Major Report Urges NHS to Prepare for a Digital Future

Peter Russell

February 11, 2019

The NHS should prepare today for dynamic changes brought about by tomorrow's digital healthcare by training a technologically literate workforce, according to a major report.

The Topol Review said that the UK was in a unique position to become a world leader in healthcare technologies, particularly in the fields of genomics, patient health data, artificial intelligence (AI), and robotics.

These game-changing technologies had the potential to bring about individualised care, improve the accuracy of diagnoses and treatments, change the way doctors and other clinicians work, and give healthcare staff more time to spend with patients.

The Effect on Future Healthcare Will Be 'Dramatic'

"No one's ever done something like this – that is taking this new set of tools that are unquestionably having a dramatic effect on healthcare's future and to bring all the disciplines together, all the experts, and start to plan how to use these effectively, and what we can do to really benefit patients with all these new found capabilities," said Dr Eric Topol, professor of molecular medicine at the Scripps Research Institute, and editor in chief at Medscape.

Dr Topol's review was commissioned by the Secretary of State for Health and Social Care and produced by Health Education England (HEE).

It outlined how early education and training for NHS staff could lead to implementation of technologies at a faster pace and on a greater scale than anywhere else in the world.

The recommendations have been designed to support the NHS long-term plan and inform the workforce implementation plan.

The Department of Health and Social Care will formally respond to the recommendations at a later date. However, the Health Secretary Matt Hancock said: "Our health service is on the cusp of a technology revolution and our brilliant staff will be in the driving seat when it happens.

"Technology must be there to enhance and support clinicians. It has the potential to make working lives easier for dedicated NHS staff and free them up to use their medical expertise and do what they do best: care for patients.

"Technology will make the NHS the best in the world and I want everyone who works in the health and care system to be empowered to embrace it – from porters to pathologists, surgeons to social care workers."

Support, Education, and Training

Prof Ian Cumming, chief executive, Health Education England said: "What the Topol Review shows us is how technological advancements can improve the care and treatment hard working NHS staff are able to give if we provide these staff with the support, education and training they need now.

"To be ready for this exciting future NHS organisations will need to collaborate in creating a learning environment in which staff can embrace these technological leaps throughout their careers.

"As part of the NHS long-term plan, we will work with partners developing the workforce implementation plan chaired by NHS Improvement chair Baroness Harding to make these recommendations a reality. A reality that gives the clinician the skills, knowledge, leadership and investment they need to make these changes work for the NHS and the people it serves."

Harry Evans, researcher at health think tank The King's Fund, commented: "Technology underpins some of the most ambitious targets in the NHS long-term plan so it is vital that staff are able to use digital tools and understand the data they generate.

"The Topol Review makes a number of welcome recommendations to create a digitally-savvy workforce with the knowledge and flexibility to embrace emerging technologies.

"At a time when staff have never been more stretched, technology has an important role to play in making life easier for over-burdened nurses, doctors, and other staff, freeing them up to focus on supporting patients. As well as training staff to use technology, new systems should be designed to reduce the daily pressures facing NHS workers."

As the review was published, Medscape UK asked Dr Topol about some of the main changes that could be expected in healthcare over the next 20 years.

Q&A

Medscape UK: How important is it for the NHS to be planning a digital future now?

Dr Topol: It's certainly an opportunity. Over the years, the UK has established itself worldwide in genomics, so it's a natural to have these other capabilities integrated, and reboot how care is provided.

So this is really I think quite an important deflection point in healthcare, and this is an exemplary place for it to be moved forward.

Medscape UK: What will a digital healthcare system look like?

Dr Topol: There are many elements to that. Firstly, that you understand each person, each human being, at a much more granular level [as part of] individualised medicine. And that is bringing together not just the usual health record information but the genomic data and other biologic data as well as sensor data, physiologics – so all these different areas of information.

So that's one major part of it but then the fact is that each person is actively generating their data, seeing their data, and getting feedback – that's something that's very new, and it's taking hold with all these different sensors going to people's smartphones.

And then algorithms of AI take all this multi-modal data and give it to the person to help coach them, whether it's for a disease condition like high blood pressure, diabetes, or depression; or whether it's for complete general health guidance.

So these are the things that make the future look totally different than what it is today.

Medscape UK: What will all this mean for today's clinicians and for those yet to even begin their medical training?

Dr Topol: I think this is where they'll see some pretty drastic changes because so much of the task that doctors and clinicians do today will be augmented because of algorithms and machine support so the workflow, productivity, and efficiency can be greatly improved; and then there's the room to be connecting better with patients and to fight the burnout problems and the sense of not being able to care for people, which has been a pervasive problem, certainly in the US, and my understanding, also here in the UK.

Medscape UK: Burnout in an overstretched NHS is a recurrent theme in the UK. Are you saying that a more digitally focused NHS can improve that situation?

Dr Topol: I think that's perhaps the most important component, this gift of time, yes. Because it's not just a question of feeling less pressured but also the patient feels like there's a much more meaningful sense of coaching and guidance. So this is what's essential and what's been missing, and we've seen gradual erosion of that over decades.

It's time to restore it.

Medscape UK: But to achieve that, today's doctors and clinicians will first have to become more technologically literate?

Dr Topol: That's true but we hopefully can't get tainted by the very negative experience of electronic health records which were largely a fiasco because they're so clunky and difficult and really not the kind of user interface that we want.

So, these things as they go forward have to be really smooth and streamlined and not in any way interrupt the flow of care.

Medscape UK: What response are you getting from government and healthcare providers?

Dr Topol: I met with the Secretary [of State], Hancock, this morning, and others, and there seems to be resounding support for this vision of our review. So that was really very reassuring – it's terrific to see that.

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