This article is sponsored by Philips and was first published by New Statesman on 13 November. It is re-published here with permission

How should we address the problem of our ageing society and its impact on the NHS? It’s a question that ministers and health professionals have long been grappling with.

The challenge is enormous. The needs of older people are complex. One in four hospital inpatients has dementia and one in three adults admitted acutely to hospital is in the last year of their life. With life expectancy increasing – by 2030, it will be 88 for men and 91 for women – demand for services won’t slow down. This has created a difficult situation for the NHS, which simply doesn’t have the capacity to cope with the numbers coming through its doors. Indeed, many hospitals are reporting huge pressures from both increased A & E attendance at the front end and delayed transfers of care at the back end, according to a benchmarking report, Older People in Acute Settings, published by the NHS in April this year.

More integrated health and social care provision will help, as will the army of volunteers that Sir Thomas Hughes-Hallett recently suggested we need. The chairman of Chelsea and Westminster Hospital in London believes that a “HealthForce” of volunteers could be trained to help care for elderly and frail individuals before, after and even during their stays in hospital.

However, there is a need to reduce the number of people physically accessing NHS services. Achieving this requires a combination of preventative measures that support healthy living and well-being and self-care initiatives that reduce reliance on hospitals.

Here, technology has an important role to play.

Better health at the push of a button

At their most basic level, websites provide information, support and companionship. Carers UK, for instance, has an online forum on which carers can pose questions and share advice; Cura offers a simple, secure and shareable online calendar that helps families find respite care for their loved ones; while Grannynet supports a community of more than 3,000 grandmothers.

Smartphone apps can also help to optimise personal ageing. There are some 100,000 health apps available today, many of which aim to address health inequity, increase physical activity and healthy diets and empower people to take control of their own health.

Loneliness and isolation have been linked to a range of health problems, from depression to the increased risk of heart attack and stroke. To try to address this, tech companies are developing easy-to-use tools to connect older people to their friends and relatives, such as a Skype-like video-conferencing facility that works through a set-top box and remote control, rather than through a computer. However, with the prevalence of smartphones and tablets these days even among the older community, tools such as SMS, WhatsApp, Snapchat and Instagram are also becoming more commonly used.

Staying independent for longer

“For older people whose illness and disease have been diagnosed, assistive technology has the potential to help them manage their conditions much more easily,” says Alan Davies, director of home health care at Philips. He refers to how telecare, telehealth and telemedicine can all contribute to longer independent living, more cost-effective provision of care and less wasted time.

“Telecare is the provision of remote alerting technology for people often living in their own homes. It doesn’t replace physical care itself but it can reduce the supervisory element of it, encouraging more independence whilst giving the person peace of mind that when they do need help they can still get it,” he says.

Davies uses the example of fall detectors to illustrate the benefits of telecare. Falling is the most common cause of injury-related death in people aged over 75 in the UK. There are around 282,000 reported falls each year, costing the NHS £2.3bn. Fall detectors can be an effective way to combat this problem. The Philips Lifeline AutoAlert is a pendant that people wear around their necks. It uses a series of sensors and algorithms that can detect when someone has fallen and will subsequently notify the carer or health team. This enables the wearer to access medical treatment much more quickly and potentially prevent further complications.

Telehealth involves the remote collection of physiological trend data – for example, by monitoring vital signs, such as blood pressure, heart rate and glucose levels – all from the comfort of the individual’s home. “At its most complex, it uses a range of sensors that would have previously required a trip to hospital. Nowadays, however, it can also simply mean an SMS-based care-plan prompting tool into which the user manually enters data or even a preventative, change-of-behaviour-oriented app linked to an mHealth [mobile health] wearable sensor. Whichever is used, the data is collected for interpretation against goals or thresholds and can be used by both the individual and clinicians to make decisions about actions to improve an individual’s health,” says Davies. “It can also mean individuals can get home earlier from hospital with a complementary programme of step-down recuperative care.”

Telemedicine, in which consultations are delivered remotely through video and audio, also reduces the need for patients to travel to hospital or the GP surgery.

“Telecare, telehealth and telemedicine enable patients to remain at home and give them back some measure of control. For example, for a COPD [chronic obstructive pulmonary disease] patient, if they are feeling anxious, they could review their recent trend data against the clinically defined thresholds set for them to get a sense of how the aggregate information collected measures up. If the equipment is showing that they are within acceptable boundaries, then that can reassure them and reduce the need for calling an ambulance,” says Davies. “Meanwhile, this same information is being received by a clinical multidisciplinary team (MDT) member, who, on a different week, seeing the trend moving in a concerning direction, might be in touch with the individual to help them take corrective action well in advance of the situation becoming more serious. It’s technology like this that can play a useful role in freeing up capacity within the NHS and better leveraging the available resources.”

For all the benefits that technology can bring, there are challenges, too – especially around adoption.

In May 2014, Philips and the Global Social Enterprise Initiative (GSEI) at Georgetown University’s McDonough School of Business, Washington, DC, held an event titled “Ageing Well Working Session: Creating Connected Communities for Ageing Well” to try to identify some of the attitudinal barriers that need to be overcome if smart home technologies are to be more widely adopted. Some 91 per cent of older Americans say that they want to live in their own homes as they age; however, most do not plan to take the necessary steps, such as remodelling their home or adopting smart technologies.

One way to tackle this, the event report suggests, is to focus on developing and promoting tools that involve technology they are familiar with. “Ageing Americans are willing to invest in new tech for things that they are comfortable with and use regularly and in which benefits are tangible,” argues the report, which also suggests that people will “age into tech”. “Product strategies are needed to expose boomers to smart apps now to ensure a seamless transition to more assistive, smart technologies later on,” it says.

Older people are becoming more familiar with new technologies. The number of people aged 65 and over accessing the internet rose by more than a quarter in the space of a year, driven by a threefold increase in the use of tablet computers to go online, Ofcom revealed in 2014. The proportion of those aged over 65 who are accessing the web reached 42 per cent in 2013.

Despite this, older people can also have very complex needs that can make the provision of appropriate technology more costly and complicated to deliver. For example, a study by the Blackpool Teaching Hospitals found that the average 65-year-old with diabetes will have several other morbid conditions. Making sure that the telehealth provision meets all of those needs and is delivered in a way the individual understands can be challenging.

Telehealth-supported remote care is not suitable for every patient. “If you have a history of self-harm or alcohol abuse, it can be difficult to provide remote technology that can improve the quality of life. In these cases, a different approach to developing a goal of wellness must be taken but, once stabilised, this technology can then be introduced to support,” says Davies.

Support for carers, too

It isn’t just older people who can benefit from technology. It also helps their carers. Of the 6.5 million unpaid carers in the UK today, some 40 per cent look after their parents or parents-in-law. Technology can help reduce or remove some of the many duties they have. For instance, tablet dispensers help them manage medicine, while remote consultation facilities and online services allow them to connect with service providers. It is even possible to place GPS trackers in shoes to help care for patients with dementia who are prone to wandering off by themselves and getting lost (assuming a “best interests” test has been undertaken or consent provided, in accordance with the Mental Health Act).

Again, there can be barriers to adoption. A study by Georgetown University, also as part of the Ageing Well hub that is supported by Philips, showed how some caregivers are unconsciously disregarding enrichment as a goal in their care recipient’s life, instead focusing on the functional and practical duties of each day. For this to change, the report suggests, much more support and training for carers is needed.

Technology provides us with the opportunity to reimagine ageing and to find creative ways to address the challenges that our health service currently faces. Increased use of the facilities mentioned here and more can help maintain independent living and encourage cost savings. A win-win for everyone.

This article is sponsored by Philips and was first published by New Statesman on 12 November. It is re-published here with permission.

When you pay for your goods at the supermarket, the chances are that you also collect loyalty points. This data is then used by the supermarket to identify sales trends, understand its customers and optimise what it offers – as well as to develop special deals that might entice people back for more.

Your local council may be doing something similar with the data it holds – looking for trends in rubbish collection, energy usage and the volume of traffic to deliver better services for residents.

In health, it’s no different. Many decisions concerning the type of health care that the UK needs and how best to deliver it are being made based on vast amounts of data.

The collection and use of “big data” have grown exponentially over the past few decades, powered mainly by the availability of ever cheaper, smaller, Wi-Fi-enabled technologies, including smartphones and tablets, which enable individuals and businesses to connect to the internet and cloud storage.

As more data is created and recorded, more analysis can be done to reveal patterns, trends and associations, especially relating to human behaviour and interactions. On the whole, these are not trends that can easily be detected by the eye alone – and so complex algorithms are relied on to identify patterns that can be used to enhance knowledge and inform decision-making.

Within health care, this data can be very useful. There are benefits for the mass population (big data) and for the individual (what the health-care company Philips calls “small big data”).

Big data in health care is used in a number of ways. It can help us to predict epidemics, cure disease, improve quality of life and avoid preventable deaths. A recent example is the response to the ebola outbreak, in which agencies used computational modelling to provide in-depth analysis of how the disease might spread. Big data is also valuable in the development of new and more effective drugs, while the processing of genotypic and phenotypic data is helping researchers to identify biomarkers that can be used to stratify disease risk.

More recently, big data has been helping governments around the world to understand their local populations and tailor the delivery of health care according to their needs, says Jeroen Tas, chief executive of health-care informatics solutions and services at Philips.

“When you look at the patterns over time from within a city of, say, 1.5 million people, and you see how people move through different risk classes, you can begin to understand what triggers those risks. Once you do that, you can predict what the health needs and costs will be and can begin to organise clinical programmes around those needs,” he says.

Small big data

The next stage in the digital revolution is to use data to understand as much about a patient as we can, as early in their life as possible. By collecting and analysing data and maintaining a constant, seamless connection to relevant health professionals, those gathering the information aim to prevent illness and disease from occurring and to address them at a much earlier stage, thus maintaining well-being in the individual and saving costs for the health service.

This is about not just electronic medical records but the full spectrum of data garnered across the health continuum – from healthy living, prevention and diagnosis to recovery, treatment and home care. It includes information on vital signs and physical and mental well-being. This kind of data can be gathered through wearable technology, apps or home-based devices that patients use themselves, as well as through the monitors and imaging systems that are available at hospitals and health centres.

Prevent, predict, heal

Small big data encourages individuals to take a more direct role in their health, including in the areas of prevention and treatment. The Philips Picture of Health report has shown how personalised health data, such as that contained within Fitbit apps, can inspire people to manage their well-being more actively. Some 79 per cent of those who track their health using apps and other self-diagnosis tools say that they have changed their habits as a result of the data provided, be it by increasing the amount of exercise they take or by eating more healthily.

Over the course of the past few weeks, I have had the opportunity to speak with several members of the Philips team to discuss what benefits this “digital revolution” might bring to the NHS. They say that when personalised health data – not only basic vital signs collected through smartphone apps but more complex data, such as blood pressure, glucose levels, and so on – is shared with doctors and other medical professionals, the potential for better, more effective and economical health services grows exponentially.

“The most exciting [aspect] for me is the ability of data and technology to predict emergencies,” says Neil Mesher, managing director of Philips Healthcare UK and Ireland, referring to how access to huge databases of information about the state of the health of the general public will allow problems to be spotted before they occur and remedies – either medicinal or educational – to be prepared in advance.

“It’s tiny variations in the data that give the clues as to what’s actually happening. If you monitor vital signs over time within an ICU [intensive care unit], you can predict a cardiac incident, so you can intervene and actually stop it from happening. This means you don’t need to have crash teams trying to resuscitate patients, which influences how you plan your activity within your ward. The impact on the patient is also profound and it also changes the type of follow-up care that person may need. There is so much you could do with that kind of data,” he says.

This article is sponsored by Philips and was first published by New Statesman on 4 November. It is re-published here with permission.

In August 2015, New York City experienced an outbreak of Legionnaires’ disease. The worst in the city’s history, it claimed 12 lives and affected more than 120 people. As the sickness spread through the South Bronx, more and more people wanted to know what it was and how to prevent it. The first place many turned to for information was Google. Searches for “Legionnaires’ disease” spiked over 1,000 per cent, instigating an update on information from Google in its health conditions feature.

Overall, one in 20 searches on Google is for health-related information and the website now offers information on roughly 900 different conditions, covering symptoms, treatments, prevalence and prevention. This information can be downloaded and printed in PDF form – a facility Google recently began offering in response to requests from doctors.

In the UK, a third of the population uses search engines for health advice – the same proportion as those who contact their GP, according to recent research by the Natural Hydration Council, which surveyed attitudes among 2,000 consumers.

Meanwhile, the Picture of Health report commissioned by Philips found that 75 per cent of the British public is digesting health information from a wide range of sources, primarily health-related websites (26%), medical professionals (38%), search engines (27%) and food packaging (22%). Of those British adults who turn to social media channels for health information, many consult these channels at least once a week – Twitter attracting 69%, Facebook 68%, YouTube 56% and blogs 53%.

“As you might expect, millennials are more likely than the majority of adults to use search engines, websites and social media channels as their main information sources,” wrote the report’s author. “Having this information at their fingertips means they are more likely to consult a search engine than a health professional as a health information source – in stark contrast to older British adults, who, without question, consult the doctor most.”

It isn’t just websites to which the public is turning for health information. Home testing kits are also becoming increasingly popular. Pregnancy testing has of course been a form of self-diagnosis that has been around for many years, but in recent years more products have become available. It is now possible to test for diabetes, heart disease, bowel cancer and much more – all from the comfort of your own bathroom.

Meanwhile, new connected devices – such as the Philips health watch, which continuously and automatically measures a wide range of health biometrics – are becoming increasingly popular, particularly with those aged 18-24, who are “just as likely to use social and ‘connected’ outlets to assist with health management as they are to visit a professional”, according to the Picture of Health report.

If you are a slightly cynical individual, or prone to worry, you would be forgiven for raising concerns about the reliability of online or home-based health care and, indeed, the risk of mis-diagnosis. In the case of DIY health testing kits, the consumer group Which? found those it tested to be misleading, offering false reassurance or triggering false alarms. Meanwhile, websites containing certain information on symptoms and conditions do not take into account family history and social context when providing analysis and so can miss information that is vital for an accurate diagnosis.

“A large proportion of us are trusting information that can be accessed in seconds to provide answers to issues that could be fairly complex. Although there is a lot of credible information on the internet, there are also a lot of health messages out there that often have no evidence to back them up. I urge everyone to check the credibility of the advice they are seeking online,” says Dr Henderson, a senior partner in a Shropshire general practice.

However, although these concerns are valid and there are certainly risks attached to relying on information online, the public is not always as gullible as media reports insinuate.

Christine Marton, in a piece of research published in the Journal of Hospital Librarianship in May this year, found that approximately half of UK respondents checked the authorship or source of the consumer health websites they visited to determine which organisation was responsible for the content, whereas only 15 per cent viewed the website’s privacy policy to determine how it uses personal information obtained from users. Equally, the most popular site used for health information is NHS Direct, receiving 64 per cent of visits – suggesting that people are keen to ensure the information they are looking at can be trusted.

All of this contributes to a much wider public understanding of health and health care, Christine Marton found. Almost all (93 per cent) of respondents stated that “the health information they found online had helped them to improve their understanding of an illness or injury”, and over half (57 per cent) had taken action to improve their health based on what they had learned. “Furthermore, several health outcomes resulted from searching from health information online, in particular, improving eating habits, increasing exercise, and relaxing more, especially for those who had used the NHS Direct website,” her report states.

These findings reflect those of the Philips Picture of Health report, which stated how health-care professionals observed psychological benefits among patients who track and share data. Fifty-five per cent of professionals believe that patients are more motivated to follow through with treatments and 41 per cent believe patients are more likely to observe their advice as a result of turning to digital sources for information.

Clearly there are challenges with self-diagnosis: the same Philips report also found that 41 per cent of health-care professionals said patient reliance on digital media for health and wellness information makes their job more complicated and can act as a barrier to the doctor learning about the individual. However, there are also benefits for the patient-doctor experience.

“Patients who are better prepared with their own statistics and their own health data can also prepare and help the clinician and the GP to give a better assessment and a better diagnosis,” says Neil Mesher, managing director of Philips Healthcare UK & Ireland, adding that “the other opportunity is giving patients the tools to better describe and analyse their symptoms”.

Dr Taylor, a GP from Warwickshire, agrees. “When patients come in having read about what might be wrong with them, it can help me guide my questions and get to the source of the problem much quicker. However, if you go against their opinion you have to do so in a way that is very persuasive and explains precisely why you don’t think they have whatever condition they have researched. Good communication skills are paramount.”

As technology improves so, too, will the quality of the information available to both patient and doctor, and the benefits of online health-care information and self-diagnosis tools will be felt more widely. We are already beginning to move towards an era of online patient records, while medical advances mean phenotype and genotype modelling is now possible, giving much greater insight into a patient’s genetic make-up and individual characteristics. Combine this information with the data contained in health tracker apps and soon it will be possible to view a holistic picture of an individual’s health profile from any PC, tablet or smartphone. The patient/professional data exchange has the potential to improve efficiency and efficacy when it comes to both prevention and treatment, thus improving health in the individual and reducing pressure on the NHS.

Of course, better access to quality information is vital to improving the nation’s health, but it is not a substitute for health care itself. As Hippocrates once said, “Science is the father of knowledge; opinion breeds ignorance.” Health-care professionals should always be consulted in the event of medical concerns.

This article is sponsored by Philips and was first published by New Statesman on 16 October. It is republished here with permission.

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Heart failure patient Gordon Hennessy doesn’t go into hospital as often as he used to. These days he monitors his own vital signs using a package of technology, education and support from clinicians at Bristol Community Health.

The health centre has been working in partnership with Philips to deliver an innovative supported self-care project, aimed at building evidence for a large-scale, long-term condition management programme. Sponsored by the West of England Academic Health Science Network and concentrated on the population of one GP practice in Bristol, the project focuses on increasing patients’ confidence in managing their own health needs at home, keeping them independent for longer. It also highlights more complex patients who require intensive monitoring and regular support to prevent their conditions becoming worse. If successful, it will be expanded across Bristol.

“All patients self-care to some extent, and supported self-care is all about enabling them to do that better – giving them the tools and support to help them manage their health and well-being,” says Hanna Eklind, a community matron at Bristol Community Health.

As new technologies come on to the market, more opportunities to manage health better are being created, bringing with them . No longer does the patient experience have to be fragmented and reliant on appointments that need to be made many days, or even weeks in advance. With , big data analytics and algorithms, as well as secure cloud-based technologies, it is now possible for care teams to monitor hundreds of different people in different locations at the same time – reducing costs and improving efficiencies – and for individuals to take much more responsibility for their own health.

“By securely connecting patient-gathered information to clinical data and turning this into actionable information, we’re helping promote better self-management,” explains Alan Davies, director of home health care at Philips. “Technology is empowering patients to take control. It gives them a better sense of their own well-being and encourages them to do something about stabilising or managing it.”

Pilot projects that encourage patients to take a more active role in managing their health have identified big cost savings for health providers. In America, an at-home telehealth programme for patients with multiple chronic conditions, operated by Philips and Banner Health, reduced care costs by 27 per cent; it also reduced acute and long-term costs by 32 per cent over a six-month period. These savings were driven by a reduction in hospitalisation rates of 45 per cent over the same period.

“Telehealth is opening up choices for patients and providers, giving them the freedom to transform how, when and where proactive care is delivered,” said Derek Smith, senior vice-president of Hospital to Home at Philips. “By focusing on those patients who generate the greatest health-care spend, we’re able to help these individuals get better care in the comfort of their own homes, while helping health-care providers achieve the financial reductions they need.”

Prevention better than cure

Of course, the benefits of supported self-care are not restricted to those with acute long-term, pre-diagnosed conditions. They also apply to individuals who can use supported self-care to help slow down the worsening of milder forms of illness and disease. As we know, the best way to optimise our health and well-being is to limit risks and take advantage of prevention interventions. Technology can help facilitate this, be it by encouraging people to increase physical activity, balancing nutrition, tracking vital health indicators before a problem occurs or reminding people to take their medicines.

Technology could, for example, prove to be a useful tool in the battle against the big killers: heart disease, stroke, cancer, respiratory diseases and liver disease – conditions that account for more than 150,000 deaths a year, some 20 per cent of which are believed to be entirely avoidable, according to the Department of Health. Although there can be many reasons why people develop these diseases, lifestyle factors such as smoking, obesity and high levels of alcohol consumption increase the risk.

For example, about a sixth of the total UK population smokes cigarettes, including 22 per cent of adult men, 17 per cent of adult women and roughly 8 per cent of teenagers. Smoking accounts for more than a third of all respiratory deaths, more than a quarter of deaths from cancer and about one-seventh of cardiovascular disease deaths. Overall, about half of regular cigarette smokers will eventually be killed by their addiction.

How can self-care technologies help these people? Surveys show that about two-thirds of current smokers would like to stop smoking. Mobile apps have been developed to help them achieve this. The programme of support on offer includes daily trackers, money saving calculators, motivational pictures and videos, and signposting to other services – all in the palm of the user’s hand.

Similar apps exist to help people lose weight, get fit, track the number of calories or units of alcohol they’ve consumed, or nudge them to move if they’ve been sitting for too long – easily done, when you consider our increasingly sedentary pursuits, be it at a desk, in a car or in front of the television.

Apps such as these are a familiar addition to many smartphones these days. However, there are others that are even more intelligent when it comes to the management of health conditions. There are apps to check for signs of skin damage, apps to allow cancer patients to manage chemotherapy toxicity effectively . . . It is even possible to attach ECG machines to smartphones. Meanwhile, Philips has developed apps to and chronic obstructive pulmonary disease manage their own care in partnership with health professionals, while the company’s connect clinicians to patients and enable remote monitoring and intervention.

��Quality first

The integrity of the data a tool carries is vital if it is to be useful for both clinician and patient. As an industry leader and global brand that works in partnership with health systems around the world, Philips tests all of its new tools thoroughly, both before they hit the market and throughout their lifespan. However, any app that can be downloaded off the internet needs to be investigated properly to ensure it does what it says it does, otherwise patient safety could be compromised. The NHS is aware of these risks and has launched its own that contains only those apps it has reviewed for safety.

Equally, health-care professionals need to understand which apps and other forms of self-care technologies are able to meet the needs of patients, and which patients should be given access to the technologies in the first place.

“GPs feel accountable for their patients and want to know that they are safe,” says Alan Davies. “So one of the things Philips does with supported self-care is to make sure GPs have access to the information they need. It’s vital that we make the connection between any data an individual may be tracking and the medical data tracked by professionals.”

A key factor here is ensuring that patients are supported when it comes to using and interacting with these new technologies, Davies says. “I’ve talked to some GPs who are concerned about those patients who, instead of being motivated to manage their health within a set of parameters, become more anxious given this clinical knowledge. These are legitimate concerns but can be addressed.”

For instance, it is possible to use modelling techniques to assess a person’s propensity and capability to use and understand technology and its results, particularly more complex machines, such as blood-pressure cuffs, scales and glucometers. “There’s a proportion of the population for whom it may not be suitable for them to use what’s on offer, but for those who can use it we look to educate them through one of our content partners,” he explains. The British Lung Foundation, for example, provides videos for people with COPD, who are then tested on what they have learned, while non-clinical supplementary health coaches can sometimes be provided to answer questions and provide additional support.

While many patients may be nervous or unsure at first, it is often the case “that, once people are used to the new technology, they don’t want to let it go because it does provide a lot of care and reassurance”, Davies says.

These comments are reflected by Gordon Hennessy’s own experiences. He initially found the technology used to monitor his heart condition “daunting” but soon got used to it.

“I’ve found it very reassuring. My community nurse is at the end of the phone, and my doctor’s at the end of the phone,” Hennessy says. “This scheme gives you confidence. If there’s anything wrong my doctor will pick it up.

“It certainly helps me, and I think it would help other people, too.”

This article is sponsored by Philips and was first published by New Statesman on 1 October. It is re-published here with permission.

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A woman gets up in the morning and brushes her teeth using her smart toothbrush that charts her brushing activity and shares it with her dentist. She then exercises using an app on her smart phone that visualises muscle activity and tracks her progress, and makes a note of the calories she consumes at breakfast – important if she’s to maintain a healthy weight.

Her journey to work is by scooter, which has an electronic alert system that automatically alerts her relatives in the event of a crash. Once at work, she sits at her smart desk, which part way through the day notifies her that she’s been sedentary for too long and then orders her lunchtime salad. She also makes the most of her wearable device that tracks her alertness – using her smart sleep mask for a power nap if needing to boost her productivity.

Once it might have sounded like a scene from Back to the Future but today this technology exists, and there’s an increasing appetite for it.

The Internet of Things, as it is known, is growing in size, momentum and economic value. In 2005, there were 2.5 billion connected devices, mainly PCs, smartphones and tablets. By 2020, Gartner predicts this figure will have risen to more than 30 billion, with most devices not being PCs but other objects such as those listed above, adding an estimated $1.9tn to the global economy. Not all of these devices will add value to people’s lives, certainly not in a health context. But of those that do, they have the power to transform the way in which we deliver and receive healthcare.

The Internet of Caring Things (IoCT) has been coined to describe a network of connected objects that serve to actively care for an individual’s physical and mental wellbeing, safety, security and oversight of their loved ones. The vision is for the network to connect an individual’s personal space, and everything they need and value, including health and social services, charities and third sector groups, gyms and leisure activities, and so on. For the NHS, where less than 2 per cent of patient interactions are currently digital, the challenge is how to connect the dots in a way that will create the scale and breadth needed for it to play a full and effective role within this new age.

The NHS isn’t alone in facing such a challenge. Wireless technology is causing disruption across all sectors. In retail, customers are wirelessly comparing products and prices while shopping in store; in the hotel industry, Wi-Fi is now considered the most important amenity to offer guests; and Wi-Fi is even expected to be provided on planes with fliers keen to maintain connection with their favourite apps and social networks while up in the air. As universal connectivity becomes an accepted part of everyday life, it is natural that our healthcare and how we manage our wellbeing should also benefit from the multitude of innovative technologies available today.

There are a number of factors that are driving demand. Cheaper and more efficient wireless chips, barcodes and sensors are making it viable to add connectivity to more objects; Wi-Fi speeds have increased significantly; expansion of the cloud means there is more storage for all the data created by the IoCT; while geo-location tools make it possible for an individual’s location to be known almost to the nearest centimetre; and previously the development of new hard and software would have been the remit of big technology companies with large budgets, but thanks to crowdfunding, anyone with the right skills can do it. Meanwhile 5G is about to significantly speed up downloading and uploading times.

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A key priority within the NHS England’s Five Year Forward Review is the shift in focus to helping prevent and more effectively manage long term health conditions. It’s here that the opportunity for the IoCT is greatest, particularly in terms of predicting human behaviour and empowering individuals to manage their own health.

The rise of self-care, which empowers individuals to manage their own health with the support of healthcare professionals, has an important part to play in enabling the collection of data used by the IoCT. One organisation that is making great strides in this area is Philips, which believes that cloud-based and connected technologies, combined with the use of big and small data, hold the key to improving health outcomes.

“Healthcare is the last industry that still does everything face-to-face but that is going to change as a result of new technologies that allow us to monitor people’s health,” says Jeroen Tas, chief executive of healthcare informatics solutions and services at Philips.

He explains how by using phenotype and genotype modelling – a system of assessing bio- and physio-logical characteristics and traits – along with complex algorithms that are pre-programmed into devices and associated databases, patients can be educated on the changes they need to make to lifestyle and diet. They can also be provided with the tools they need to monitor their health – ranging from smartphone apps that count the steps they walk, to home-based devices, such as blood pressure monitors and insulin readers. In addition, health coaches can be used to provide motivation and cost-effective, on-going support; while prescriptions can be re-ordered and delivered without the need to visit a surgery.

“We can also collect patient data and stream it to a telehealth centre where it is then analysed and compared with the profile of the patient. If any red or amber flags occur, a healthcare professional can then prioritise and dynamically allocate key healthcare resources to where they are needed most,” he says, emphasising how this gives the patient greater control over their own lives and frees up the NHS to concentrate on the most needy and urgent cases, enabling faster diagnosis and more effective clinical decision making.

For example, as part of its digital HealthSuite, Philips has developed a prototype solution that continuously monitors patients with chronic obstructive pulmonary disease (COPD), including while they are at home. The solution collects patient vital signs from a wearable sensor as well as feedback the patient enters directly into a mobile application. This data is tracked and compiled in the Philips HealthSuite digital cloud, which is then monitored by care providers who are able to make adjustments to the care package if needed. Meanwhile, the patient has access to the same data, giving them, their family and carers much greater insight into their condition.

Given that shortness of breath is the third most common emergency call and that COPD results in 24,000 deaths each year, the need is immediate. For a nation that is grappling with how to reduce A&E admission and GP appointments, and to provide cheaper care in the home, being able to better manage just this one condition represents a significant opportunity for greater efficiencies and improved patient outcomes.

It isn’t just individuals who can benefit from the IoCT. The aggregated data can help Healthcare professionals understand population trends and their impact upon service delivery, and it can help hospitals and medical centres manage their in-house technology more effectively. For instance, technical problems with a heart monitor can be tested, diagnosed and even fixed remotely – dramatically reducing time and repair costs – while devices needing supplies, such as helium in an MRI scanner, can be tracked and refuelled before they run out, thus avoiding downtime. Meanwhile, managing all of this via the cloud allows doctors to easily see which machines and teams are in use and where there are gaps in scheduling – helping to reduce waiting lists.

The Secretary of State for Health, Jeremy Hunt, is keen to see the NHS maximise the opportunities self-care and connected health have to offer. He has recently taken steps to bring about the changes needed by announcing that by 2018 all patient records are to be online and accessible from any location by both medical professionals and patients themselves.

“Evidence from all over the world shows that when patients start accessing their medical records then they start to think about their health in a different way. When you have shared access healthcare becomes a shared endeavour,” he said during his speech at the recent NHS Innovation Expo in Manchester, highlighting how this results in better health outcomes for the patient.

Modern 21st century healthcare has to be fit for purpose, patient-centred and capable of dealing with a population that lives longer but not necessarily healthier lives. And it has to achieve this while finding savings of £30bn by 2020. The Internet of Caring Things looks set to make achieving that goal a whole lot easier.

This article is sponsored by Philips and was first published by New Statesman on 1 October. It is re-published here with permission.

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We use the internet for shopping, banking, for so many aspects of our lives. Yet we’ve barely scratched the surface when it comes to health-care, which is curious because health-care matters more to us than any of those things. So, here is the question – can Britain step up to the plate and be the global leader in the use of innovation and technology in health-care, in the way we have done so often in the past?”

This was the challenge that Jeremy Hunt, Secretary of State for Health, set the NHS when speaking at the NHS Innovation Expo in Manchester earlier this month.

Of course, in a country where only 2 per cent of interactions with the national health service take place online and some medical centres still rely on fax machines, meeting Hunt’s challenge isn’t going to be easy. However, it is going to be essential if we are to close the widening gaps between the health of our population, the quality of care provided and the funding of these vital services.

The challenges our health service faces are well documented: an ageing population; increasing cases of chronic disease, such as diabetes, heart disease and cancer; unhealthy, sedentary lifestyles. These all threaten to destabalise and potentially cripple our most treasured institution: the NHS.

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The solution, as identified in the Five Year Forward View, published by NHS England in October 2014, is to complete a “radical upgrade in prevention and public health”, particularly around obesity, smoking, alcohol and the other major health risks that cause avoidable illness. The way people access health services also needs to change; patients are to be given far greater control of their own care while services are to be delivered in a way that supports the individual as a whole, not just a single disease. And all of this needs to be achieved while saving some £30bn from the budget. It’s a tough call, but not impossible, say companies such as Philips, a global leader in HealthTech. Not least because of new technologies and innovations that use data-driven, patient-centric approaches, and which have the potential to make significant improvements in population health.

There are already major steps being taken towards reducing the cost and burden of managing long-term chronic conditions. Take diabetes as an example.

People with diabetes type 1 make around 200 decisions a day regarding how best to manage their condition. From the moment they wake, until they go to bed, they are thinking about how they feel, testing insulin levels and making sure they have eaten the right foods. Although these decisions and the information upon which they are based could provide a doctor with useful insight into how better to care for the individual, they are not recorded; instead patients are forced to rely upon memory or their own notes if the doctor ever requires further information. Meanwhile, their previous notes are held in a file, where the patient cannot see them.

Imagine how much more effective it would be to manage diabetes type 1 if the individuals blood sugar and insulin readings were recorded and analysed electronically and in real-time – and could be accessed immediately if needed. Imagine how much easier it would be for the individual to cope with the psychological strains this disease places upon them if they had online access to health-care professionals, other patients and a social community who understand what it is like to live with diabetes.

This is what the future of diabetes care looks like and – thanks to a new prototype app from Philips, being tested by Radboud Medical Centre in the Netherlands – that future is here.

“Sometimes people with diabetes do everything by the book but still their readings can be high. Rather than having to wait for a doctor’s appointment, this new technology allows them to stream their data to a nurse who can respond immediately,” explains Jeroen Tas, chief executive of health-care informatics solutions and services at Philips.

This isn’t the only area where managing illness and disease is about to be transformed. Within heart health, the technology now exists to determine which patients with chest pain are likely to have a heart attack. Three-dimensional printing is allowing surgeons to better analyse the adjustments they need to make to vital organs before they operate. Clinical grade genome analysis and decision support tools are in development that will allow doctors to interrogate all known human genes for pathogenic mutations, which may be the underlying cause of a patient’s inherited disease.

“Philips has looked at patients presenting with a variety of different illnesses, including serious, life-threatening conditions such as heart problems. With each new connected technology we develop, supported by a digital health platform that captures and analyses historical and personal health data, we see better diagnosis and less invasive forms of treatment,” says Tas.

Meanwhile, 2018 could usher in a time when all patient records are electronic, allowing both the patient and health care professionals to access the most up-to-date medical records from anywhere (including an individual’s mobile phone) at any time.

This is just a small sample of the exciting innovations that are taking place within our health service and which have the potential to transform both outcomes for patients and the way in which we plan and deliver health care.

“It tends to be the top few per cent of the population that places a heavy load on the health-care system. By collecting and analysing data, we are able to spot patterns and establish how people move through the risk classes and what may trigger their illness. Clinical programmes can then be organised around those needs – and importantly can help identify appropriate prevention strategies,” says Tas.

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Successful adoption of such technologies, however, is dependent on a number of critical factors. Some are barriers that need to be removed – NHS IT capabilities and a willingness by health-care professionals to adopt new ways of working. Others are focused around the tech industry itself, such as the way in which it interacts and collaborates with the NHS when developing new systems and processes to improve health-care provision.

Some aspects of NHS digital infrastructure have been successful – NHS Choices (a public-facing website containing information about conditions and services) receives 40 million visits a month while the NHS Spine (the infrastructure that connects clinicians, patients and local service providers to essential national services, such as the Electronic Prescription Service and the NHS e-Referral Service) handles 200 million interactions a month-. However, others have not gone so well.

Ministers, NHS leaders and industry experts have all explained how lessons have been learned and they say that things will be different this time.

“In future we intend to take a different approach. Nationally we will focus on the key systems that provide the ‘electronic glue’, which enables different parts of the health service to work together. Other systems will be for the local NHS to decide upon and procure, provided they meet nationally specified interoperability and data standards,” the Five Year Forward View reads. And Hunt told the audience attending the NHS Innovation Expo at the beginning of September that the current track record of the NHS on delivering IT projects has given him confidence in what else it can achieve.

The use of new technologies such as the ones already highlighted relies on the collection, exchange and analysis of data, which in turn raises important questions about data security and the potential for data breaches. Hunt has stated that he has faith in the NHS to tackle this issue with the support of Dame Fiona Caldicott, the National Data Guardian. Encryption will also help – particularly when it comes to streaming data between patient and doctor devices.

“When banking online was first touted as an idea, lots of people said it would never happen because of the security concerns, but today it is an everyday secure solution used by millions. There is no reason why we can’t make it work for health”, says Philips’ Tas.

He says that part of the reason why previous tech projects haven’t worked is that “the model was wrong and didn’t fit the need”.

“It’s not about the technology, it’s about how you organise around it. You need to change people’s minds and the way in which they work,” he says, emphasising how technology projects shouldn’t neglect to focus on the cultural elements in favour of the hardware and software.

These changes need to extend beyond IT infrastructure and into the entire architecture of the NHS. For example, current financing and staff reward structures create incentives that can ultimately be counter-productive – such as hospitals being paid and staff performance being judged by the number of people they treat, rather than their ability to heal.

“Nurses are measured on activity not on the health of the patient. It has been designed this way because we didn’t have the data required to show accurate health outcomes. Now we do,” Jeroen Tas says. Our ability to collect, store, analyse and manage data in huge volumes is enabling us to understand the impact of our health-care systems and services in ways that previously we were unable to do. And that information can then be used to streamline, personalise and integrate these systems and services across the entire health continuum in ways that also haven’t been possible until now.

It would appear that Bruce Keogh, medical director for NHS England, is on a similar wavelength. Speaking at the same NHS Innovation Expo as Jeremy Hunt, he recognised that “the payment system introduces perverse incentives” and can influence organisational approaches to tackling specific procedures. This needs to be changed “quite quickly”, he said.

There are clear benefits to developing and strengthening partnerships with some industry providers, particularly those within health-care technology. The NHS is not a technology company. It does not have the skills, the resources or the public will to create, test and build the innovations that are needed and to shoulder the associated risks. Private companies do, and so in that sense collaboration with industry is a welcome and necessary element of transforming and improving our health service.

Likewise, the previously mentioned switch from an activity-based model to one that is outcome-based could help that relationship become more effective, particularly when it comes to costs, reckons Philips’ Tas.

“We want to enable the transformation of the NHS from a patient outcomes perspective. We can share the risk with the NHS by avoiding large upfront investment and costs of equipment. We provide services in which we share the burden and responsibility for improved patient outcomes. Our fee structure is dependent upon outcomes. By working in this way we can shoulder some of the financial risk and reduce the bill – we believe we can reduce costs by up to 20 per cent by keeping patients out of hospital,” he says.

One major potential barrier to the take-up of new health-care technologies is patients themselves, if feedback from delegates at the NHS Innovation Expo is any indication of mood. They were concerned that the benefits would be realised only by wealthier, healthier individuals who had the capacity to understand how the new tools worked. Would those who were too ill, or too old, or who have mental health issues find it difficult to access the new systems?

The answer is that there isn’t a one-size-fits-all model, and that systems and processes can be adapted to meet the needs of the individual.

“Technology can be a great leveller and, contrary to some perceptions, many older people use the internet. However, we will take steps to ensure that we build the capacity of all citizens to access information, and train our staff so they are able to support those who are unable or unwilling to use new technologies,” the Five Year Forward View says.

Behavioural economics, which uses psychological, social, cognitive and emotional factors to influence decision-making, also has a role to play in increasing take-up.

Professor Donal O’Donoghue concurs. The medical director of Greater Manchester Academic Health Science Network, who is also a mentor on the National Innovation Accelerator, said: “If we co-produce new tools with people and if we link it to behavioural economics, then you can make a 10 to 15 per cent difference to uptake. There will still be people who are challenging and have different health beliefs, which we need to work with, but if we go in with the mindset of all the sciences and all the skills that we have access to, and if we build it in with our local populations, then we can start to address the challenges we face.”

This co-production with both patients and providers – putting real-life needs and experiences at the heart of development –is key for effective innovation, stresses Philips’ Tas.

“We believe there is not a single party that can solve a complex problem [such as diabetes], so we like to partner with people who share in the same vision and that can bring to bear complementary capabilities,” he says. For instance, Philips is currently trialling a new digital platform called HealthSuite in partnership with Salesforce, which uses relationship management software to influence health choices by patients and to support decision-making by professionals. It believes this platform will eventually help people to maintain healthier lives and reduce costs for our health service.

Philips and other industry providers are being supported in their innovation programmes by the NHS itself. The National Institute for Health Research and its Healthcare Technology Co-operatives, for example, are bringing together a range of partners to help co-create new ideas and concepts. For its part, the National Innovation Accelerator (NIA) programme, set up by government with the express purpose of creating the conditions and cultural change necessary for proven innovations, is working to ensure that changes are adopted faster and more systematically throughout the NHS.

This is all well and good. However, to succeed, these advances need to be supported by health-care professionals, who will be required to work differently from the way they do at present. This in turn has an impact on medical curriculums.

So far, however, it would appear that medical schools have been slow to respond. As Davinder Sandhu, the Severn Deanery postgraduate medical mean at the Royal College of Surgeons, mused in a blog on the NHS website “doctors are training in a system that is outdated in terms of curriculum, patient expectations, and hospital structures”.

Limited information is available publicly as to which medical schools are embracing, updated curriculums that focus more on innovation. However, it is understood that the University of Surrey is one of a handful that are looking to launch an integrated Engineering for Health degree promoting the use of technology in medicine.

For inspiration,we should look to the United States instead. The American Medical Association has launched a $1m initiative called Accelerating Change in Medical Education. This svheme is designed to encourage medical schools to change their curriculum. And the New York University School of Medicine offers a module that requires students to analyse a database of hospital admissions for clues around health trends.

UK medical schools need to step up the pace. NHS talent is central to the future success of the NHS. As Bruce Keogh told audiences at the Innovation Expo: “The intellectual capital to solve many of the problems we face on a day-by-day basis lies not in some darkened room in Whitehall, but within the minds, the brains and the ingenuity of those people who work within the NHS and associated services, people who are prepared to do the best they can for our patients”.

Combine this intellect with the innovation and technologies that are entering the market and the NHS has access to a very powerful force. Harness that, and Jeremy Hunt’s challenge just might be achievable after all.