Following the NHS ConfedExpo last month, Health Tech World hears from a Google Health panellist about how technology can bridge the gap in healthcare access, drive patient satisfaction and build user confidence.
As the NHS approaches its 75th anniversary, Google Health and the NHS Confederation released a collaborative report delving into the relationship between technology and patient empowerment in healthcare.
The report’s findings shed light on the enormous challenges faced by the NHS as well as the potential of technology to transform healthcare delivery and enable patients to take control of their health.
The key findings of the report formed a large part of the discussions at the NHS ConfedExpo in Manchester earlier this month.
Tailoring technologies to individuals’ needs, ensuring inclusive access and promoting digital literacy were just some areas of focus that were highlighted as vital steps towards shaping a patient-centric future.
Speaking on a Google Health panel at the Expo was Jonathan Abraham, CEO of the AI-powered patient management system, Healum.
Abraham described the tone of the conference as “generally optimistic”.
Although, depending on the panel session, the atmosphere could switch from utopian to despondent.
“In one [panel], you have an impending sense of immortality and utopia, and in the other, you have an impending sense of doom,” Abraham said over Zoom.
“I tend to choose the panels that have real forward thinkers and thought leaders who are looking at the way forward.
“Overall, I think there’s a lot of optimism in the next five years or so.
“I think when we look back, we’ll say, once we got the plumbing fixed and the data interoperability, loads of great things happened [in that time].”
Addressing disparities in digital health
While the report highlights a significant rise in digital health adoption among patients, there are disparities in its usage.
This is particularly apparent between people of different age groups and socio-economic status.
Adopting new technologies can often be a source of apprehension for some, leading to a lack of confidence in embracing digital tools.
The report reveals that older individuals tend to rely more on healthcare professionals, showing lower engagement with digital tools.
This discrepancy raises concerns about the digital exclusion of older adults.
In addition to age and socio-economic factors, the report reveals that education also plays a significant role.
Patients with higher levels of education tend to be more engaged with digital health tools and exhibit a greater sense of empowerment.
The report stresses the importance of digital pathways being designed to accommodate patients with low confidence in technology.
The key to this will be combining technology with personalised connections to healthcare professionals.
Part of this, Abrahams said, is about building trust between patients and clinicians while also offering alternatives to people who are reluctant to use digital tools.
“There are going to be people who never want any of that stuff,” Abraham said.
“They’re going to need a lot more face-to-face work.
“How we can support systems and solutions for teams that are caring for those people is an important question. It’s definitely about being really clear on segmenting who needs what.”
In the case of Healum, some patients on the platform are not interested in its digital care platform, favouring in-person care and paper-based support.
Abraham continued: “Even if there’s a cohort of people that don’t want to be served digitally, there are other ways that the system that you’re developing can better understand people’s data and provide them with more relevant, useful services and interventions that are relevant for their care.
“[You] can ensure that that’s delivered to them in a method that they want, like personalised letters and personalised printouts.
“There are many other ways that you can look at delivering healthcare that is not through a laptop, a video call or on a smartphone.”
The road to building user confidence
Understanding the reasons behind limited technology usage, such as a lack of trust, will be crucial in addressing disparities.
Participants in the report expressed a preference for healthcare professionals endorsing their actions and the tools they use.
Although most people currently utilise some form of health technology, their confidence in using these tools is limited, in part due to a lack of guidance from clinicians.
“This was one of the questions that came up [in the panel discussion],” Abraham said.
“It was around the role of healthcare professionals engendering trust amongst their patients around which digital tools are useful.”
Healthcare professionals play a critical role in endorsing and validating these tools, but for Abraham, this should start with the developer rather than the clinician.
If developers are to instil confidence in their product among users,ne they must first build trust with healthcare professionals.
To achieve this, adhering to standards, conducting continuous research and providing evidence of the product’s benefits will all come into play.
“As a company, we have taken the long-term view,” Abraham said.
“We make sure that we adhere to all of those standards, ensuring that when we look at the NICE evidence standards framework for digital health technologies, we have an appropriate research and development roadmap, specifically so we can give those health care professionals trust.
“If you’re committed to providing that confidence to healthcare professionals, you always have to engage in research.
“There is probably, in the UK, a sub-selection of 50 to 100 companies or so that really take that seriously.
“And then there are thousands of others who don’t often have access to the necessary funding and the time and patience to do that work.”
Driving patient satisfaction
Confidence is not the only issue when it comes to the uptake of technology.
According to the NHS Confederation report, a significant number of people, especially those with long-term conditions, currently use health technologies and express a willingness to embrace them.
However, it also indicates that overall satisfaction with existing technologies remains moderate, with only half of the respondents expressing contentment.
“Our perspective has been that, actually, people expect to be able to have high-quality digital services, to be able to access their records and to be able to manage their health in collaboration with healthcare professionals,” Abraham said.
“The expectations amongst the users are not the issue.
“On the flip side, the supply of well-co-designed solutions that address the things that matter to people in managing their health is where there is the biggest gap.”
Healum has aimed to put this into practice in the development of its patient management system, which connects patients and healthcare professionals.
The approach centres around the issues that really matter to patients.
In many cases, these are missing from electronic health records.
Abraham shared an example from one of Healum’s randomised control trials where patients with chronic diseases were encouraged to give specific custom objectives.
Real-life examples include losing weight to fit into a dress for a daughter’s wedding, overcoming depression and having more energy.
By factoring these personal drivers into care plans, Healum aims to enable motivational conversations between the patient and clinician.
“A lot of entrants to the market haven’t done the work to really understand what those needs are from people,” Abraham said.
“You [have] to go and sit in community sports halls and other places to listen to people’s frustrations and really understand some of the basics of what they want.
“Putting the objectives of what patients want at the heart of our approach has been really important.”
According to the NHS Confederation report, cost barriers must also be considered, as employed individuals exhibit higher levels of satisfaction, suggesting potential financial challenges for technologies not currently available through the NHS.
AI vs human expertise: striking the balance
Artificial Intelligence (AI) presents vast opportunities across the healthcare system, from enhancing diagnostics to personalising treatment recommendations.
The NHS Confederation report states that AI has the potential to empower patients and support healthcare staff in delivering tailored care.
Approximately 72 per cent of patients surveyed expressed interest in receiving personalised health insights and recommendations generated by AI.
However, concerns about data security, bias and ethical considerations surrounding AI adoption remain important factors to address.
The debate around striking the correct balance between human expertise and AI-powered tools is only set to continue as the technology develops.
Healum is taking a different approach to most AI players in the health sector.
The platform employs a live learning network that is trained by the people that use it. By using the tool, healthcare professionals help further improve and validate the system.
“[We’re] training these models and validating them with the wisdom of healthcare professionals,” Abraham explained.
“This isn’t about replacing them. This is about giving them machine learning at their fingertips which has been trained by their peers.
“This is unique and different.
No one else is doing it this way; crowdsourcing the wisdom of healthcare professionals to train the personalised interventions that get delivered to patients.
“That for us is our next two years of research.”