It’s almost become something of a cliché to say our lives are set to be transformed by wearable technology.
Whether tracking our steps on a Jawbone or FitBit, paying to get on the tube using an Apple Watch or capturing video using soon-to-be-relaunched Google Glass, these gadgets are becoming increasingly pervasive.
But one area where few expect to encounter wearables is our National Health Service.
The NHS has a tortuous history when it comes to adopting any technology (the £10 billion National Programme for IT, anyone?), never mind the most cutting-edge innovations.
Few NHS organisations have started actually using consumer wearables, aside from the odd pilot.
There is one underway in Poole to integrate personal data from epilepsy’ patients smartphones and wearables with its patient records system, for example, and another in Staffordshire where patients wear cameras with GPS, motion and light sensors to help them combat memory loss.
These are just a couple of examples of early adopters. However most agree it is only a matter of time until wearables are pervasive in the NHS.
“I’m sure wearables will become embedded within NHS practice, though I suspect it is probably a few years off,” the Royal Free Hospital’s chief information officer Will Smart says.
“Six years ago we didn’t use tablets much but we’re already getting into wearables now…I think in five years’ time there will be a lot more of that kind of technology in place,” Graham Softley, associate IT director at Buckinghamshire Healthcare NHS Trust, said at a recent event.
NHS medical director Sir Bruce Keogh has also said wearables will have a vital role in securing the NHS’s future.
Technology “enables you to predict things, to act early and to prevent unnecessary admissions, thereby not only taking a load off the NHS but, more importantly, actually keeping somebody safe and feeling good”, he told the Guardian in January.
Potential to ‘revolutionise’ healthcare
The potential benefits offered by wearable technology within healthcare are vast.
They could make it much easier to get reliable data to monitor conditions like diabetes or asthma, ensure patients remember to take their medication and reduce the need for hospital or GP visits, the Health Foundation’s strategy director Jo Bibby suggests.
It could amount to a revolution in the way people see healthcare: as something they control and manage proactively, rather than something ‘done to them’ by professionals.
The Apple Watch, launched this year, has the ability to store about 60 different types of data, including blood pressure and glucose levels, according to Dr Matt Stroud, the Digital Catapult Centre’s head of personal data.
“It opens up the public market for self-funders [people with their own devices] to manage and support their own wellbeing,” Jim Ellam, assistive technology lead at Staffordshire County Council, says.
“For the first time technology means vital signs can be monitored remotely, we can be automatically prompted about appointments, if mum went for a walk I know where she is, it’s almost limitless in terms of what it could do,” he adds.
“I can see a situation where devices monitor your health, send you alerts to take your medication or see your doctor. It would help us get fitter, live longer and require fewer interventions,” Camden Council CIO John Jackson says.
“Think about some of the agendas we manage: health, elderly people, early intervention, supporting the vulnerable. We rely on rich information about our citizens then joining it up. I can see at some point a connection between wearables and this sort of data. It would allow us to do service delivery in a very different way. It’s very early days though,” he adds.
It could also save a lot of money, something not to be sniffed at in an era of austerity and with the NHS facing a funding gap of at least £30 billion by 2020.
There are about 24 million visits to Accident and Emergency units in the UK every year, each costing £110 on average: a total bill of £2.6 billion.
Imagine if wearables could reduce that figure by 10 percent – £260 million. That is just a tiny example of the potential impact they could have across the whole NHS, Ellam suggests.
However, there are barriers that will need to be overcome first, not least in the way the NHS distributes money internally.
“The internal NHS market works against savings. We save in one part but another sector benefits. If a GP stops a hospital admission, that’s £250 saved. But the GP sees a lot less benefit than the hospital because of the NHS funding structure,” Ellam explains.
The NHS funding structure is not the only thing holding back the adoption of wearables. There are also issues relating to the culture within the NHS, security concerns and privacy fears – all of which pose serious risks.
Traditional culture v modern tech
The NHS does not have a culture or history of encouraging innovation, and it is unusually jumpy, even compared to its risk-averse public sector colleagues.
There is often little appetite or incentive to take risks, or even try out new, proven technology, especially where individuals’ personal data is concerned.
“It’s getting it embedded and having sufficient evidence. You’ll need a real impetus behind it to force transformation through a very traditional health service,” Ellam warns.
Privacy fears over schemes like the delayed GP data collection project Care.data are a powerful reminder the public expect their data to be treated sensitively, and believe they should have control over it.
Senior chiefs in the NHS have acknowledged the service’s culture clashes with the fast-paced adoption of cutting-edge technology.
They have promised to tackle it- setting up ‘innovation accelerator’ schemes and funding to scale up tech pilots, for example, although these are both piecemeal projects.
Martha Lane Fox was recently appointed by health secretary Jeremy Hunt to come up with proposals to boost the use of innovative tech in the health service, due to report in the coming months.
Though difficult to define, it’s clear that culture remains a – perhaps the - major barrier to the adoption of new tech in the NHS.
There are also real concerns over privacy and security.
Given security researchers have managed to hack into all sorts of devices, including pacemakers, insulin pumps and defibrillators, it’s not hard to see why.
The main worry is not just with the devices themselves, but whether the data they generate will be safe in NHS hands, should patients trust their local health bodies with it.
A Freedom of Information request last year found 83 percent of NHS trusts admitted they have no strategy for managing wearable technology, despite clear evidence it will play an increasingly important role.
“There are a series of privacy issues we need to look at first [before adopting wearables],” Royal Free Hospital CIO Will Smart admitted.
Trusts will have to ensure they have the adequate means to collect, store and analyse digital patient data in real time, while keeping it secure – no mean feat, he warned.
Given people allow Google, Apple and Facebook access to their data – the question might be: why not the NHS?
However the health service is held to higher standards. It is bound by the Data Protection Act, and therefore has strict rules about how it may and may not use individuals’ data, including a need to be transparent with them.
Security and privacy fears should not be used as an excuse not to adopt wearables. But it’s vital the NHS handles people’s personal data with care and with their permission, if it wants to avoid damaging headlines.
“Data privacy has long been a concern but we are entering the next phase of the digital revolution and now is the time for personal data to be unlocked, shared and used for wider wellbeing gains,” Dr Stroud says.
“To achieve data trust, organisations need a completely new set of innovative architecture tools and business models.
“These include new voluntary codes and trust frameworks focused on the use and re-use of personal data. By putting these standards in place, organisations can help protect data, as well as setting standard benchmarks for both the public and private sector,” he adds.
When it comes to adopting wearables in the NHS, the size of the prize – happier, healthier patients receiving more proactive care, while saving vast sums of money – is huge. As Keogh suggests, they could form a core part of making our NHS sustainable for the future.
However the barriers are almost if not equally vast, and present a real challenge. For all our sakes, we can only hope the NHS finds a way to overcome them.
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