a considerable opportunity for remote testing, but that does not paint a complete picture. We’re working on niche projects, such as clinical trials and university research studies. While these are currently small scale, they have potential to grow enormously in the coming years, as organisations witness the ease with which they can perform remote diagnostics.
We’re just at the beginning of realising what’s possible in this exciting sector, and the capacity to deliver diagnostics in this way is not only compelling from an innovation standpoint, but it could have a hugely positive impact on the wellbeing of an entire generation, as we strive further towards preventative healthcare.
