Yearly round-up of the best interviews. 10 opinions, visions and ideas shared by digital health experts: John Nosta, Lucien Engelen, Vytenis Andriukaitis, Cecilia Bonefeld-Dahl, Brian O’Connor, Francesca Colombo, Bertalan Meskó, George Crooks, Rachel Dunscombe and John Crawford.
John Nosta, Digital Futurist, President of NOSTALAB
Nowadays, progress is so rapid that technologies become outdated even before they become widespread and widely available. The nature of healthcare is quite unique. Whereas introducing a given product on the market is a relatively fast process in other industries, it is burdened with complex and time-consuming regulative procedures in healthcare, which are totally incompatible with the life of technological innovations. Another aspect is society adapting to the changes and accepting them. Medicine deals with the life and health of a human being, so the risks posed by the changes are larger. It’s not a surprise that many doctors are afraid of the innovations because they want to be sure their patients get the best and safest care. So, on the one hand we have the legal regulations and rules of adapting technologies, and, on the other hand, we have human nature and the unique nature of the sector.
Lucien Engelen, Director REshape Center, Radboudumc & Global Strategist Digital Health, Deloitte Center for the Edge
Digital health can also bring efficiency but I think first of all it will bring comfort for people that want to get healthcare in a place where they want to, at the moment they need it and also in the way they wish to have it. Apple, Google, Amazon have an experience in creating a great user interface. And I think that’s exactly broken in healthcare. Healthcare interface is not anymore calibrated with the outside word. Societal recalibration is needed to create a better user-experience. That’s the priority we should focus on, otherwise healthcare will be revolutionized by the companies from the outside like Apple, Amazon or Google.
Vytenis Andriukaitis, European Commissioner for Health and Food Safety
Citizens will not only get access to their personal health data, they will also get a more active role. By using wearables and mobile health apps, they can actively engage in health promotion and self-management of chronic diseases. They can also send feedback and data about their health to their doctors. This can improve the quality of health services and ultimately people’s health and well-being. Moreover, it may help control the rising demand for and improve access to health and care, especially in countries with remote areas or ageing communities.
All this will indeed go together with a reform on how healthcare is organised. We all agree that health systems need to shift from treatment to health promotion and disease prevention. From disease focussed perspective to a focus on well-being and individuals. From a fragmentation of health services to its integration and coordination along the continuum of care.
Cecilia Bonefeld-Dahl, Director General of DIGITALEUROPE
The public health expenses represent about 8.4% of the EU GDP. Not only can digitalisation bring down operational costs, but these funds could be spent for preventive and predictive care solutions based on AI and other technologies. Digital solutions can reduce the administrative burdens, remove waste in public spending, analyse and process extremely large amounts of data to identify health risks and accelerate the creation of cure for life threatening diseases.
It also opens new opportunities for people with disabilities and for our most senior citizens to remain active and included in society through important communication technologies. In addition, the development of drugs or therapies using genomics can be researched at greater speed for a fraction of the cost. Finally, it also provides citizens control over their health information, access prescriptions around the world and create a wide range of opportunities for people to improve their lifestyles. There is an urgent need that the design of health systems should be done closely with patients and health professionals. Both must have a say in ensuring that healthcare remains relevant, easy to use and valuable.
Brian O’Connor, Chair at European Connected Health Alliance
Every new technology is greeted with concerns and worries. That is understandable and those concerns should be listened to and addressed. However, the consumer make choices every day about risks and rewards, crossing a road, flying, driving a car, using a smartphone etc. We do our best to understand the risks and weigh them against the benefits and overall we are pretty good at it. When I hear people pointing out the “problems“ with AI I always ask, what do you suggest?
Ban the use of it? Too late.
Surround it with regulation and good practice? Of course, but don’t stop something which is already doing much good.
Leaving aside the technology, it is said AI will never replace clinicians. I agree, but what it will do is take routine tasks, about 80% of doctors’ work and allow them more time to spend with their patients. It is always easier to recite the possible problems than implement solutions.
Francesca Colombo, Head of OECD Health Division
Clinical and patient data have huge potential for improving health system performance, research and patient care. Better linkage across different datasets has the potential to create new learning, knowledge and intelligence. The promise of precision medicine, for example, will never be realised unless a range of datasets are routinely linked for analysis. Breakthroughs in such difficult areas as dementia can be encouraged by better linkages across clinical, epidemiological and other datasets. There is potential to bring in ‘outside’ data as well, such as that collected from individual digital applications and activity trackers. The challenge, of course, is to make this secure (ensure privacy) and frictionless (interoperability and common standards across digital platforms) – but this is both possible and within reach.
Bertalan Meskó, Director of The Medical Futurist Institute
The only great examples of digital health adoption I have seen were those that involved people dedicated enough to push this through their over-regulated, conservative system. Either this happens, or patients have to find their own way. Policy-makers, medical professionals and basically every responsible person should contemplate the possible responses to pressing ethical questions and the challenges that digital health presents. As the waves of different technologies are already flooding patients, the faster the appropriate answers come from the regulatory side then the better it will be for the whole of society. The reluctance and lack of incentives for physicians as well as policy-makers in this cultural transformation make patients the leading driving forces in initiating change.
George Crooks, CEO, Digital Health and Care Institute Scotland
So what are the conditions that make it more favourable for technology solutions to be successful in health and care? Doctors and nurses are looking for solutions that are easy to use, fit in well with existing clinical processes, do not interfere with the interaction with the patient, make the job easier by reducing workload, support decision making and reduce clinical and personal risk. To do all of these things there requires to be significant time and effort spent on co-design. This is often less about the generic product but how the service wrap around is developed to support an informed redesign rather than dictating the working practices of staff.
Technology enabled care will transform how we deliver significant parts of our health and care activities. However, this agenda is NOT about replacing doctors, nurses or carers with pieces of technology. We should NOT simply use a digital solution because it is available. We need to use these technologies appropriately and redesign our services accordingly. The most valuable resource any health or care system has is the people who deliver those services and technology can support them to ensure that when any of us needs to see a health or care professional we have ready access to that person.
Rachel Dunscombe, CEO, NHS Digital Academy
AI can help us to automate the simple tasks allowing our clinicians and professions to work at the top of their license. It will free up time by giving our doctors and nurses everything they need to know in one view. This allows the clinical workforce to spend more time with the patient – listening, communicating and working with empathy. We use AI to route our nurses so they spend less time driving and more time in the patients home. This improves care and experience. My view is that we must proceed with appropriate governance but it is our duty of care to use AI as this saves lives, improves lives and makes healthcare more efficient.
John Crawford, European Healthcare Industry Leader – IBM
AI is already being used in healthcare, and its use is likely to accelerate fastest in areas where the AI solutions are at least as good as the alternatives, but provide faster access and more convenience. Certainly in areas such as improving health literacy, symptom checking, and the rapid analysis of medical images, it will become common in the next few years. It will take longer to find its way into clinical pathways, but when it does, it will transform the ability of doctors to speedily make the most accurate diagnosis and best treatment decisions – precision medicine will become a reality.
The biggest challenge remains the availability of a sufficient quantity and quality of data, to train AI systems, and to allow them to continuously improve. There is also insufficient independent evidence of the effectiveness and safety of AI solutions, but this will surely develop faster over the next few years. To gain the support of the medical profession, transparency is also important. It must be possible to understand why AI systems have produced their recommendations, and to look at the evidence behind them. Finally, it is vital that AI is deployed in such a way that it does not replace human contact and judgement, especially where complex needs have to be assessed, or decisions made about treatment plans.