I recently logged on to my GP's office to book an appointment for a routine health check. Arriving at the surgery on the allotted date and time, I checked in using the tablet mounted on the reception desk and then watched the screen until my name came up, summoning me to room 5. So far, so digital - entering the consulting room I was met by an Advanced Nurse Practitioner (ANP), so not a doctor, but certainly not a hologram! The system had applied its rules to my stated need and provided the appropriate healthcare professional, and ensuring the doctors were available to deal with more urgent and clinically complex patients.
Whilst technology is certainly becoming pervasive in our health services, it seems a long way yet from replacing our doctors or other health professionals. We are starting to change attitudes to digital health technology, alongside increasingly available and accessible products and services. It is quite surprising to reflect over the relatively short period of time from 2014 to today, the size of the shift that has taken place towards embracing digital options.
In 2014 the AXA PPP Health Tech & You programme profiled new and emerging technologies that were starting to bring digital into the mainstream of health care and self-care. Finalists and winners were in the main, discrete items of technology or digital services that answered a single or a relatively bounded component of need, e.g. wearable technologies, apps to encourage and support self-care (BrushDJ, Elvie, and EYKOS), and fitness and lifestyle (Nuffield HealthScore). This focus is reflected again in the 2017 winners and finalists, indicating that innovation and development is still significant and flourishing, including: LiveSmart health assessment enabling individuals to understand how healthy they are today so that they make beneficial changes for their future health; Portable food allergen tester; Affinity: enabling people with cancer to monitor their blood cell counts from home; Cellnovo's mobile digital insulin pump; and Memrica Prompt, supporting older people with memory challenges.
However, since the start of the Health Tech & You programme we have seen an exponential growth of digital channels providing access to health advice and services. From early attempts like HealthSpace, built on subsequently by publicly funded NHS initiatives (Patient Online, NHS Choices, NHS111); and other innovators and entrepreneurs (Big White Wall, Sheffield Flourish, Patients Like Me, including AXA PPP Health Tech & You finalists and winners, PsyOmics, Patients' Know Best, and Babybuddy). Such services are now part of the everyday. This coming of age of such online health services is celebrated by the winner of this year's Wow! Award Winner - HealthUnlocked, which as the largest social network for health in the world supports millions of people to improve and maintain their health through online peer support and self-management in over 600 health and wellbeing online communities; becoming activated 'Participatients', in line with the King's Fund metric.
Looking to the next big shift, many point to a more comprehensive and central role for digital technology in the form of Artificial Intelligence (AI), where diagnosis and other services will be delivered by digital minds, not just digital channels (such as IBM's Watson and Google's Deep Mind), rather than human ones. This is outlined in a recent Guardian article, which explored the idea that the "impact of artificial intelligence could be not merely augmenting the pool of medical talent but beginning to replace it"; before coming to the conclusion that there is still a long way to go until we can replace the human doctors, nurses, and other health professionals. However, this discussion is certainly advancing apace and the need is pressing as our publicly funded NHS services creak under the strain and the acknowledgment that there just aren't enough healthcare professionals to go around.
Aligned to this is another anticipated area of significant shift, that of personalised medicine. Underpinned by the linking and analysis of the increasing amounts of digital personal health data from our wearables and apps, in the context of population data and intelligence, and combining it with advances in genome sequencing and the better understanding of how diseases affect different individuals; thus, ultimately enabling lifestyle management and treatment plans to be precisely designed for each individual.
So, whilst we are still some significant distance from the tipping point of entirely digital doctors and other healthcare professionals and services, we continue to make progress in exploiting available technologies and innovations, as showcased and supported by the AXA PPP Health Tech & You Programme over the past three years as it continues the horizon scanning and exploring future possibilities.
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