As anyone living in Ireland can testify, the Health sector may sometimes be slow to embrace change, but if the speakers at last month's Dublin Tech Summit are correct, big changes are coming.
And these changes will take place right across Healthcare from hospitals where big data will make treatment more effective, all the way to the GP clinic where MedTech devices may drastically reduce the need for visits to the doctor.
Here in TEKenable we’re interested in what happens to Health because we already work with a number of Health sector clients. To take just two examples, our development team built five national systems for the Health Service Executive (HSE). We also worked for Vodafone to deliver a mobile drug prescribing app for St James's Hospital.
So the Health module of the Tech Summit was a great 'one-stop shop' to hear about the latest global trends with two presenters in particular catching my attention. Both were from America, perhaps not surprising given that the United States spends almost 18% of GDP on Healthcare.
The first, Dr Samir Qamar, has founded a start-up called MedWand. It's building a device to allow doctors examine a patient remotely rather than forcing the patient to visit their doctor.
The other presenter, Laura Craft from Gartner, shared her vision of how MedTech would totally transform Healthcare. She outlined how the Health sector might look ten years from now, using technology either available today or currently being commercialised.
But first, Dr Qamar and why he developed the MedWand.
‘The Patient will see you now’
Samir Qamar is an American doctor, specialising in general practice. His aim is to eliminate the traditional doctor patient consultation. As Dr Qamar says ‘ No one visits their bank anymore – why should they visit their doctor ?
He began by saying that today when a patient feels unwell, he must visit the doctor. That happens because it’s inefficient for the doctor to make house calls.
But as Dr Qamar pointed out, making the patient come to the doctor just pushes this inefficiency over to the patient. If we accept the primary reason the doctor meets the patient is to gather data, then we can find a better approach.
One element is communications. With broadband, doctors can speak to patients over a video link and find out more about their condition. This is already common in the United States, where companies like Teladoc and Doctors on Demand provide telemedicine services.
However Dr Qamar explains, the solution “needs to be more than chat”. For him the patient examination is essential - “If you haven’t been examined you haven’t been to the doctor”.
MedWand – ‘The 21st Century HouseCall’
To bridge the gap, Dr Qamar has developed MedWand, a small portable device that captures most of the data a doctor would traditionally collect from a patient.
MedWand looks like a digital ear thermometer but it’s actually seven devices in one, comprising an otoscope, ophthalmoscope, stethoscope, thermometer, dermatoscope, EKG and pulse oximeter. It also has built-in connectivity, so data can be uploaded to the cloud and accessed by a doctor. Finally, The MedWand works with a variety of Bluetooth-enabled peripherals, like glucometers.
In future as Dr Qamar sees it, the patient will arrange an online appointment, then allow the doctor examine him remotely over the internet. The patient will be free to conduct this online appointment from his home, from the office, even while away on business or on vacation. Over time, Dr Qamar believes the MedWand will drastically reduce the number of patient visits to the GP clinic.
The vision Dr Qamar shared with us is exciting and he’s not the first person to have identified the opportunity for a device like the MedWand.
A well funded Israeli start-up called Tyto Care (it has raised over $18 million since 2012) plans to launch a similar device later this year. It will come in two forms, one aimed at clinicians and costing $900 and another aimed at consumers and costing $300.
But regardless of whether MedWand or TytoCare gets to market first it’s clear that both companies have identified a big opportunity and one where technology can make a major difference.
Naturally, the journey won’t be plain sailing – expect delays in getting FDA approval for example, and expect inertia among medical professionals. However, Dr Qamar’s presentation makes me think solutions like the MedWand will have a big impact over the next decade.
Gartner - ‘Technology will extinguish Primary Health Care’
Laura Craft is a Research Director in Gartner's Healthcare Industries Research group. Among her responsibilities as Research Director, she is involved in producing the ‘Maverick’ series of reports for Gartner, reports that challenge the conventional wisdom and don’t always reflect official thinking at Gartner.
Her presentation was a logical follow-on from Dr Qamar's MedWand session and examined how technology would change the way health services are delivered.
Her central message? First, Primary Care is no longer fit for purpose. Next, advances in technology mean that algorithms will largely replace the human interface. Finally the barriers to making this happen are more of a perception than a reality.
Looking at Primary Care, Laura Craft said that the annual medical examination is not improving health outcomes. Just one piece of evidence – a 2012 study by the Cochrane Institute. Time Magazine quoted the Danish team who carried out the study. ‘From the evidence we’ve seen, inviting patients to general health checks is unlikely to be beneficial,’
The American Medical Association agrees. According to Laura Croft it has told patients ‘only visit the doctor when you think there is something wrong with you’.
Today patient visits to the doctor are using up scare medical resources but Laura Craft believes technology will change the picture. She asked the audience to jump forward ten years and talked us through how two imaginary personas ‘Susan’ and ‘Harry’ would interact with their health care provider.
She also used the video below to explain the 'virtual health assistant' concept.
Not surprisingly technology plays a big part in her vision of the future with devices like the Wize Mirror to detect illness, wearable devices to provide continuous monitoring and transmit health data, even medicine delivered by drone - all co-ordinated through a virtual health assistant or VHA.
Laura Craft emphasised that her vision was not science fiction and that the technology to allow it happen was already here or in development. The Wize Mirror for example, is a EU project that uses 3D scanning, multispectral camera and gas sensor technology to spot the early warning signs of disease and other health problems.
She added that people are also using wearables to monitor their health and that new devices like the MedWand and the Tyco will be available soon.
Overcoming the barriers
Before her vision this becomes reality, Laura Craft said three barriers must be overcome.
The first is the Legal Barrier. Laura believes this will be surmounted soon. That's because it will become malpractice not to use the most suitable technology. As an example she pictured a hospital being prosecuted for not using the best sepsis algorithm.
Next is Regulatory Barriers. She accepts that regulations will slow the pace of progress but doesn’t think this is any more of a challenge than it is for getting innovative drugs approved today.
The last barrier is the Doctor Patient Relationship. Is society ready to let go of this relationship ? According to Laura Craft, it's is already happening.
She quoted a statistic that 25% of people in the United States now have an app to monitor their health. In her opinion it's millenials - already comfortable with technology and expecting convenience - who will be the first to break the link.
So Laura Croft is very optimistic that technology will transform Primary Healthcare. She makes one final point. Health Insurance companies will be just as important as doctors and patients in allowing technology play a greater role, perhaps even more so. However here too she is very optimistic and strongly believes that Insurers will fully back new technology where it can reduce costs.
'Ripe for Disruption'
Nowadays, it's almost a cliche to say that an industry is 'ripe for disruption' but if any sector requires requires major change, it's Health. The scope for technology to make the Health Sector more efficient seems enormous ranging from the digitisation of medical records to the better management of hospital capacity.
Samir Qamar and Laura Craft gave some excellent examples of how technology could improve Primary Care. Here at TEKenable, we're looking forward to seing how new products like the MedWand become mainstream in the next five to ten years.
Whatever the precise outcome, we think big changes are on the way.