Smart healthcare

There is a lot of excitement around the potential benefits arising from the convergence of information and communications technology with healthcare. Two recent announcements illustrate the impact that this trend may deliver.

First is the use of smartphones as “pocket doctors”, diagnosing Parkinson’s and other degenerative diseases with astonishing accuracy on the basis of users’ movements and voice. The recent British Science Festival in Birmingham heard that large-scale trials of the technique are getting under way with up to 3,000 patients, after smaller lab-based studies showed that it could pick out people with Parkinson’s – a disease that is notoriously hard to diagnose definitively – with up to 99% accuracy.

Max Little of Aston University, who is working on the technology with colleagues at Oxford University and funding from the charity Parkinson’s UK, said it could be used both to diagnose Parkinson’s in people showing possible symptoms ­­and to monitor the progress of known patients.

Modern smartphones can record speech patterns with great precision, revealing small variations in voice. They also contain accelerometers, which can reveal abnormalities in the user’s movements. The combination of changes in voice and movement, analysed by computer algorithm, can show early signs of Parkinson’s.

One study is taking place at 11 hospitals in the Thames valley, where 900 patients have already been recruited. The smartphone technology will be included in a more extensive investigation of ways to diagnose Parkinson’s before overt symptoms appear – which can be 10 to 15 years after the onset of subtle changes in the brain.

Paul Wicks, a research neuropsychologist who collaborated with Dr Little, is now vice-president of innovation at PatientsLikeMe, a Boston company planning to commercialise smartphone health information by providing a better, more effective way for individual patients to share their real-world health experiences in order to help themselves, other patients like them and organizations that focus on their conditions.

Claire Bale, of Parkinson’s UK, responded enthusiastically to the research. “Smartphones offer huge potential as they continuously capture information and can monitor subtle changes, such as an increase or decrease in someone’s tremor,” she said. “Arming doctors and people with Parkinson’s with this technology could revolutionise the way the condition is managed.”

Second is the recent announcement that social media, app and smartphones are going to be used in a revolutionary European project to find new ways of gathering information on suspected adverse drug reactions. The project, to be called WEB-RADR, is to be funded through the Innovative Medicines Initiative, which is a public private partnership between the European Commission and European Federation of Pharmaceutical Industries and Associations.  

The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) will lead a consortium of different organisations across Europe that include the European medicines regulators, academics and the pharmaceutical industry in a project that is looking to develop a mobile app for healthcare professionals and public to report any suspected adverse reactions to treatments directly to national EU regulators. The group are also exploring how they can use publicly available social media data that is identifying potential drug safety issues. The consortium has also been quick to stress that any data from social media used in the project will be made anonymous to protect data privacy.

As well as reporting suspected adverse reactions, the app could be also developed to send accurate, timely and up to date medicines information to patients, clinicians and care givers. WEB-RADR will also examine the value of these new tools for monitoring drug safety. It will help to develop recommendations for medicines regulators and the pharmaceutical industry internationally on how these should be used alongside existing systems.

Mick Foy, Group Manager in the MHRA’s Vigilance and Risk Management of Medicines division said:

“The growing use of smartphones and tablets by patients and healthcare professionals creates a need for reporting forms to be provided on these platforms to ensure regulators receive ADR reports that are easy to access and complete.“

“Additionally the recent growth of social media platforms such as Facebook, Twitter and the many specialist sites and blogs has given rise to many people sharing their medical experiences publicly on the internet.”

“Such data sharing, if properly harnessed, could provide an extremely valuable source of information the monitoring the safety of medicines after they have been licensed. WEB-RADR will deliver recommendations for international drug safety monitoring as to how these resources should be used ethically and scientifically.”

On a more mundane level the use of simple communications tools such as teleconferencing can have a positive impact on healthcare. Just this week the Financial Times reported that my local hospital, Airedale General Hospital, is using teleconferencing to treat a small number of its patients at home. Not only can this cut hospital use by more than a third, but it is also a far more compassionate way of caring for people with difficult conditions. Treatment at home is particularly beneficial for elderly patients; it is worth noting that the NHS spends about seven times as much on an 80-year-old person as on a 30-year old and coming years will see a rapid rise in the elderly share of the population. This may be a small step towards plugging an NHS funding gap that is forecast to reach £30bn by 2021 but, as one of our leading supermarket chains used to say “every little helps”.