What are the four main remits of digital healthcare?

The four remits are:

1. Electronic patient records
2. Mobile health (mHealth)
3. Data analytics
4. Telehealth

Provide an example of each of the four remits:

Electronic patient records:

This would be information such as consultation notes, digital imaging files and test results that are kept in a digital system with a record for each patient treated by the medical provider. These can then be easily shared with other providers should the patient be seen at another clinic or hospital.

Mobile health:

A lot of mHealth apps at the moment address fitness and wellbeing through exercise, diet, sleep and mood tracking. In the future, we may see apps that can detect or diagnose health problems before even seeing a medical professional. Hhowever, this is potentially a dangerous line to cross due to the chance of errors, which is why these apps currently should not give medical advice under current regulations.

Data analytics:

Data from mHealth apps or electronic patient records can be used to draw conclusions in research. For example, with medical and location data, you could describe how a disease is spreading geographically through a population, or by using pharmaceutical treatment and patient wellbeing data, you could draw conclusions about how long it takes between a course of drugs and the resolution of the disease.

It can also apply on a user basis as well with apps alerting the user or health professionals when a desired metric goes beyond defined limits. An example of this would be an blood glucose measuring device that alerts the user when their blood glucose is too high or too low so that they can resolve the problem before it can turn into something more harmful.

Telehealth:

Telehealth tends to address the idea of having GP consultations remotely. This is usually done by phone or video call, of which the Babylon Health app is prominent example.

The development and the delivery of each of the remits are at different stages in the UK. Why do you think this is the case?

Primarily, I think that one of the biggest factors for the prolonged delivery of digital health within the NHS is due to the national scale it has to address and the large investment that requires. There are definitely promising trials within local areas, but for these to be upscaled to the whole of the NHS requires a lot of work which can take years and an awful lot of money.

Which of the remits do you think is most and least established in the UK? Why

Regarding electronic patient records, it took some digging to find out that there was an attempt at an electronic system called the National Programme for Information Technology that started in 2002 and was officially written off in 2011 after a total investment of £12.7 billion. This was because of poor planning, but it may have also been a little ahead of it’s time and the technology for something on that scale wasn’t necessarily feasible, or at least it wasn’t thoroughly checked that it was feasible. On the other hand, it now seems almost absurd to think that some areas of the NHS might have still been using paper records until just a couple of years ago. In 2014, NHS England released their Five Year Forward View which states that they aim to make patient records largely paperless by 2020.

Mobile health is becoming more popular within the UK. There are certainly well established wellbeing and fitness tracking apps, but these are rarely integrated with the healthcare system. The NHS now has an apps list for apps with reliable medical information, or even to use with some NHS systems such as digital booking and prescriptions, and even monitoring your baby if it is intensive care.

Data analytics is certain to be a big player in digital health over the next few year. The NHS uses analytics to improve health surveillance, medical research and policy making. In general, the more data they have, the more likely analytics will be able to make connections about how to improve healthcare for everyone. Unfortunately, things are never quite that simple and such a large entity as the NHS does not come without it’s own problems. Data capturing, inconsistencies in the ability for analytics across the NHS and skills shortages are all issues that the organisation faces and with such large amounts of data being produced, it’s easy to see why.

Honestly, it took me a long time to find anything on the state of telehealth in the UK. Generally I found that certainly places have trialed it with some positive outcomes and some claiming that the cost is (or was) not worth the reward. It seems that telehealth is established in areas that need it or have had positive trials with it. Personally, I know that my local GP trialed phone consultations at one point, but after poor implementation, it was soon dropped.

Telehealth definitely strikes me as the least established within the UK and the rest all seem to be gaining traction, but I the the electronic health records have come a long way, so I would say that they are the most established.

Which remit are you most familiar with? Which remit are you least familiar with?

Currently I would say that I am most familiar with electronic patient records and data analytics in research, but also mobile health as a consumer.

A couple of years ago, I did a project on identifying antimicrobial prescription patterns in rabbits using electronic patient records from the Small Animal Veterinary Surveillance Network (SAVSNET) and produced descriptive statistics showing the antimicrobial usage over recent years.

I am least familiar with telehealth, although I know of the Babylon Health app, it is not something that I have used before and I haven’t had phone consultations with my GP either.

What area of your digital health knowledge are you most interesting in developing?

After doing data analytics on electronic patient records, I am really interested in the use of big data and what insights it can give us about healthcare and diseases, specifically communicable diseases and epidemiology. I also enjoy tinkering with computer and programming, so it is nice to be able to bring that into my work.

Having said that, as a user of an exercise tracking watch, I am also interested in learning more about the devices that we can use to monitor our health and what the future may hold for advancements in this area.