Will wearable technology transform healthcare?

Posted by Centre For Health Solutions on 2/07/2014 at 6:10 PM Permalink Comments (0)

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Wearable technology is an industry that continues to grow and adapt to meet the ever-changing needs of our world. Many health- and fitness-related technologies have multiple applications and encourage wearers to be more engaged in their own fitness, help modify behavior by reminding wearers to exercise or take medication.

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Building trust in the collection and use of real world health data

Posted by Centre For Health Solutions on 26/06/2014 at 12:50 PM Permalink Comments (0)

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As our recent report Better care for frail older people identified: healthcare continues to face enormous cost and capacity challenges; largely as a result of increasing demand from growing numbers of older people with multiple complex conditions and a rise in the incidence of non-communicable diseases such as diabetes, cancer and obesity.

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Fast-tracking drugs to market – an opportunity for all stakeholders?

Posted by Centre For Health Solutions on 18/06/2014 at 4:05 PM in International Permalink Comments (0)

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One of the key challenges for life science research and development (R&D) is identifying which biochemical pathways and diseases to target. Given the average cost of bringing a new drug to market is now an estimated $1.3 billion dollars as revealed in our 2013 R&D ROI report, it’s clear that R&D leaders are looking to maximise their returns. However, it is also becoming increasingly clear that only those drugs that deliver additional patient benefits will gain approval and funding.

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How’s your father? Improving the detection and treatment of prostate cancer

Posted by Centre For Health Solutions on 12/06/2014 at 8:57 AM Permalink Comments (0)

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Across the UK, prostate cancer kills one man every hour (or 10,636 every year) and is the most common cancer in men. Indeed, 40,000 men are diagnosed with prostate cancer every year and currently there are 255,000 men living with and after the disease.[i] In the UK prostate cancer survival rates are below the European average and quality of care can depend on where you live.

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Over the counter medicine - Will Pharma exploit the potential in emerging markets?

Posted by Centre For Health Solutions on 4/06/2014 at 4:54 PM in New research pieces Permalink Comments (0)

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The over the counter medicine (OTC) market, whereby customers can buy drugs or medicines without a prescription is increasing in value and volume across the western world, with the potential for growth in emerging markets even more exciting.

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Health metrics, lifestyle and environmental factors: How healthy is your city?

Posted by Centre For Health Solutions on 28/05/2014 at 4:22 PM Permalink Comments (0)

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We often see headlines ranking cities on specific health-impacting measures such as air quality or commuting time, or highlighting regional differences in health outcomes, but rarely do we get a comprehensive picture of a city’s health and wellbeing.

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Mobile Health Apps: A passing novelty or a game changer for healthcare?

Posted by Centre For Health Solutions on 21/05/2014 at 5:17 PM Permalink Comments (0)

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In December 2012, the Deloitte Centre for Health Solutions’ report ‘Telecare and telehealth- a game changer for health and social care’ focussed on the costs and benefits of scaling up the adoption of traditional telecommunication technology. Given that the adoption of mobile technology in healthcare was still in its infancy we proposed returning to the use of mobile technology at a later date.

Since then, mobile applications (apps) have become ubiquitous in many aspects of our lives, largely as a result of the widespread availability of tablet computers and smartphones, as well as 3G and 4G networks. Indeed the smartphone, with 24/7 access, has changed irrevocably how we interact with technology. This, in turn, has boosted the use of mobile healthcare apps (mHealth apps). In 2012 there were around 40,000 mHealth apps, today there over 100,000.

The mHealth apps market is classified into health apps and medical apps. Health apps comprise exercise, weight loss, nutrition, sleep and meditation, and medication reminders which all encourage adherence to healthier lifestyles. Medical apps on the other hand are segmented into:

  • medical reference apps that provide information about drugs and how to take them, diseases and symptoms, and the locations of pharmacies or doctors
  • medical condition management apps that track, display and share user´s health parameters, medication intake or provide information on a specific health condition such as diabetes, mental health or asthma.

Remote monitoring and consultation apps still represent only a small share of the current market, however this category is expected to have the highest business potential in the future. Fitness apps, which currently have the most business potential, are expected to diminish in relative importance. Meanwhile, mHealth apps that reduce non-compliance and hospital readmission costs are expected to have the biggest impact on healthcare commissioners and providers.

Of increasing importance is the fact that mHealth apps allow the collection of considerable medical, physiological, lifestyle, daily activity and environmental data to provide the basis for evidence based practice and research activities. They also facilitate patients' access to their own health information and empower them to manage their health more actively, while supporting them to live more independently in their own homes.

MHealth apps can also help the healthcare workforce to be more efficient by supporting real-time communication with patients, e.g. via the exchange of app users’ data, thereby helping healthcare systems deal with constrained healthcare resources. They also allow more medical and care interventions to be done remotely or by the patients themselves, guided by monitoring and reporting systems, thereby reducing hospitalisation and providing an efficient method of managing chronic diseases.

In reality, however, while there is a great deal of interest in mHealth apps and enthusiasm for their use, they have yet to be mainstreamed as part of healthcare provision, and in many respects are still viewed as a novelty. Part of the problem is that patients face a confusing array of mHealth apps with little guidance on their quality or advice and support from their doctors. While doctors can see the potential benefits of mHealth apps, they remain wary of formally recommending them to patients. Barriers include a lack of evidence of their benefit, limited professional guidelines on their use in practice, concerns over security of personal health information that may be generated or transmitted by the app, and uncertainty over regulatory requirements. Furthermore, commissioners, providers and others, such as employer wellness programmes, rightly expect clear evidence of the benefits before considering funding, reimbursement or promoting the use of such apps.

Over time, it is likely that mHealth apps will progress from being recommended on an ad hoc basis to systematic use in healthcare, and ultimately to becoming a fully integrated component of healthcare management. In this respect, mHealth apps are not intended to replace healthcare professionals, who remain central to providing healthcare, but rather intended as a supportive tool for managing health conditions. There may also be the added bonus of helping overcome patients' reluctance to seek help because of stigma or shame, as it is the case with mental illnesses, where about every second person experiencing a disorder seeks treatment.

MHealth solutions have the potential to change patients from being largely passive to taking a more participative role while enhancing their responsibility over their own health. They will also raise people’s awareness of health issues through easy-to-understand information, thus helping them to take more informed decisions on their own health. This shift towards patient-centric care will inevitably change the role of healthcare professionals who are more likely to monitor patients remotely and interact with them via e-mails more often. Whether the healthcare service is ready for this change – only time will tell – however the explosion of mHealth apps suggests patients are already embracing this technological assisted approach to self-managed care. As we said in our Telecare and Telehealth report, the question as to whether this will be with or without the involvement of health care commissioners and providers remains to be answered?

 

Karen TaylorKaren Taylor
Research Director, Deloitte UK Centre for Health Solutions

 LinkedIn 


Dementia: Improving care by earlier diagnosis and post-diagnostic support

Posted by Centre For Health Solutions on 14/05/2014 at 7:46 PM in Current affairs NHS, Frail and elderly Permalink Comments (0)

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Dementia is a progressive, terminal brain disease currently affecting an estimated 800,000 people in the UK, a number that is expected to reach one million by 2021. Dementia causes a decline in memory, reasoning, communication skills and the ability to carry out daily activities.

Around twenty-one million people in the UK have a close friend or family member with dementia. Dementia has suffered historically from poor awareness and understanding, combined with the stigma attached to both mental illness and old age. Indeed, people fear dementia more than any other disease with 39 percent of over 55s fearing Alzheimer’s the most, compared to 25 percent who worry most about cancer. A lack of understanding and concern over access to support is a key reason for this fear.

Caring for people with dementia has a considerable impact on public and private finances with current, NHS and social care spending on dementia, across the UK, at least £15 billion. Furthermore, around two-thirds of people with dementia are cared for in the community by an estimated 670,000 unpaid carers, saving the state £8 billion per year. Most of the direct costs, however, are spent on responding to crises, often involving institutional care, rather than providing proactive and effective management and support for people with dementia and their carers.

In response to critical reports in 2007, from the National Audit Office and Alzheimer’s Society, the Department of Health launched its first ever national strategy for dementia in February 2009.  Living well with dementia: a national dementia strategy for England[i] (the Strategy), focussed on three broad themes - improving awareness and understanding, timely diagnosis, and living well with dementia. Following the 2010 election, the Strategy was adopted by the incoming government, who affirmed the need for its implementation and in March 2012, the Prime Minister went a step further in publishing his personal Dementia Challenge report, which highlighted key areas which he wanted to see addressed[ii].

Both the Strategy and the Challenge highlight the importance of early diagnosis and post diagnostic support. Indeed, there is now a consensus that early diagnosis combined with effective social, psychological and pharmacological support and intervention strategies, are key to the successful management of dementia for both people living with it and their carers. For this to happen, primary care providers, especially general practitioners (GPs), need help to understand the availability and importance of effective post-diagnostic support for patients and carers. Furthermore, with early intervention and access to the right services and support, people with dementia can continue to live well for many years.
 

Despite increased publicity for early diagnosis and year-on-year improvements in diagnosis rates, doctors still avoid diagnosing dementia because they feel that “nothing can be done” to help people who have been diagnosed. Yet diagnosis is not an end in itself, but a gateway to making informed personal life choices. It should also be the lever that promotes access to treatments. However, despite explicit government policy that every person with dementia has the right to be diagnosed and offered relevant information and help regardless of the severity of their condition, in England, only 48 per cent of people have a formal diagnosis and many of these lack access to effective support.

Over the last few years, a number of approaches to post-diagnostic support have emerged, but to date, there has been limited evaluation of their effectiveness. One approach identified in our report Better Care for frail older people, developed by the Guideposts Trust (Guideposts) is the Guideposts Dementia Information Prescription (DIP). Launched in 2012, it is the culmination of over eight years’ experience in providing support and advice to people with dementia and their carers and is designed to be used by doctors and other health and social care professionals to provide local information on the support services available in their local area. It is also available directly to carers and people living with dementia and is backed up by a local Helpline.

There was a great deal of anecdotal evidence that people with dementia and their carers found the DIP to be really helpful and that more people would benefit if it was more widely available. Given the importance of this issue, the Centre for Health Solutions developed an independent survey questionnaire to evaluate the usability, reusability and effectiveness of the DIP as a support tool. Conducted during January 2014, the survey was completed by 33 health and social care staff and 47 service users (people with dementia and their carers). In addition 1,000 people who had accessed and downloaded a Guidepost Trust’s Hints and Tips document were sent a separate survey to ascertain whether they would have found the DIP helpful. Some 115 people completed this second survey. A report on this evaluation is available on the Centre’s website.

Overall there was overwhelmingly positive support for the DIP as an effective post-diagnostic support tool with 87 per cent of care providers (including GPs) considering it either very good or excellent. The DIP was seen as user-friendly with approximately 76 per cent of carers using it to find information on local healthcare support and 91 percent of people with dementia and their carers likely or extremely likely to use the DIP again.

While this is only one of a number of support tools available, it demonstrates the importance of evaluation in order to promote the scaling up of adoption of such tools. More importantly, from reading each survey response, it confirms is the sheer demand for post diagnostic information, how much it is needed and valued, particularly the ease of access for up-to-date information customised to each locality. Given the political and provider consensus that post-diagnostic support is critical to the effective management and care of people with dementia and their carers, what is now needed, is agreement on how to provide that support. This evaluation suggests that the DIP is an effective way of delivering such support.

 

Karen TaylorKaren Taylor
Research Director, Deloitte UK Centre for Health Solutions

 LinkedIn 

 

 


[i] https://www.gov.uk/government/publications/living-well-with-dementia-a-national-dementia-strategy

[ii] http://media.dh.gov.uk/network/353/files/2012/11/The-Prime-Ministers-Challenge-on-Dementia-Delivering-major-improvements-in-dementia-care-and-research-by-2015-A-report-of-progress.pdf