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  • Victoria Buyer

The challenge of Healthcare Technology utopia in the UK

The never ending conundrum facing our National Health Service (NHS) is how to deliver more efficient treatments, to more patients with greater needs than ever before.

In order to achieve this mammoth task, ourhealth service has to embrace digital change in the way other sectors, for example travel and banking have. Potentially we stand at the edge of a new NHS, version 2.0, with ever more compelling reasons for entrepreneurs and developers to focus on health.

While you are reading this, you mightbe thinking about how rapidly the healthcare technology (healthtec) market has grown and how innovationhas changed our healthcare system in ways that were unimaginable only 5 years ago.

Former London mayor Boris Johnson, launched MedCity in 2014, combining the academic powerhouse universities; Imperial, Kings College London, University College London, Oxford and Cambridge, saying that they had formed “a 'golden triangle' of scientific innovation and we need to channel that intellectual pre-eminence into a positive impact on our economy.”

Sadiq Khan subsequently backed healthcare technology through funded with £1.7 million of European Regional Development Fund (ERDF) monies which is currently helping 32 companies.

So the politicians, academics, investors and the entrepreneurs are all in unison, and we the patients see this as a great sign.

Some of the developments emanating from this collaboration between experts have already benefited the NHS with technology to support therapeutic care, diagnostics, and patient management. Furthermore, a number of innovations have centered around ‘self-care’ and peer support services.

In 2016 the global number of healthtech applications (apps) had reached 259,000 available on all operating systems. Today there are over 59,000 apps on the Apple app store available to customers worldwide, and the trend is only rising. (DKV Global, 2018). These digital health tools cover all areas of human health and administration in both primary and secondary care services. A broad outline of the areas of health management are as below.

A number of heavily funded breakthrough companies, have made inroads into this lucrative market.

Some examples include;

1) Fitbit, the wireless-enabled wearable technology devices that measure fitness data, with$66m funding to date.

2) Babylon Health reports over 10,000 downloads of their online doctor service app and recently raised and additional $60m to further develop and incorporate artificial intelligence into the product.

3) Headspace,the guided meditation app, benefits from $75.2m in funding, 11 million downloads and close to half a million subscribers.

However, many newer entrants into this market will not show a level of profitability in line with that of their original investment forecast.

In my opinion, the real area of focus for policymakers, clinicians and investors now, should be not only to fulfil unmet patient need, but also to make many more businesses succeed.

What is also crucial to recognise is, doctors, caregivers, nurses, and patients have different needs and behaviour patterns and navigating each of these is complex. There are also a number of unintended consequences where there is engagement, for example, when people complete their 10,000 steps often feel they deserve a reward and eat more.

Understanding these behaviours is especially necessary for those healthtech innovators who are slightly bemused that the old adage of ‘build it and they shall come’ has not materialised.

Interpreting the landscape

Healthtech adoption is a waiting game, as many patients will wait until they need a doctor before looking at an app to use.

Hospital management and clinicians will wait until a new technology is proven as effective before considering implementation. Google is 20 years old. Trust takes time to develop, especially when you are making clinical decisions based on the the data from algorithmic symptom checkers.

The significant difference in terms of making an impact in the UK versus any other EU country and the US is, no patient expects or wants to pay for this type of technology.

For good reason too, the NHS delivers fast, free, curative and emergency healthcare. There is no paperwork, healthcare insurance requirements or means testing and is renowned worldwide.

70 years ago Aneurin Bevin created the longest and most enduring social experiment, the UK health system was voted the best when compared to Canada, the US and the EU based on cost, quality and efficiency. (Culzac, 2014)

Unfortunately, the NHS cannot continue to manage this ever-expanding experiment as both the cost of delivery and the ever-increasing life expectancy continue to outstep the public purse.

A suitable way forward is the wide scale adoption of technology to enable the system to be both cost effective and attend to the clinical risks; safety first.

Accelerating implementation

There are some strong barriers to technology uptake within the NHS, in fact I often advise clients to reconsider selling into the health service in the initial phase of their growth, as it will be an elongated process and drain cash flow.

Lack of availability of resource, manifests as a major hurdle to the adoption of technology in three broad ways:

A) Funding to invest in new technology

B) organisational resource (people) necessary for the implementation of the new technology

C) time to invest in adopting the technology

(Liddle, Adshead & Burgess 2008)

In addition, clinical decision makers are sometimes a major obstacle to rapid healthtech adoption.

More has been achieved across the strategic leadership at the Department of Heath, but at a local level there is often an inconsistent approach to roll out of new services.

Clinicians sometimes do not see the benefit of technology when it is fulfilling an administrative, rather than clinical, function.

Many services will have experienced the complexity of an old legacy system being upgraded for a new patient notes system for example. Clinicians’ will bemoan the addition time required to log their patient notes, when the patient care and reporting capability of the new system far out weighs the previous version.

Alongside this clinical scrutiny, the commissioning process is geared towards assessing new technologies on a ‘least cost’ basis. There are few incentives for commissioners to invest in technologies that represent any form of risk such as a longer-term return on investment or those that require change in the care pathway.

A key aspect of digitally mature commissioning will include a greater understanding of the costs involved in delivering these new services such as the patient engagement strategy or the clinical pathway redevelopment.

If the NHS provided information about the digital health tools available across each therapeutic area, as the British National Formulary for the many thousands different drugs the country uses everyday, not only healthtech enhance patient lives but also rapidly be implemented across the the system.

In summary

While we have yet to reach healthtech utopia within the UK, I do believe we are standing inside a healthcare revolution!

Ensure your growth strategy is not solely focused on public health, but also has a strong commercial plan such as private health, care providers, or where relevant direct to the customer.

When selling technologies into the NHS develop an evidence-based business case that demonstrates value in terms that are relevant to the purchasing decision-maker.

Technological adoption occurs most effectively within the NHS when you provide product understanding, clear patient benefits and how to incorporate into existing clinical services.

Consideration developing a system to:

1) spread information through networks, both organised and informal

2) support clinical and patient champions for your new technology

All of the above not only requires differentiating yourself from competitors but also accepting that marketing activity is key. You will need to continually keep your brand at the forefront in the potential buyers’ mind.

Healthtech is still the new frontier and whilst exciting to be part of the change in the way disease and patient care is delivered, business success takes enormous determination, financial planning and a realistic view of the time to develop a “blockbuster”.

Written by Victoria Buyer, where we support digital technologies and enable them to disrupt traditional health and care models.

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