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Week in Horizon Scanning: working in health and care through a potential revolution in monitoring technology

16 August 2013

technology

When you think about technology in health and care, particular types of stories probably spring to mind: the MRI machine harnessing the laws of physics to improve diagnostics, or the news from MIT this week showcasing a 3D-printed bionic ear that has been built to detect and transmit radio signals. However, often omitted from these stories are the health and care staff tasked with integrating emerging technology into services and help realise their potential. 

In our Big Picture Challenges work, we identified that preparing the workforce for changes resulting from innovation and technology is a key theme for the next 10 years and in this blog we will illustrate some of the most important questions that arise by looking at revolutions in monitoring technology and the ‘quantified self’.

Monitoring technology: a breakthrough or a revolution?

Along with the news from MIT, two connected health stories in the field of monitoring technology caught the team’s attention: Timothy Hay’s article in the Wall Street Journal on the ‘Quantified Self’ in healthcare and this week's BBC Horizon show ‘Monitor Me’. I know what you’re thinking and no, the CfWI Horizon Scanning team doesn’t just review the BBC show each week. Instead, we use a structured methodology to understand trends and themes that may impact the health and care workforce of the future.

These news stories identify a transformation in health and care through resonances between:

A forthcoming CfWI Horizon Scanning report on technology identifies five main areas of health and care technology; therapeutic, diagnostic, enabling, preventative and organisational. The resonances outlined above impact them all, which is perhaps why, when introducing the Horizon programme, Dr Kevin Fong goes as far as suggesting “we might be on the brink of a revolution in healthcare”.

What does this transformation mean?

According to Dr Fong, developments in monitoring are not only impacting traditional services such as how the Lifepak 15 and other technologies are helping to turn paramedic services into mobile A&Es.  These are part of an ideological shift where more individual health data could lead to better health. Dr Fong argues that this has potential to alter the public’s relationship with health and care services and even ‘make doctors of all of us’.

Hay’s article offers a more commercial perspective. It notes that large investments are being made in this industry and that this revolution both plays to consumers’ love for gadgets and the need for health and care service workers to manage demand.

The question is: 20 years from now, will health and care revolve around our close monitoring of our own health data? In the same vein as some car insurers encourage policy holders to use driving monitoring apps to base premiums on, will health and care service users be increasingly encouraged -  or even mandated - to take more responsibility to look after themselves?

So far, we have focused on the effects on service users– namely the new treatments and services they could expect. But by creating new ways of promoting, preventing, curing, caring and changing public expectations of the services they receive, technological advances are impacting ways of working in health and care services. This is outlined in our February 2013 Big Picture Challenges report.

The workforce horizon?

Focusing on self-monitoring and the quantified self, we offer three considerations for the workforce.

Firstly, could we see information itself becoming a form of treatment and will this transform how care is delivered? This is particularly relevant for community and primary care where the workforce would play a central role in promoting and facilitating self-monitoring. Sooner than we might expect, could service users be routinely prescribed apps rather than traditional treatment? Who accredits these systems and how would frontline staff stay up to date? Our forthcoming technology paper will examine these challenges in more detail, including the equity implications of varying technological literacy. Progress has also been made by Skills for Care in the area of assisted living to support self direction through emerging technology.

Secondly, is a new service-user emerging armed with increasing amounts of information and expertise and, in turn, demanding more information too? Our forthcoming paper will consider potential changes in the relationship service users have with providers as we move from an informed to a participative public. How do practitioners integrate these new, rich information sources into health and care case management?

Finally, improvements in monitoring could introduce increasingly powerful yet low-cost diagnostics to the ‘point of care’. This has implications for the way that skills are deployed by services. An example we explore in our upcoming paper is the potential substitution of laboratory-based testing with low-cost mobile technology. How do we ensure the right skills are in place to utilise the new resources available, and recognise the limitations?

Whether or not monitoring technology and the quantified self is a true revolution in healthcare is not clear yet, but, with the MHRA approving its first app in January this year, changes are already taking place and, importantly, these are driven perhaps more by consumer behaviour than by policy.

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Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.