News
Future healthcare dependant on information sharing
6 June 2008
Robot surgeries, portable electronic records and implanted monitoring
devices are some of the potential developments in future healthcare
technology. These are the views of Quicksilva, an independent UK-based
supplier of systems integration and messaging services to the public
sector.
The company has used its industry knowledge and experience to create
a research report examining the healthcare advances likely to be in
place by 2030. As part of this, Quicksilva has compiled a top-ten list
of trends that the NHS and patients are likely to see by 2030 — many of
which are already being developed and adopted.
Public healthcare in the UK is being driven by the need to match
finite resources against an aging, and less healthy, population that
needs increasingly expensive treatments. By 2030, the European
Commission estimate that Europe will lose 20.8 million people of working
age and will have 34.7 million citizens over 80, compared to 18.8
million today (1).
This overarching trend underpins how healthcare will be structured in
the future with an increasing need for integration, automation and care
outside traditional hospitals. In the UK alone 1.7 million people are
supported by social care services at any given time and fifteen million
people have long-term health needs (2).
“The demographic timebomb facing healthcare provision needs to be
addressed if the NHS vision of treatment free at the point of delivery
is to be maintained,” commented Gayna Hart, managing director,
Quicksilva. “Based on our experience, research and a little crystal ball
gazing, the future will see dramatic changes in how healthcare is
delivered. What is central to all these initiatives is fast, secure
access to patient data across not just the NHS itself, but also shared
with other public sector organisations in the UK and internationally.
The current debate on sharing patient data is therefore critical to the
development of future healthcare.”
The top ten initiatives Quicksilva foresees happening by 2030 are:
1. Automated surgeries
As the Government aims to increase preventative health measures,
traditional surgeries will be augmented by robotised systems that
carry out regular tests for ongoing patient conditions and
automatically prescribe treatments based on test results. These
could be situated in city centres, supermarkets or health clubs to
make them easily accessible and would be open 24 hours per day.
2. Individualised drugs
£100 million pounds (3) is wasted on prescribing drugs that are
never used. Some waste is down to drugs not working with particular
genetic makeups. With more comprehensive patient scanning drugs will
be designed specifically to match individuals, not only cutting cost
but also avoiding potentially fatal side effects. We have already
seen tailored chemotherapy – this is just an extension of the
thinking.
3. Telemedicine
Previously used in developing countries, increasing specialisation
will see telemedicine adopted in the UK. Surgeons will be able to advise
and operate remotely from anywhere in the UK, avoiding the need to
travel for specialist care and mitigating the postcode lottery for some
treatments. The IT industry has first to eradicate any problems with
network latency which delay communications.
4. Information sharing
An increasingly mobile population will demand the ability to access
healthcare globally. IT systems will therefore need to be able to link
up to allow patient data to be made available across not just Europe but
the entire world. The proposed European Spine linking national
healthcare records is the first step in this process.
5. Portable electronic patient
records
Microsoft and Google have already launched online repositories that
allow patients to upload their records to the web in the US (4). UK
adoption will be slower, but demand will grow from patients looking for
increased access and control over their records. These records could be
extended to include digital information, such as video recordings of
operations to protect surgeons from being sued for negligence.
6. Online pharmacies
Unregulated internet-based pharmacies fulfilling private
prescriptions will be replaced by online NHS fulfilment as prescribing
becomes totally electronic, following the NHS Electronic Transmission of
Prescriptions (ETP) initiative. Regular prescriptions will be ordered
online for local delivery by post or through ATM style hole in the wall
depositories that allow 24 hour access.
7. Increased monitoring
Resource issues will mean that there is increased need for Care in
the Community. For example, one in six of all working adults currently
suffers from clinical depression at any one time and mental ill-health
accounts for over a third of all illness in the UK. Previous monitoring
technologies have been unable to ensure that medication is being taken
at the right times. New techniques such as implanted chips that monitor
body changes to ensure patients are taking the correct drugs would
increase safety and reduce the need for hospital visits. The need for
wireless healthcare has been recognised by OFCOM, which recently
launched a consultation paper on the subject (5).
8. Back in time to 'cottage hospitals'
90% of contact with the NHS already takes place outside
hospitals and fear of infection and the need for longer term care will
revive the case for smaller non-acute cottage hospitals, specialising in
recuperation and recovery. Data sharing will support this and enable
economies of scale across multiple sites. This service could be met by
the proposed polyclinics if they were planned to take inpatients.
9. Cleanliness issues with increased technology use
New technology such as handheld scanners and laptops that are moved
around hospitals and are difficult to disinfect will bring further
instruments into contact with patients, increasing the risk of
infection. The ongoing challenge will be met by trials of new systems
indicating where infected patients are sited (6) and by instant
infection tests like those employed in A&Es in Norway.
10. Health as a private–public partnership
The trend of increased outsourcing of services to specialist private
providers will accelerate. For this to actually benefit patients and
deliver joined up care data integration between all systems, whether
private or public will be critical.
“With the current focus on the Connecting for Health programme, there
can be a tendency to ignore what will come next,” concluded Hart. “While
our predictions may not all make it into the real world, healthcare IT
needs to put the building blocks of technology in place now to enable
the patients of the future to receive the best possible care tailored to
their needs.”
A full White Paper on Quicksilva’s views of the changing face of
healthcare can be downloaded from:
www.qxlva.com/upload/file/NHS-ITWhitePaper.pdf
References
1 Source: EU, as quoted in
www.management-issues.com/2006/8/24/
research/demographic-time-bomb-ticking-under-europe.asp
2. Our Health, Our Care, Our Say. Department of Health White Paper,
January 2006
3.
http://ukcommunitypharmacist.blogspot.com/
2007/05/100m-worth-of-drugs-wasted-each-year.html
4.
www.baselinemag.com/c/a/IT-Management/
Google-Microsoft-Take-Health-Care-IT-Pulse/
5. OFCOM — Tomorrow’s Wireless World, May 2008
www.ofcom.org.uk/media/news/2008/05/nr_20080507
6.
www.e-health-insider.com/news/3662/
trust_uses_it_to_help_manage_‘superbugs'
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