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Eight technologies that could change healthcare beyond recognition Eight technologies that could change healthcare beyond recognition
(14 days later)
1. The smartphone1. The smartphone
Although not new, the smartphone’s potential is yet to be realised in health and care. Efforts to curate quality apps, for example through an NHS app library, have had little success. Sophisticated apps can fit into health services. Ginger.io offers people with depression or anxiety problems the ability to track their mood and share data with clinicians to offer interventions.Although not new, the smartphone’s potential is yet to be realised in health and care. Efforts to curate quality apps, for example through an NHS app library, have had little success. Sophisticated apps can fit into health services. Ginger.io offers people with depression or anxiety problems the ability to track their mood and share data with clinicians to offer interventions.
Smartphones can serve as the hub for new diagnostic and treatment technologies. Some people with type 1 diabetes, dissatisfied with medical technology companies’ progress, are driving forward the development of an artificial pancreas.Smartphones can serve as the hub for new diagnostic and treatment technologies. Some people with type 1 diabetes, dissatisfied with medical technology companies’ progress, are driving forward the development of an artificial pancreas.
Their ubiquity also makes them ideal to gather large amounts of data to improve understanding of disease at a population level. BigPD is a project seeking to sign up 100,000 people to track their health and develop new insights into Parkinson’s disease.Their ubiquity also makes them ideal to gather large amounts of data to improve understanding of disease at a population level. BigPD is a project seeking to sign up 100,000 people to track their health and develop new insights into Parkinson’s disease.
2. At-home or portable diagnostics2. At-home or portable diagnostics
Clinicians can bring hospital-level diagnostics to the home through portable x-ray machines, blood-testing kits and other technologies. Patients can use tools like the AliveCOR ECG, embedded in a smartphone case, which helps interpret heart test results via an app and facilitates sharing with clinicians.Clinicians can bring hospital-level diagnostics to the home through portable x-ray machines, blood-testing kits and other technologies. Patients can use tools like the AliveCOR ECG, embedded in a smartphone case, which helps interpret heart test results via an app and facilitates sharing with clinicians.
Some people with disabilities or long-term conditions use assistive devices to help them perform certain tasks or activities. Assisted devices could have embedded sensors capable of gathering data on their use. A tremor spoon is already on the market for use by people with Parkinson’s disease. By incorporating sensors and deploying its data analytic expertise, the aim is to understand how someone’s disease changes over time.Some people with disabilities or long-term conditions use assistive devices to help them perform certain tasks or activities. Assisted devices could have embedded sensors capable of gathering data on their use. A tremor spoon is already on the market for use by people with Parkinson’s disease. By incorporating sensors and deploying its data analytic expertise, the aim is to understand how someone’s disease changes over time.
3. Implantable drug-delivery mechanisms3. Implantable drug-delivery mechanisms
Between a third and a half of all medication prescribed to people with long-term conditions is not taken as recommended. Several technologies in development could enable patients and care professionals to monitor and improve adherence to a prescribed drug regime.Between a third and a half of all medication prescribed to people with long-term conditions is not taken as recommended. Several technologies in development could enable patients and care professionals to monitor and improve adherence to a prescribed drug regime.
There is sensor technology so small it can be swallowed and combined with drugs in pill form. When the pill dissolves in the stomach, the sensor is activated and transmits data via a wearable patch to a smartphone app. Patients and clinicians can see how well they are adhering to their prescription, though it raises important questions about patients’ privacy and autonomy.There is sensor technology so small it can be swallowed and combined with drugs in pill form. When the pill dissolves in the stomach, the sensor is activated and transmits data via a wearable patch to a smartphone app. Patients and clinicians can see how well they are adhering to their prescription, though it raises important questions about patients’ privacy and autonomy.
4. Digital therapy4. Digital therapy
Digital therapeutics are health or social care interventions delivered through a smartphone or a laptop. They embed clinical practice and therapy into a digital form.Digital therapeutics are health or social care interventions delivered through a smartphone or a laptop. They embed clinical practice and therapy into a digital form.
Computerised cognitive behavioural therapy (CBT)Computerised cognitive behavioural therapy (CBT)
A new generation of automated digital therapies has been developed that aims to deliver CBT at scale with better engagement. Sleepio is one example, a six-week tailored programme delivered through the web designed to treat insomnia and help alleviate anxiety and depression. There have been positive early results in randomised controlled trials.A new generation of automated digital therapies has been developed that aims to deliver CBT at scale with better engagement. Sleepio is one example, a six-week tailored programme delivered through the web designed to treat insomnia and help alleviate anxiety and depression. There have been positive early results in randomised controlled trials.
5. Genome sequencing5. Genome sequencing
Advances in genome sequencing and the associated field of genomics will give us better understanding of how diseases affect different individuals. With the genetic profile of a person’s disease and knowledge of their response to treatment, it should be possible to better predict their response to treatment.Advances in genome sequencing and the associated field of genomics will give us better understanding of how diseases affect different individuals. With the genetic profile of a person’s disease and knowledge of their response to treatment, it should be possible to better predict their response to treatment.
Population-level studiesPopulation-level studies
Major projects are underway internationally to understand the relationship between genes and health at a population scale. In the UK, the government is sponsoring the 100,000 Genomes project in England. In the US, one company promises to build a database featuring 1m genomes by 2020 and currently has 20,000 sequenced genomes linked to other data about people’s physical characteristics.Major projects are underway internationally to understand the relationship between genes and health at a population scale. In the UK, the government is sponsoring the 100,000 Genomes project in England. In the US, one company promises to build a database featuring 1m genomes by 2020 and currently has 20,000 sequenced genomes linked to other data about people’s physical characteristics.
6. Artificial intelligence6. Artificial intelligence
Machine learning is a type of artificial intelligence that enables computers to learn without being explicitly programmed, meaning they can teach themselves to change when exposed to new data.Machine learning is a type of artificial intelligence that enables computers to learn without being explicitly programmed, meaning they can teach themselves to change when exposed to new data.
New insights into big datasetsNew insights into big datasets
Several businesses hope to use these techniques to provide diagnostic support. Enlitic, IBM’s Watson division and Google’s Deep Mind have started to explore potential applications in healthcare.Several businesses hope to use these techniques to provide diagnostic support. Enlitic, IBM’s Watson division and Google’s Deep Mind have started to explore potential applications in healthcare.
7. Blockchains7. Blockchains
Blockchains are decentralised databases that keep a record of how data is created and changed over time. Their key feature is they can be trusted as authoritative records without a single, central authority guaranteeing accuracy and security.Blockchains are decentralised databases that keep a record of how data is created and changed over time. Their key feature is they can be trusted as authoritative records without a single, central authority guaranteeing accuracy and security.
Electronic health records are widely used, but they are usually centralised, provided by a small number of suppliers. Some commentators have described how records using blockchain technology would bring benefits like resilience and encourage interoperability, with the patient or clinician given the encryption keys to control who sees the data.Electronic health records are widely used, but they are usually centralised, provided by a small number of suppliers. Some commentators have described how records using blockchain technology would bring benefits like resilience and encourage interoperability, with the patient or clinician given the encryption keys to control who sees the data.
8. Online communities8. Online communities
Social networks like MedHelp, PatientsLikeMe and HealthUnlocked bring together people with interests in health and care to support each other, share learning and even provide a platform for tracking health data, helping people manage their condition and contributing to research.Social networks like MedHelp, PatientsLikeMe and HealthUnlocked bring together people with interests in health and care to support each other, share learning and even provide a platform for tracking health data, helping people manage their condition and contributing to research.
With new technologies like these come new opportunities for our health and care system: improving the accuracy and usefulness of information we can gather on our health as citizens and patients; changing how and where care is delivered; and offering new ways to prevent, predict, detect and treat illness.With new technologies like these come new opportunities for our health and care system: improving the accuracy and usefulness of information we can gather on our health as citizens and patients; changing how and where care is delivered; and offering new ways to prevent, predict, detect and treat illness.
Challenges include how to ensure universal access to the benefits of technologies through the NHS. The system needs to get better at dealing with the great volume of health information these technologies generate.Challenges include how to ensure universal access to the benefits of technologies through the NHS. The system needs to get better at dealing with the great volume of health information these technologies generate.
Matthew Honeyman is a policy researcher at the King’s Fund and Dr Cosima Gretton is an academic foundation doctor at Guy’s and St Thomas’ NHS foundation trust
This is an abridged version of an article that first appeared on kingsfund.org.uk.This is an abridged version of an article that first appeared on kingsfund.org.uk.
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