Ben Heubl is a digital health advocate, activist and journalist for Health 2.0 innovations. He is a speaker at various healthcare innovation events, a TEDMED delegate, founder of the not-for-profit organisation Health 2.0 Copenhagen, Mentor at the HealthXL accelerator, and supporter of the crowdfunding organisation Medstartr. He was a keynote speaker for JPC’s client: Imperial College London’s Invent the Future Make-a-thon Workshop Series. We had the pleasure of interviewing Ben today on the future of technology in healthcare.
What are your views on Telehealth and Telecare? (Editor’s note: Telehealth is the delivery of health-related services and information via telecommunications technologies. Telehealth could be as simple as two health professionals discussing a case over the telephone or as sophisticated as doing robotic surgery between facilities at different ends of the globe. Telecare is the term for offering remote care of elderly and physically less able people, providing the care and reassurance needed to allow them to remain living in their own homes. It provides a range of assisted technologies such as sensors and alarms in the home, which monitor activity changes over time.)
I love these questions! Telehealth and Telecare are like asking me about my view on smartphones for communication. Technology for communication is everywhere now, no point arguing the value of such. I predict, this won’t be different for Telehealth and Telecare technologies. I think what I want to say is that the value does not come from the tech innovation part alone, as least it is not the defining factor to make a judgement. The critical question is not: “Will technology work, e.g. will Telehealth and Telecare work?” The question should be: “What can Telehealth and Telecare do for us that everyone on the table recognises the value for accessible healthcare, and how can we integrate tech into our culture in order to experience the value?” As Telecare uses alarms, sensors and other equipment to help people live independently for longer, particularly those who require a combination of social care or health services, Telehealth is aimed at supporting people typically with long term health issues to monitor and manage their own condition.
Fact is, we need some help. The number of primary care consultations increased significantly over the last 15 years (here). Across all acute trusts in the UK, there is a year-on-year increase in A&E attendances, including millions of unplanned admissions and systems plagued by physician shortages. The biggest two barriers of Telehealth and Telecare adoption are, both in Europe and globally, cost and legal barriers. We need to make things cheaper and we need to be quicker in approving, setting up such programmes using Telehealth and Telecare, educating the public and scaling.
What do you think the impact of these will be for patients and healthcare organizations going forward?
I am a big fan of Malcom Gladwell who once expressed his view on health innovation and adoption (here). He mentioned that even the greatest ideas in the world often had a very difficult time to make it into the marketplace. The reason is, Gladwell explains, they require a second step to be accepted. “Such ideas must be presented or framed to the public in an appropriate way”. It links back to our culture and how innovators must approach adoption. One example Gladwell mentioned is the adoption of seat-belts and how difficult it was to convince the US citizens to use them. Once the messages were changed and the right advocates identified (children had to start wearing them), adoption was successful. The same is happening for Telehealth and Telecare I believe, and healthcare organisations need to change their approach. There is no doubt that such technologies and its monitoring features are of indisputable value for patients, carers and healthcare professionals. The problem is still to frame it to the public in an appropriate way that they get it. What most people understand is for example the value of Skype for communication online. You can video chat and talk. Healthcare organisations now need to make sure that the message and the understanding for Telehealth and Telecare is framed in a similar way. It needs to become a no-brainer for people to adopt or recommend it. Funny is that the UK (here) just announced to allow GPs to talk to patients by email and Skype. Or here in the US, where Telemedicine has been spurred in part by the Affordable Care Act. No matter where you go, this is finally happening, real and starting to become main stream. Former Apple CEO John Scully just invested in a Telehealth company (MDLive), and mentioned in a statement that MDLive’s service is expected to increase 10 times in the number of patient visits this year”. It shows how real the commercial opportunity for this sector is.
I worked with a Telemedicine pilot myself, in Copenhagen Denmark. One significant soft aspect of Telemedicine (next to academic metrics like admissions and mortality rates) was that if chronic disease patients, as for instance for COPD, are made aware that they have unlimited access to care and immediate help 24/7, via reliable technology, they would start to feel much safer. This would add incredible value to their quality of life. This kind of security would help people to calm down and to live better lives by knowing that help is within reach and their status is being watched. That is where technology makes a considerable difference in how it feels. And how it feels is so important to the public and patients when it comes to adoption. People are much more receptive to these soft factors, and less interested in how efficient the technology is in reducing admissions.
The other problem is that old and less tech savvy people are not the early-adopters target group for Telehealth and Telecare equipment. If, for new innovation, there is hardly any first mover target group it is really difficult to introduce innovation and scale it, as the first movers will convince the second movers to adopt. However, I see that care providers become more tech savvy and that there is clearly a consumer demand by care providers. If I had something to monitor and help my grandmother to live in an easier and more independent way, the cost for such equipment would be secondary, a no-brainer. What matters is how she feels using it.
A good example how innovators can do it right is the company Speakset. It transforms granny’s television into a communication tool to chat to carers and doctors. Most old people spend so much time in front of the telly anyway. Speakset comes in with an interface senior citizens understand.
What are your thoughts around the proposals to electronically share patient data across care communities?
Again, we should ask, what can data sharing do for us? I believe it is a good idea, as long as there are safeguards and it is done with patient consent. The biggest challenge will be access, designing and building a system which can be accessed electronically across care communities. This can be a complex task. You need to take into account different computer systems, layers of security, single user vs. multiple users, read only vs. updating records etc.
However, I think we will overcome these challenges. For example, BT already has an interoperability system that will join together all the different IT systems and allow them to talk to each other. Even if privacy is still of many people’s concern, a working health and social care system is already dependent on data access. I predict it is only a matter of time that opportunities will outperform the weaknesses.
How could the NHS have handled this better in terms of keeping the public informed in light of the recent backlash in the press?
The care.data backlash in the press was unfortunate due to the previous six months of NSA spying, wiki leaks stories, hackers stealing customer data and so on. The care.data story seemed to come at the end of a long list of stories which lowered the public’s confidence in data protection and the safety of confidential information.
What are the biggest 2-3 challenges faced by the healthcare sector over the next 3-5 years and where do you see technology playing a role in helping this?
The biggest challenges I have identified are access-to-care, the increasing older population, managing the rise in obesity and diabetes and education of medical professionals. I see great opportunities in these challenges, so let’s break it down.
I predict that for our senior citizens, complex technology interfaces will have to move further into the background. I agree with the statement of Richard Smith, ex-editor of the BMJ and professor at Imperial College London who said that we now live in a world where people don’t have one problem but multiple problems and that electronic health records are among essential tools for managing modern health challenges. This will continue to be the case, but technology for communication will become as easy as using the remote control on a TV.
Second, missed appointments costs the NHS hundreds of millions of pounds every year. Improving access to the systems operating appointment scheduling will help reduce the number of no-shows and last minute cancellations. Companies like Zesty have already started to invade our daily lives because of its simplicity, convenience and value for all generations which accessing the web for healthcare. Millions of people are already researching health conditions online. I agree with Jonathan Care-Brown, Managing director of NHS Choices, who says that patients need to be offered actions to access care after they’ve researched treatments or medical conditions online. Innovators will be the ones providing these technologies in the coming years.
Thirdly, technology can help share insights and learning in real time, big issues like the treatment of diabetes can be better understood with access to clinical trial data, patients’ progress over time, effects of changes in diet, weight or stress levels. Technology has the potential to “glue together” a lot of progress and data currently operating independently of each other. Crowdsourcing and healthcare online social networks such as SmartPatients, PatientsLikeMe or Vitanect, have the fundamental power to transform healthcare. And they are doing it as we speak.
Technology can empower the patient to take more interest and control of their health. We have seen the power technology has in improving other industries such as travel, retail and financial services. Let’s continue to raise awareness of what tech can do for healthcare!
Follow Ben on Twitter @benheubl
Interview with Ben Heubl is part of many inspirational features of the JPC “Thought Leadership Interview” series, where we reach into our extensive network of thinkers, doers, future gazers, business leaders, book authors, innovators and experts who are first in their fields to share their insights, wisdom, and game-changing perspectives on the world we live in today.