"The meeting had ‘buzz’. I went home with new perspectives"

Posted on 1 January 2019 (Permalink)

Andrew Entwistle, carer and public representative for Clinical Research Network West Midlands, University of Warwick UNTRAP - Universities/Users Training and Research Action Partnership blogs about the Health 2.0 West Midlands Inaugural Event

Health 2.0 West Midlands is one of 29 European chapters of Health 2.0 global which promotes cutting-edge innovation to transform and accelerate digital technologies in health care. Digital technologists, health professionals, patients and carers share ideas, skills and experiences to identify opportunities to inform the transition to digital health and social care systems.

Neil Mortimer, Digital Lead for Health 2.0 WM opened the meeting with the ‘why’s’, ‘when’s’ and ‘how’s’ of Health 2.0 WM and facilitated an end-of-meeting workshop on future challenges and take-home messages.

Dr Peter Lewis, consultant psychiatrist and executive medical director Birmingham and Solihull Mental Health NHS Foundation Trust (BSMFT) gave the keynote address titled ‘The Future of Health Care is Digital’. Dr Lewis set the scene by describing the dilemma facing innovators – difficulties of predicting the future, citing the IBM President in 1943 ‘I think there is a world market for about five computers'! What is clear, however, is that ‘today is a time of big advances (in digital health care)’ the main questions being innovation, incubation and marketing/implementation. Advances can be incremental with gradual improvements, or disruptive by transforming old ways into something different – revolutionary change.

Dr Lewis cited four examples of revolutionary change 1) collection of personal data by wearables linked to ‘Big Data’ and health analytics to monitor body activities for early predictions of health change; 2) Avatar psychosis therapy that replaces threatening ‘voices in the head’ by non-hostile digital representation of the therapist’s voice, which then helps to resolve psychotic episodes. 3) the Abilify MyCite digital ingestion tracking system for schizophrenia medication; data from an inbuilt sensor in the pill transmits to a skin patch then via BlueTooth to a smartphone. Data is shared with family and doctors to monitor adherence to prescribed medication; 4) Youthspace, a single point of emotional support and crisis response tool linked to the Silver Linings app for smartphones. This enables young people to build up the knowledge, skills and capabilities to self-manage the behaviours, moods and sleep quality that matter to them personally, thus to manage their care and symptoms and avoid the transition to adult mental health services.

Dr Lewis went on to discuss the Internet of Medical Things (IoMT) an AI system critical to deployment and communication in digital healthcare by increasing accuracy, reliability and productivity of electronic devices in applications such as precision medicine, remote patient monitoring, drug monitoring, and advanced cancer therapy.

Finally, Dr Lewis explained how ‘Nudge Theory, can aid behaviour change to healthier lifestyles.

There followed three presentations by digital health companies starting with Richard Westman of KAIDO, a company that applies digital technology to personalised wellbeing, physical and mental health care. KAIDO is collaborating with the University of Birmingham to incentivise behaviour change to healthy lifestyles, that is, to self-manage our health and reduce demands on the NHS. Factors include physical activity, mental health, nutrition and sleep, all of which lead to sustainable health. The KAIDO wellbeing system has helped people lose weight, increase physical activity, improve sleep and feel fitter, all components of good health.

Westman’s key learning messages were: start simple; start private; prove impact and generate income; don’t delay taking up promising ideas; drive value for the health care system; collaborate with other experts.

Tom Mawka of Proxicon described real-time location systems (RTLS) and Fotoware digital asset management (DAM) software to track equipment, patient activity and safety, environmental monitoring, that apply to hospitals, care homes for the elderly and emergency services. Barriers to resolve were access to patient databases; inadequate/out of date infrastructure and software; and user habits – i.e. behaviour change. Take home messages were: show a benefit; situations differ; obstacles can be overcome; focus on situations of greatest need; keep simple and effective.

Eugene Golubova of the GiveVision company then went on to describe G1 electronic goggles, similar in appearance to those used by scuba divers, that help the visually challenged to see and take an active part in everyday activities and improve quality of life. The G2 version was smaller, more comfortable, looked like glasses, much less obtrusive, hence more acceptable especially to children; and improved morale.

Barriers to marketing were the need not just to convince effectiveness - acuity, contrast sensitivity and patient acceptability but for NICE to demonstrate financial savings, not always easy in early-development stages.

A speakers’ question and answer session started with a PPI member of CLRN WM, they asked if the language of digital technology should be understandable by patients and carers: the speakers’ panel was unanimous in their agreement emphasizing that co-design with patients and carers was critical to identify problems that matter to them and should be involved in further development. Additional questions centred on data security; standardisation of systems in different parts of NHS; the immediate costs of change versus the long-term savings in resources.

The meeting ended with a ‘Topics and Challenges Workshop’ to identify and prioritise ‘Future and Challenges’. Answers included ‘wearables to collect data for analysis’, ‘machine learning for analytics’; ‘lack of standardisation of systems used in different Trusts’; ‘ownership of patient data collected by NHS and private companies’, and ‘data security’.

My take-home messages were that digital technology is already revolutionising health care, enabling things to be done that otherwise could not, making systems faster and leaner and enabling personalised self-management of health.

I came to the meeting thinking that the technicalities might be difficult to understand but found the reverse: technical language was kept to a minimum and easy to understand; the meeting was actively receptive to ideas, with a total absence of silo thinking. The meeting had ‘buzz’. I went home with new perspectives and new learning and agreeing with Dr Lewis’s assertion that ‘The future of Health care is Digital’.

Andrew Entwistle, Lay Carer, CLRN WM, University of Warwick UNTRAP