In November last year a healthcare expert from PA Consulting was sufficiently moved by a Sunday Times Scotland story on the shortage of GPs ‘being a danger to patients’ that he wrote a letter to the editor.
Essentially, Alex Matthews argued, technology should be playing a much greater role in reducing the number of patient interactions across NHS Scotland, in an attempt to shift the debate away from “bigger budgets and more doctors”.
“Almost every primary care interaction in Scotland currently requires a face to face appointment with a GP. This is an anachronism that has been preserved for far too long,” he wrote.
“Basic digital technologies used by many patients everyday – such as apps, social media and wearable devices – can reduce demands placed on GPs by monitoring chronic conditions, reducing unnecessary or missed appointments and delivering certain primary care services direct to patients at home.”
Matthews went so far as to say that the deployment of digital technology on the frontline of Scotland’s health system is now urgent. His analysis of a report by Reform Scotland further confirmed that ‘..of the 994 GP surgeries in Scotland only 67% have basic websites, only 51% offer repeat prescriptions online and only 10% offer appointment booking online’.
And that’s not just the view of an expert commentator from the wider healthcare consulting business. Clinicians themselves are increasingly seeing the potential of technology to monitor and in some cases even treat patients.
Dundee-based developer Waracle, which has produced mHealth applications for the NHS and Imperial College London, recently hosted a Q&A with Rodney Mountain, ENT surgeon and Associate Postgraduate Dean at NHS Tayside Dundee, who insisted in the discussion that wearable devices should be brought into the NHS as a prescription, ‘so any GP could prescribe a wearable device to help patients reduce their weight and blood pressure’.
“The obesity epidemic is just one example of an area that could really be shaken up through the proliferation and use of new wearable devices,” he said.
“We could use a device that monitors exercise, the sleep patterns and heart rate of someone with obesity. Obese people often can have difficulty breathing properly at night time.
“They can suffer from sleep apnea, be low on oxygen intake during their sleep and as a consequence have high blood pressure, heart problems and feel continually tired during the day.
“With a prescribed wearable device the GP could monitor progress and use the data gathered over time to motivate them to see the benefits of weight loss.”
Despite Matthews’s complaint about the slow uptake of technology, there is evidence that mobile devices are increasingly being used in the NHS in Scotland. GPs have started to use ‘ambulatory blood pressure monitors’, which patients take home for 24 hours so that their blood pressure readings can be periodically monitored.
Doctors have said the technology can provide better base line data compared to a GP setting, where anxiety levels can skew readings upwards.
Clearly, there is an appetite among clinicians to see the technology market harness its expertise to the betterment of patient care. With the launch of the much-feted Apple Watch this week, the tech giant also unveiled a new biomedical platform called ResearchKit, which will allow any iPhone user to enrol in tests of new drugs and therapies by downloading apps from hospitals and providers who are recruiting patients.
The system complements HealthKit, released by Apple last year, of which Jeff Williams, Apple’s senior vice president of operations, said: “ResearchKit turns HealthKit into a diagnostic tool.”