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Technology adoption in health – is the NHS ready? martin wakeley
1.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 1 Technology adoption in health – is the NHS ready?
2.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 2 Background Martin Wakeley Experienced NHS Leader Lead CEO lead for SPFiT Part of the PwC team that introduced the independent sector to the NHS Executive Director of Circle – opened their award winning hospitals and led the acquisition of Hinchingbrooke Siro of the largest NHS investment in BI in the UK Turnaround director across numerous hospitals and CCGs Co-founder of Nth Dimension Nth Dimension are backed by Tech Mahindra Set up to innovate and disrupt in Healthcare Set to create joint ventures across the NHS and universities Focus on interoperability and data exchange Create new markets
3.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 3 AI and Healthcare Technology and AI is growing at a rapid pace in healthcare AI spend in USA healthcare is projected to increase from $660m in 2014 to $6 Billion in 2021 and that’s probably a gross underestimation (Frost & Sullivan) The number of companies utilising machine learning algorithms in healthcare is growing rapidly.
4.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 4 The pace of innovation is exhilarating Google Deepmind is collaborating with London hospitals such as Moorfield's IBM Watson and Medical Sieve are gathering significant momentum Sense.ly and Babylon are changing the face of AI Atomwise is accelerating compound research Zorprisma Publiek know more about the efficacy of clinical
5.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 5 Worldwide healthcare demand is increasing 0 20 40 60 80 100 120 140 160 180 200 Africa Rest of Americas South East Asia Europe Eastern Mediterranean Western pacific Population and healthcare resource Median Age % > 60 Doctors per 10,000 Nurses per 10,000 The median age in Africa is 19, in Europe its 39 In Africa the % of people over the age of 60 is 5%, In Europe its 21% The UK population is projected to grow by 9.7 million over the next 25 years By 2039 8% of the UK population will be > 80 yrs.
6.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 6 There are not enough qualified staff to meet growth 0 2000000 4000000 6000000 8000000 Africa Rest of Americas South East Asia Europe Eastern Mediterranean Western pacific Clinical Staff Actual Nurses Actual doctors 0% 50% 100% 150% 200% 0 1000 2000 3000 4000 Per Capita spend growth Per capita Spend 2002 $ Per capita Spend 2013 $ Growth There are over 7 million nurses in Europe for a population of 906 million There are just under 3 million doctors in Europe The OECD reports that 36% of UK doctors were born overseas Spending in South East Asia grew by over 130% in 10 years Spend in Europe grew by 98% Western Pacific spend grew by 172%
7.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 7 The NHS is under considerable pressure The NHS faces a £16 Billion shortfall in its funding by 2020 Existing productivity gains cannot meet the gap The deficit in 2015 was a record £2.5 Billion and its not improving
8.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 8 Social care is in a similar position To meet current demand the budget for social care will need to double in the next 15 years The largest area of spend is in physical support for the over 65’s
9.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 9 Interesting developments? Artificial intelligence can automate significant elements of how healthcare can be delivered IBM Medical Sieve can triage thousands of images and direct the radiologist to the image requiring their attention Remote monitoring can observe patients and take action more more effectively than a human being Avatars can engage with patients and anticipate events and take preventative action. Recent studies suggest that patient are more open with Avatars than real people Genomics and other initiatives are pushing ahead the precision medicine agenda along with anticipatory medicine
10.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 10 Where could AI help? NHS 111 receives 33,000 calls a day Each triage call takes an average 15 minutes 61% were directed to primary care GP Out of Hours recorded 5.8m interactions in 2013/14 3.3m were face to face Each patient cost £7.50 In 2013/14 there were 41.1m imaging examinations of which 22.6m were x-rays
11.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 11 Off the shelf solutions Solutions such as Sense.ly and Babylon can replace some of the services provided by 111 and NHS Direct. They can also link into OOH services, linking patients to providers or services without the need for human intervention. IBM Medical Sieve could provide on-line automated triage of plain film x-rays 24/7, freeing up staff to focus on more complex tasks AI can provide routine follow up and monitoring services for patients post operatively or replacing face to face follow up
12.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 12 The NHS has to adopt new solutions Demographic pressures and the impact of reduced availability of clinical staff from overseas will force the requirement to explore non-human modes of delivery. The productivity requirement for the NHS to deliver against its targets is at a level higher than any other comparable healthcare system has ever delivered. The process to schedule and deliver care is based upon a model that has hardly changed since its inception in 1948
13.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 13 However? The NHS has a poor track record with the adoption of technology The current situation means that cash for transformation is in short supply There is a shortage of technology advocates pushing solutions at a national or local level Procurement often requires reference sites but where are they in the UK?
14.
Copyright © 2015.
All Rights Reserved. l Nth Dimension Confidential. 14 Why is adoption slow? • Who is going to pay for the technology? • Product or service? • Who is going to benefit from the technology • What are the procurement and governance and regulatory issues that need to be addressed? • Who is responsible for adoption? • How do you identify and address professional parochialisms? • Identifying and managing across inter organisational tensions • Working with patients and getting their support
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All Rights Reserved. l Nth Dimension Confidential. 15 There are emergent opportunities GP federations are becoming new providers and they don’t have legacy business models or investments that prevent them from innovating. Interoperability solutions will gather pace and will generate longitudinal data sets at massive scale supporting AI adoption and accelerated innovation New care pathways are dependent upon real time data collection and analysis to direct patients towards digital solutions
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All Rights Reserved. l Nth Dimension Confidential. 16 Rose doesn’t seem to be eating Rose – We’ve been alerted by the NHS to your fall - We’ll send someone to help make your home safe for you Shared Data Rose – We’ve let our colleagues know in Social Care that there could be some side effects to your medication... Rose is anxious after her fall Can you tell the Fire Service that Rose now stores oxygen bottles at home... Can you alert your staff to the aggressive dog that lives next door to Rose... Rose – The hospital has alerted us about your recent fall. Your GP will be in contact soon after your discharge. Rose – The NHS have alerted us to your disability. We’ll issue a blue badge and a bus pass automatically.... Rose – Your daughter, who lives in Australia is now able to apply, order and pay for services directly for you... Rose – your blood pressure seems to have gone up overnight – is everything ok? 2 3 6 4 5 8 7 1 10 9 This is possible now
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All Rights Reserved. l Nth Dimension Confidential. 17 What next? Lets get doctors and nurses excited Lets get patients and their relatives excited Lets create business propositions that make sense to the people who pay De-risk failure but reward success Identify the top 10 advocates and adopters Be flexible
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All Rights Reserved. l Nth Dimension Confidential. 18 Disclaimer Nth Dimension Limited, herein referred to as Nth Dimension provide a wide array of presentations and reports, with the contributions of various professionals. These presentations and reports are for informational purposes and private circulation only and do not constitute an offer to buy or sell any securities mentioned therein. They do not purport to be a complete description of the markets conditions or developments referred to in the material. While utmost care has been taken in preparing the above, we claim no responsibility for their accuracy. We shall not be liable for any direct or indirect losses arising from the use thereof and the viewers are requested to use the information contained herein at their own risk. These presentations and reports should not be reproduced, re- circulated, published in any media, website or otherwise, in any form or manner, in part or as a whole, without the express consent in writing of Nth Dimension or its subsidiaries. Any unauthorized use, disclosure or public dissemination of information contained herein is prohibited. Unless specifically noted, Nth Dimension is not responsible for the content of these presentations and/or the opinions of the presenters. Individual situations and local practices and standards may vary, so viewers and others utilizing information contained within a presentation are free to adopt differing standards and approaches as they see fit. You may not repackage or sell the presentation. Products and names mentioned in materials or presentations are the property of their respective owners and the mention of them does not constitute an endorsement by Nth Dimension. Information contained in a presentation hosted or promoted by Nth Dimension is provided “as is” without warranty of any kind, either expressed or implied, including any warranty of merchantability or fitness for a particular purpose. Nth Dimension assumes no liability or responsibility for the contents of a presentation or the opinions expressed by the presenters. All expressions of opinion are subject to change without notice. Please contact Martin.Wakeley@nthdimension.com
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All Rights Reserved. l Nth Dimension Confidential. 19
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