Connected health: empowering consumers, reducing costs, building data & insightsBob Gann

Head of Business Development – International, NHS DirectVisiting Professor – Health Informatics, Plymouth UniversityUnited Kingdom

September 2013

M2M Middle East Forum, Dubai

Connected technologies can meet today’s health challenges

Global health challenges

•Inadequate access•Unsustainable costs•Increasing burden of chronic illness•Increasing customer expectations

Connected technologies

•Mobile devices•Cloud computing•Decision support•Social networks•Big data

Impact on health

•Remotely delivered care•Chronic disease management•Peer-to-peer support•Targeted wellness•Personalised care

Significant consumer

demand for connected

healthPeople now manage

bank accounts & travel bookings

online – we can do same for health

records & appointment bookings

Other industries have cut costs &

improved customer experience through digital self-service –

we can provide online consultation

& self management

Millions of online communities, reviews & ratings – we can share experience & insight between clinicians &

patients

Businesses understand their markets – we can build & use big data to

target health communications

Digital first

Opportunities to transform healthcare through:•Telephone & online triage•Remote video consultations•Digital notifications – appointment reminders, test results•Mobile enabled health staff•Connected devices for telehealth

NHS Direct – pioneering multi-channel healthcare

NHS Direct has provided remotely delivered health services, via telephone, web and app, since 1998

Driving down cost while improving quality & access

Ambulance

£250

Accident & Emergency

£100 Minor Injuries

Unit

£70

Out of hours family doctor

£50

In hours family doctor

£36

TelephoneNHS111

£7 - £9per call

Web£0.12

£Cost

Channel: Emergency Urgent GP Telephone Digital

Our goal is to improve access, support patient choice and shift demand to lower cost services, whilst improving quality and maintaining patient safety

Reduce unnecessary referrals – 22%

Teach patients to cope with recurring illness - 15%

Prevent worsening conditions – 3%

Recommend lower cost care - 60%

How digital symptom checkers save costs

In a year…•0.7m ambulance & emergency attendances•1.5m family doctor consultations•0.6m other face-to-face appointments avoided through patients using NHS Direct telephone & digital servicesSaving £148m

NHS Direct symptom checkers: channel shift to self service

NHS Direct has both shifted existing users to lower cost digital channels & reached new audiences who prefer digital

Why are health care interventions delivered over the internet? J Med Internet Res 8(2) e10

Consumers want to use digital health because:

•Cheaper to use•More convenient•Access when needed•More anonymous (reduces stigma)•Increased sense of personal control

Remotely delivered telehealth

Telehealth services enable patients to use connected devices to monitor their own vital signs & communicate these to monitoring centre for review by clinician

Image from www.tunstall.co.uk

Telehealth for 3 million lives

Companies involved: 02 Health, Air Products, BT Health, Care Innovations, Cisco, CSC, Harmoni, Invicta Telecare, Medvivo (formerly Telehealth Solutions), MSD, Peaks & Plains Housing Trust, Pfizer Health Solutions, Philips, Qualcomm Life, Robert Bosch Healthcare, S3 Group, Solutions4Health, Technology Strategy Board, Tunstall Healthcare

In UK government & industry are working together to deliver the benefits of telehealth tothree million people living with long term conditions

Mobile revolution puts health in hands of consumers

• In future, transformation in health will increasingly be led by consumer devices

• 6.8bn mobile subscribers worldwide – 300m in Middle East

• 40,000 health apps - downloaded 40 million times a year

• Wireless health market will reach £60bn by 2018 – with mobile health apps the biggest opportunity

Wireless health market: global trendsMarketsandmarkets.com

Monitoring me

How’s my heart

rate?What’s

my oxygen intake?

How am I

sleeping?

How much

exercise? Am I

eating healthily

?

What’s my blood

sugar level?

How’s my

posture?

“The average person looks at their mobile

phone 150 times a day so it’s ideal for health

monitoring”Dr Eric Topol

Apps for everything

Send pictures of skin conditions for diagnosis

Measure heart rate by pointing at face

Monitor sleep patterns

Save & share health records

Test & map DNA

Increasing numbers of Arabic health apps

Wearable M2M devices

Wristbands monitor activity, synchronising to mobile phone

Wearable, washable baby monitors

Temporary tattoos measure sweat lactate

levels for athletes

Under clothing sensors transmit real-time biometrics to monitoring health professionals

By 2016 sales of wearable health

devices will reach 100m a year

(ABI Research)

Digital pills text doctor to say you’ve taken them

7 out of 10 Americans

monitor their own health

(Pew Research)

Connecting digital devices

• Digital devices provide data output and connect in various ways.

• Some enable wearers to monitor their own readings using a mobile phone and website.

• Some allow data to be downloaded and viewed by third parties such clinicians who are watching trends that merit medical intervention.

• Some devices encourage wearers to share their fitness progress with work-out buddies and friends via social media sites.

Regulating & recommending digital health tools

European Union & US Food & Drug Administration regard some apps as medical devices which need regulation

Doctors are starting to prescribe apps & digital health devices from recommended catalogues

As consumers control their own data they can share with others

Example: PatientsLikeMe

• Patients provide detailed, structured information about their condition & treatment (including symptoms, medication, side effects)

• They can share their experiences with others, including clinicians & other patients

• They can link up with other patients like them

• Builds into voluntary provided, big data for research & clinical trials

Wisdom of crowds: individual consumer experiences combine to build rich data & insight

• In US cities multi-channel 311 service allows citizens to report problems - & services (& other citizens) to respond

• Builds rich knowledge base of citizen concerns

• Now implemented in England as Care Connect

• Twitter knows first – early alert to emerging health problems

Challenges of connected health

• Privacy: security of highly sensitive personal data

• Quality assurance of digital tools & products

• Technical infrastructure

• Business models• Creating

cyberchondria?The Arab digital generation may have more concerns about connected health that UK & US consumers

Connected health recommendations for the Arabdigital generation

Connected digital services can drive significant improvement in quality, access & affordability in health care in the Middle East – with three priority areas

1.Credible, high quality information delivered via web portals & apps to encourage healthy lifestyles2.Improved access through remote consultations & shared health records3.Big data: consistent, large scale data gathering on medicines, patient histories & public health

Digital health information initiatives in Middle East are meeting

challenge

Supporting connected health: locally & globally

Licensing digital symptom checkers to other countries

Providing professional advice

& consultancy

Enabling digital health innovation

locally in UK

Thank you

For more information contact:

Email: bob.gann@nhs.netTwitter: @bob_gann

September 2013