Dr Anne Blackwood, chief executive & Joop Tanis, MedTech consulting director, Health Enterprise East, write about the increase in medtech adoption during the pandemic and why it needs to continue.
Two years of the COVID-19 pandemic have bred a revolution in healthcare technology. The necessities of the pandemic have stimulated innovation in accelerating the development, and application, of technology to produce efficient, cost-effective solutions for previously un-met needs in the NHS.
Prior to the pandemic, while the development of innovations in, and applications for, technology across medicine and healthcare was encouraged, routes to mass adoption and integration were slow and turbulent, constraining the health service’s ability to operate to maximum potential.
Prevalent issues such as regulation complexity, devolution and bureaucracy, all meant that, while the willingness to explore innovations in healthtech was widely shared amongst clinicians and healthcare providers, the capacity to integrate and adopt new inventions in a systemic way was always lacking. Urgent necessity, brought about by the pandemic, almost immediately eradicated the steadiness of the status quo, and capacity was created to integrate new technologies in the fastest and most impressive pivot of any industry throughout this time.
As well as the important commendation of the front-line clinicians and healthcare works for their stoicism and the true grit shown throughout this health crisis, accolades must also be given to those administrators, directors and technology providers who enabled the mass integration of new systems and technologies into the leviathan health service throughout the pandemic. The integration occurred at such an incredible pace because central bodies enabled the changes to occur, providing guidance on information governance and fast-track procurement frameworks, for example. Meanwhile, healthcare professionals have responded with agility and innovation as well as a collective iron will, which has enabled them to continue to provide services to patients in the face of adverse circumstances.
The move to technology enabled care provision has noticeably accelerated. Hospitals, primary care providers and care homes have risen to the challenge at the start of the pandemic by reviewing their practises and, where possible, adopted radical changes in the way services are delivered. This was possible due to the thriving nature and number of healthtech innovators and entrepreneurs in the UK. The UK remains a cradle of invention for technological advancements, particularly in the healthcare space and, as such, when the time came for revolution, the tools to facilitate this were largely already present. This was the time to consider technologies that had been available for some time, but the adoption of which had never been as priority in the way that it is now.
Primary care in particular has seen a huge increase in the integration of tele-and digital patient consultation and, in secondary care settings, technologies have also been adopted which are designed to free up space and capacity in acute hospitals, enable remote working and reduce the risk of infection transmission in clinical settings. As the country moves forward, while the complete transition to majority digital and teleconsultation is unlikely, the widespread embracing of these services presents the opportunity to introduce a hybrid model. Alongside consultation, digital tools have also been integrated into the monitoring of chronic and long-term conditions, including the enabling of self-monitoring for certain conditions.
These changes had always been the ambition; “The NHS Long Term Plan” states the aim to introduce a digital first approach to primary care by 2023/4, including the aim to reduce outpatient appointments by a third by 2024 with a focus on reducing the volume of Did Not Attend appointments (DNAs) in particular. The acceleration of these plans demonstrates the capacity of the health service to effectively reduce the existing barriers to mass integration when required, and is a model that should be considered to facilitate unlocking routes to market for tech innovators.
Also, as we continue to move forward, it’s increasingly likely that COVID-19 will move from a pandemic crisis to a manageable endemic status. This will mean that some of the emergency measures that made mass integration of new technologies possible will need to be scaled back and that the necessary delays incurred for many elective and non-urgent care procedures will need to be addressed. According to the BMA, although progress has been made against wait list targets, the total waiting list for procedures across the NHS sits at a record high of 5.98 million and continues to grow. It is, therefore, increasingly likely that as we move forward, technologies and innovations selected for widespread adoption will be prioritised based on their viability for reducing the patient waitlist.
This will open up more opportunities for extending the applications for AI and Machine Learning in particular. There are often two opposing perspectives when it comes to application of these technologies in healthcare; there are those who believe that AI will revolutionise the health industry and, opposingly, there are those who believe that AI and the integration of Machine Learning will damage the sense of person-to-person connection required for the delivery of quality care. The reality is that neither is strictly correct. The trepidation some people have is that AI will overtake the need for critical thinking and assessment from a trained and skilled human practitioner. However, AI technologies require a significant amount of human training before they can begin to function effectively in any context. An AI technology can, for example, accurately tell the difference between two objects, or two sets of data and effectively recognise what it has been taught to recognise. Beyond that the technology reaches its limitations as it is not currently possible to train an AI to understand what it is recognising, or what it is categorising. Therefore, it cannot determine the best next step, or recommend a course of action, from the data it has organised. Human intervention, interpretation and critical reflection is needed at every stage of the process of applying AI technologies to healthcare provision. The current situation, in particular the waiting list backlog, presents a clear opportunity for applications that use AI which can differentiate data and support in the prioritisation of awaited procedures, a process that must now begin in earnest.
Similarly, with all the new data that is being collected by those patients who are successfully self-monitoring, there are opportunities for data analysis of everything being recorded and submitted by patients at source. We understand from our work with clinicians that delivering them more chasms of data to collate and interpret only adds strain to their already stretched capacity. However, the provision of effectively sorted and pre-validated streams of data will help (rather than hinder) with delivering efficiencies in both time and cost to healthcare providers. In this way, digital technologies, and AI in particular, can play an important role in making better use of limited resources, and help increase much needed capacity to deal with the current backlog, and future challenges.
For those apprehensive about the impact of AI and, more broadly, of technology on the care sector, it is important to remember that progress is made by people using technology, by clinicians, by care providers etc – not by the technology alone. However, it remains essential that, as technological applications continue to make progress, continual in-depth evaluation and research is undertaken, to deepen the understanding of the impact the rapid mass integration of technology has had on the experiences of both patients and staff. The time and opportunity to undertake critical reflection on the transformation has so far been lacking and more work is needed to effectively learn from the experience.
To embed the positive achievements from the pandemic and ensure that they are sustainable in the future, adequate funding, infrastructure and the necessary workforce are required. The effects of COVID-19 are going to continue for a long time and, as the NHS resumes routine services, understanding where digital technology can help and add most value is more important than ever.
