‘There is a need for robust systems for deciding which innovations are safe and cost-effective to use’
What are your observations in healthcare and how did you come to be a part of it?
Healthcare has reached a tipping point where demand from population growth, ageing and economically better off population as well as new treatments continues to outstrip available resources and workforce. The answer has to be a significant increase in the use of technology and artificial intelligence to undertake the more straightforward diagnostic, treatment and rehabilitation tasks in healthcare.
I have been in the health and life sciences world for all my career, initially serving the pharmaceutical industry through analytics and consulting and now covering all aspects of the field as we promote the UK’s expertise in India and other countries around the world.
What is the toughest challenge in spreading evidence-based innovation across healthcare organisations in the UK?
Firstly, we have to have robust systems for deciding which innovations are safe and cost-effective to use. We have tough regulatory bodies in the UK such as the National Institute for Clinical and Care Excellence (NICE) to do this. We then need effective networks, promotion schemes and incentives for swift adoption of innovation.
The NHS has coped with the challenges of growing demand, an ageing population and new treatments only through the constant innovation of its staff and institutions. Many of these innovations were internationally-renowned achievements of British science: stem cell transplants, the ECG, or CT scanners. Others took place as quiet, steady revolutions in practice: the introduction of cancer screening, the movement of mental healthcare into the community, or the widespread shift to day case surgery.
We have a substantial programme that promotes innovation across the NHS. For example, we have set up Academic Health Science Networks across the country that bring industry, academia and healthcare providers and commissioners together to promote the spread of best practice, clinical innovations and new technologies We have selected 104 clinical entrepreneurs to design and deliver new technological solutions and innovations in healthcare. This includes the appointment of five healthcare scientists, tackling conditions including sickle cell disease and allergic reactions. Just this month, the UK government announced backing for five new centres of excellence in Leeds, Oxford, Coventry, Glasgow and London for digital pathology and imaging, including radiology, using AI medical advances. It is only though innovation that we will be able to respond to rising demand, increasing costs of some treatments and a constrained pubic purse.
When you look at the global health system as a whole (providers, payers, regulators, doctors, patients) where did you see most / least openness for innovation?
Payers, whether individuals, insurance agencies or governments have the greatest incentive to introduce innovation that improves clinical outcomes and cost effectiveness. The UK has local committees of family doctors that do this job but we see it in major insurance companies and in the willingness of patients themselves to use mobile apps to improve and manage their health. At the same time, many of our leading healthcare institutions are interlinked with academia to research the most advanced and effective treatments for patients and it is often these that produce innovative healthcare spin outs. Some people say healthcare professionals are the least open to innovation but some of our best healthtech companies are founded and led by doctors, nurses, pharmacists and others.
How important is it for healthcare operating organisations to provide dedicated resources for experimentation – rather than attempting to leverage resources that are busy ‘operating’ the company and its components?
It is essential that we give time to working clinicians and administrators to come up with innovative answers to the challenges they face day to day. And they need to support from innovation facilitators to take their ideas into reality and spread them to other parts of the health system. This is what lies behind some of our UK schemes, for example for clinical entrepreneurs.
What’s the single most important thing that policymakers could do to enable digital transformation of health systems?
There is a need to show leadership, to support researchers, service providers and payers to experiment with new approaches. So for example, our current Secretary of State for Health and Social Care, Rt Hon Matt Hancock has started to promote the NHS as “the most dynamic healthtech ecosystem on the planet.” But leaders at all levels need to embrace the transformation that is as inevitable as it is urgently needed.
Tell us more about the India-UK collaborations in healthcare and how will this help healthcare process in both countries?
Many of the companies who are engaging with the leasers of Indian healthcare on our “Innovating for a Healthier World” Trade Mission to India in December as part of the India UK FutureTech Festival exemplify the innovation that AI can bring. We expect many of them to work with Indian counterparts to introduce new technologies to India and accelerate mutual learning across our two countries. They include: diagnostic apps and tests for early identification of eye disease, respiratory diseases, cancer and CVD (some of which can be used by local health workers and patients) clinical decision systems early detection of problems in the course of an illness for patients and their clinicians personalised advice to patients based on monitored signs and progress of the condition e.g. pregnant women improving outcomes by analysing patient reported data better customer experience for bill payments. Healthcare UK, part of the UK Department for International Trade (DIT) is currently collaborating with NITI Aayog in implementing several AI pilots in healthcare. The Healthcare AI Catalyst as the initiative is called, will take leading AI companies from the UK into India to play a role in the delivery of India’s healthcare ambitions of the future.
Both countries are looking for ways to use telemedicine to help support patients without high cost face-to-face clinical interactions. In India in particular, this has the potential to transform the way healthcare is delivered to the two-thirds of the population living in rural areas. 2017 was a crucial year for telemedicine in the NHS, with patients being offered routine GP appointments via a mobile phone app for the first time and the launch of an online version of our 111 telephone advice service.
Our two systems also face shared workforce challenges. The NHS’s recent workforce plan has committed to training significantly higher numbers of clinical staff in the coming years, whilst it is estimated that India has shortages of 74 per cent for nurses and 43 per cent for doctors. Neither country will be able to achieve their goals by adhering solely to traditional training methods, and advances in augmented reality and e-learning from both India and the UK have the potential to remove many of the current barriers we both face.