This was the month when the UK Press seemingly finally woke up to the existence of STPs (Sustainability & Transformation Plans). This article by Derek du Preez and this in Digital Health are two one of a few that pick out the hope that digital health can help with making the NHS more sustainable. Sadly the headlines were grabbed with concern over closing hospital beds, which politicians in the UK still seem to consider to be a Bad Thing. Even though hospital beds have been reduced in most European countries over recent years, and those such as Denmark now trumpet reductions in hospital beds as progress, we have still to break the connection in people’s minds in the UK that beds are a good surrogate for health service delivery volume, (even though when pressed no individual seems keen to spend longer in hospital than absolutely necessary, or would prefer a treatment as an inpatient over treatment as an outpatient.)
Though not directly connected, the NHS offered over £100m to acute care trusts for “global digital excellence” – in line with the previous comments, perhaps the money could alternatively be spent on the UK building on its excellent primary care IT with the specific intention of moving more treatment out of hospitals…and follow that up with a proposal to put the hospital that is judged to be the least “globally digitally excellent” into special measures. Spending more money on perpetuating a care structure that has the perverse incentive to keep treating people expensively that in many cases could be treated more efficiently and cheaply in the community feels like the wrong way to go.
There were a brace of important publications on technology use by older people in the US. This JAMA letter (behind a paywall – eg see here for summary) provides further evidence that digital health is still not being used by those who would most benefit. A key reason for this, and a frequent concern expressed by this editor, is that older people are not the target audience for much of this technology. However evidence from elsewhere indicates that increasingly social media are being used by such people which is beginning to reduce loneliness, a recognised precursor to depression, dementia and many other unpleasant conditions.
The DH’s Social Care blog has a particularly interesting piece on the Digital Resource Centre for Carers that Carers UK has developed – a hugely impressive set of apps and eLearning services, news of which deserves wide dissemination.
Just as, a few years ago, hospitals, nursing & care homes began to realise that telecare designed for remote monitoring can also improve inpatient outcomes at lower cost (for example by reducing wandering, catching frail people before they fell getting out of bed, etc.), so it now seems continuous vital signs monitoring, used for some time remotely (as telehealth), when used in hospitals outside the ICU offers a good ROI.
The MHRA has produced an excellent revised interactive document entitled Is your app a medical device? High recommended reading, with well designed flowcharts and different routes depending on your role. Meanwhile the FDA in the US has produced draft guidance on when to submit a software change notice – an issue especially relevant to apps as frequent software changes are made in other sectors to boost demand. Perhaps the most concerning paper on apps that emerged over the last month was on the half-life of mental health apps, which includes in the conclusion the observation of “a clinically relevant app for depression becoming unavailable to download every 2.9 days”.
Turning to events, on October 6th DHACA is holding its next event, close to Leeds station, when we will have presentations from among many, Bethany Gildersleve from NHS Digital who is now finalising the NHS’s app assessment process (ex NIB 1.2), ORCHA on private app assessment, digital nutrition, and lots more. More details and book here (and you can also book for 18th January too, in London, if you want, here).
On 28th September, to 1st October, the KTN is running an event entitled Age does not matter in London. Register here (free).
Bigger & better than ever before, the International Technology Enabled Care Conference is being held on 18th & 19th October at the NEC.
The Royal Society of Medicine has a one day conference on Point-of-Care-Testing on 22nd November which will showcase the amazing benefits both in improved patient outcomes and substantial cost reduction that testing – physical, chemical and genetic – at the point of care can deliver. As always, as the RSM is a charity dedicated to medical education, charges are far, far lower than commercial conferences, and opinions expressed are genuinely independent of corporate pressure. Book here.
As 3D printing is a key technology used in medicine, Prof Mike Short has kindly alerted this editor to the incredibly simple Eora 3D scanner that uses your smartphone to do much of the processing, so keeping cost right down. More details and to pre-order it here. Makes high precision 3D scanning eminently affordable.
The IET has launched a search for industrial SMEs who have a technology that could be adapted and commercialised to solve a real-life healthcare issue. Up to £35,000 available. Entries by 30th September – details and application here.
This editor takes a dim view of hackathons as they seem to be one of the principal causes of the detritus of half-built mHealth apps on the app stores that patients need to weed through to find quality apps. However he is making an exception for “Future Fest”, the excellent Alder Hey Hospital’s Hackathon in the Park: “Liverpool is already a leading innovator in children’s health and this two day event will build upon the wealth of expertise in the region.” Dates are 21-22 September; register here…and please only leave us with quality apps on the stores!
And there’s a US competition: Make your medical device pitch for kids! – $250k in prizes – details and entry here. Deadline 5th September.