As a distraction from the things that, before the advent of handheld technology, little boys used to do in the school playground when this editor was young, once in a while we would engage in the pointless debate of what would happen if an irresistible force met an immovable object.
Those debates came to mind when Graham De’Ath kindly drew this editor’s attention to the recently published Labour Ten Year Plan for Health & Care. Now Telehealth & TelecareAware knows better than to indulge in politics, however the document was notable in that it did not make any significant reference either to the demographic reality of the next ten years, or the likely role of ‘technology’ in assisting with the resultant increase in care required (the word is mentioned just once, in the commitment to: “Set up a wide–ranging review of NICE which will look at reforming the NICE technology appraisal process…” [actually already underway by the NIB]). The Labour Party is far from being alone in this – readers with long memories will recall our amusement as the RCGP’s ten year forecast of the changes in GP practice where the biggest role technology was expected to play in 2022 was in remote delivery of test results.
The reality, TTA believes, will be very different: it requires urgent action from whichever party or coalition is in power after the May elections in the UK. In this context, the immovable object is the NHS’s need for much additional funding in future years that may well prove impossible to deliver which is challenging its capacity to deliver more care, well-covered elsewhere; the irresistible force is the growing amount of care required both by the ageing population, and by those who choose lifestyles inconsistent with unaided future good health.
Increasingly technology can help in the delivery of care, through remote monitoring of those with chronic conditions, through remote consultation and through investigative & diagnostic aids. Particularly whilst the “doctor knows best” attitude persists in some quarters, so well described in the opening to Eric Topol’s recent book, it is hard to see how technology alone will yet deliver a stepchange in clinical efficacy.
A greater hope is perhaps self-care, where technology – particularly through a combination of apps & wearables – can significantly change people’s lifestyle to one that is healthier. It needs political support though – squabbling about which party can deliver a better free healthcare system to everyone irrespective of how they live their lives is at best a zero sum game; making people realise that their health is their responsibility – and not (as so many do at present) the responsibility of the state – should begin to pay huge dividends, immediately.
As the recent study of paying pregnant women to stop smoking proved, behaviour change can be encouraged financially. So further support for self-care could for example be given by applying a progressively tough tax on all products with known adverse health effects such as those with refined sugar as an ingredient, and possibly refined flour too, as it currently is on alcohol and tobacco.
This editor is pessimistic about whether even that will turn the tide – after all at present in the UK, a resident can eat, drink and behave as they like. then present themselves to their GP or A&E and demand care free at the point of delivery. Perhaps the time will soon come, for those who can pay, to extend the charges for NHS dentistry to GPs and other services – such as A&E and urgent care centres – that people would otherwise go to if only GPs charged?
Were that to happen, it would be a real shot in the arm for the already rapidly expanding private remote consultation services that we have described so many time before which would no longer be at such a cost disadvantage (also where there was a further announcement, concerning MDlive, only last week). And as Moore’s Law grinds on relentlessly, as Ali Parsa, CEO of Babylon Health mentions every time this editor hears him speak, the power of even the humble current mobile device will be as nothing compared with its successor in ten years’ time. Along the way, there may then be a “Dr Turing” test – when describing your symptoms to your mobile device, can you tell when the response in terms of further questioning, subsequent treatment plan and electronic prescriptions (if required) is given by a human or a machine? And if you get prompt service that keeps you fit & well, will you care?
This may just be the route whereby the world described by Erik Brynjolfsson in his excellent book “The Second Machine Age” arrives, where the doctor’s role has changed dramatically, for those who work with the technology (and those who do not)…which is why the Royal Society of Medicine has got together with the Institute of Engineering & Technology to run a one day event at the Academy of Medical Sciences in London that begins to explore the drivers for this new world. The event, entitled “The Future of Medicine – the Doctor’s Role in 2025” is on 6th May, and there is a poster submission opportunity too; bookings can be made heree. (Note medical CPD points have been applied for too, via the RSM.)
There are currently just 50 places (at £70/person, or £40/author for successful poster submissions) available so book very soon if you want to go; you might even get to take a view on which problem the technology will help solve first: the irresistible force or the immovable object!