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A genomics and digital-led NHS is possible – but investment in staff essential

Powerful technologies will lead to an “evolution of the patient-doctor relationship”

ipad doctor

Adopting digital technology such as AI and widely integrating genomics in UK healthcare can bring about a huge improvement in NHS services – but investment in staff training and culture change will be vital.

That’s the conclusion of a new report issued yesterday by eminent US cardiologist, geneticist and digital medicine guru Eric Topol (below), who has produced recommendations for how the NHS and healthcare professionals need to adapt to make the most of the technology.

Topol

Health secretary Matt Hancock has put greater use of digital technology at the top of his agenda for the NHS since taking on the job last year, and has promised to follow through on Topol’s calls to train doctors in how to use technology, and reimagine working practices to improve patient care.

“We are at a unique juncture in the history of medicine, with the convergence of genomics, biosensors, the electronic patient record and smartphone apps, all superimposed on a digital infrastructure, with artificial intelligence to make sense of the overwhelming amount of data created,” Topol said.

He says these powerful technologies will allow for the delivery of healthcare on a far more rational, efficient and tailored basis, and will lead to an “evolution of the patient-doctor relationship”, which he believes can be strengthened. Significantly, he said it could also alleviate the high level of burnout that currently seen in the medical professions because of overwork and stress.

He made it clear that progress in genomics, artificial intelligence, digital medicine and robotics were likely to change the roles and functions of clinical staff in all professions over the next two decades to ensure safer, more productive, more effective and more personal care for patients.

The UK pharma industry association the ABPI welcomed the report, and said its conclusions chimed with its own recent report regarding the need for greater investment in life sciences training and skills for 21st century technology and roles.

Andrew Croydon, Director of Skills and Education policy at the ABPI said:

“These same areas are also recognised in the Topol Review recommendations in one form or another, such as the need for: core training in genomic literacy; career pathways for bioinformaticians; expansion of undergraduate capacity in genomics, bioinformatics and data science.

“Together these reports highlight the need for a substantial increase in availability of cross-disciplinary talent to feed the needs of a world where increasingly patients are better informed and take more ownership of their care.

“It is logical that progress in meeting these challenges will be most effectively addressed through collaboration across industry, NHS and academia.

Health secretary Matt Hancock responded to the report in a speech, urging the NHS to embrace the benefits of new technology.

Hancock has made his frustration at slow adoption of new technology clear in recent months, including issuing instructions for the still-widespread use of fax machines in the NHS to cease.

Highlighting this slow uptake compared with other sectors, he said: “Tesco has more sophisticated and more efficient systems than the NHS.”

He pointed out the use of loyalty cards and other digitally tracking systems allowed them to cut costs and understand the needs of their customers better.

“In the NHS, we don’t have anything like that. We don’t use common identifiers to identify patients, we don’t know which hospitals a patient has been to, we don’t know which medicines have been put into them. We don’t even know what we already know.”

He pointed to one pilot already underway in the NHS where electronic scanning of patients’ records was producing safer and more efficient care.

“NHS staff have to make scanning a routine part of their working day,” said Hancock “It takes seconds, but saves hours. If adopted across the NHS, the time saved would equate to almost 400 extra nurses.”

Topol’s report also addresses concerns that new IT systems often get in the way of better care, diverting the attention of doctors and nurses away from caring for patients. The report stresses that wherever possible, “the adoption of new technologies should enable staff to gain more time to care, promoting deeper interaction with patients”.

However, there are also concerns that the scale of the cultural challenge, and the level of financial investment required to bring about these changes won’t be forthcoming. That’s because while the NHS has just been given a new £20bn budget uplift, this will be difficult to stretch to transformational projects.

Among the many responses online to #TopolReport, the King's Fund digital health expert Harry Aagaard Evans commended the report for its scope and depth. However he commented that the question of whether or not technology could alleviate the grave shortages in key clinical roles in the NHS.

"It seems a big part of this review could have dealt with the question: will tech be part of the solution to soaring vacancies? I don't know whether it will or whether it won't, but it feels like we need some kind of answer on this."

Read Harry Aagaard Evans' full Twitter commentary thread.

Read the Topol Review in full here.

Article by
Andrew McConaghie

12th February 2019

From: Healthcare

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