NHS hospitals have been advised by the UK Government to set up branches abroad to help increase profits, and while the knee-jerk criticisms to this kind of privatisation have been typical it never fails to amaze.

Patients Association chief executive Katherine Murphy declared “the guiding principle of the NHS must be to ensure that outcomes and care for patients comes before profit.

At a time of huge upheaval in the health service, when waiting times are rising and trusts are being asked to make £20bn of efficiency savings, this is another concerning distraction. The priority of the Government, hospital trusts and clinicians should be NHS patients.”

It can be reasonably argued that waiting times have been rising - and spending spiralling out of control - precisely because profit has not been a priority in the NHS. Speaking on behalf of patients, Katherine Murphy has a responsibility to speak for their best interests, and failing to recognise that profit must be prioritised - not instead of patients care - but as a means to improve it, she betrays the interests of the same patients she seeks to protect.

Seeking to make profit is not a “distraction”. Unless you intend on burying your head in the sand and denying the world that we live in, profit is the tool through which we can focus on improving healthcare for patients as well as deliver benefits for the taxpayer. 

At the moment the taxpayer is footing the bill for one of the most bloated, inefficient organisations in the world that is failing to deliver improved outcomes for patients and taxpayers all the while plunging itself into deeper debt. The Government needs to find creative ways of funding the NHS that don’t rely solely on taxpayers.

This move is a no-brainer as the economy will benefit from the extra jobs and revenue created by the life sciences industries trading more across the globe. This translates into profits and higher tax receipts that can be reinvested into improving outcomes further.

NHS Confederation chief executive David Stout reflected what is being reported as a minority view by the press: “If we can see the health service as something that generates income as well as generates spend, I think that’s absolutely right and we should do that.”

The NHS has always occupied a dear place in the hearts of the Great British people but privatisation is an issue that we can ill-afford to politicise because ultimately we are paying the price not with taxes, but with our lives.

Open source medicine makes large-scale collaborative research projects feasible, expands the data pool by creating transparency and accountability, and ultimately spurring innovation.

On a macro scale, open source projects multiply the brainpower focused on one project and result in new treatments, cures, and lower research costs. On an individual level, we live longer and healthier lives when we continuously monitor our health through the simplicity of a smartphone enabling exceptions to our normal state of health to be reported by the device to our ‘caregivers’.

The number of consumer-oriented devices that let people monitor their health have been well documented and showcased recently at this year’s Consumer Electronics Show, although not including this new screening technology that makes checking for oral cancer as simple as snapping a photo with your smartphone. The British government has created the Open Data Institute led in part by – the inventor of the World Wide Web – Sir Tim Berners-Lee - to gather “Big Data” for innovation and research opportunities, while also increasing health data to push information about healthcare from the NHS to researchers and industry.

We should expect the proliferation of health monitoring products aimed at consumers to increase exponentially going forward. As the tools become available, society’s contributions to the big data pool become ever more significant to study life patterns, identify new diseases, solve health problems, find cures and create treatments to give us more control over our health. By monitoring our own health data, we can improve our livelihood, while contributing to the big pool of data that will help everyone else too.

Traditionally investment in healthcare has been focused on large scale capital investments resulting in ever increasing expensive devices such as robots, imaging machines, etc.

In recent times however, sentiment is changing in line with global shifts in  economic behaviour. Cost-saving solutions for hospitals and Doctors’ practices are increasingly being driven by software-based efficiency as investment moves away from large-scale capital investments in machines and devices. In turn, healthcare marketing is beginning to reflect this change as it adapts to a cost-cutting marketplace.

Why is this happening?

Ballooning costs within healthcare systems have contributed to huge and unsustainable budget deficits the world over. This has been met with a general austerity drive to slash spending in the private as well as the public sector and healthcare has been a prime target for these cuts by virtue of significant contribution to this problem. Hospital administrators therefore are increasingly concerned with driving down costs and this has resulted in investments that will lower hospital and practicing costs over time such as electronic records, education platforms and apps designed to keep patients from returning to hospital and Doctor’s practices, as well as cost cutting solutions for billing.

In the US, Federal incentives have also been a key driver of this trend. Tax breaks, grants and other initiatives spear-headed by the Obama administration have encouraged investment in software platforms as a cost-cutting tool, with a particular focus on electronic medical records.

Indeed Software-as-a-Service (SaaS) and cloud-based computing solutions are an inherently attractive investment target due to their scalability and flexibility. Such investments are able to scale quickly and accordingly while maintaining tight control on costs, and they can “pivot” quickly if not with minimal costs in order to adapt their business models to survive and prosper. For this reason also they are seen by investors as less of a gamble as they can adapt to the needs of the marketplace.

Furthermore, cost-saving health management apps tend to be more attractive to investors simply because there is a larger target market for such solutions - from local Doctors’ practices to national healthcare services. Contrast this remote surgery robots for instance, where although margins will tend to be higher, the potential size of the market can be limiting.

With healthcare spending showing little signs of abating in the long-term, hospital and health administrators will continue to look more closely towards the bottom line and who can blame them? As such, healthcare marketers and product developers in particular must frame their message to healthcare providers with cost-savings at the heart.

Powered by new tools, tests, and apps 21st century patients can diagnose themselves. Technology in healthcare is growing exponentially, with various new developments in digital medicine, robotic surgery, nano-medicine, genomics, neuro, and connected health.These developments are addressing major challenges in cost, access, and demographics in healthcare, amongst others.

At the heart of the growth in technology and its proliferation in healthcare is the modern mobile phone, or smartphone. As the technology has become faster, smaller, cheaper and better, their uses have improved healthcare e.g. imaging (PET, CT, and MRI scans), procedures (virtual colonoscopy), tools (digital stethoscopes), access (telehealth), robotic surgery, and so on. The consequent data explosion that has resulted has thrown up a multitude of opportunities for improved quality of care, but also presents challenges for organising and interpreting data. The smartphone as a central tool in this universe of new technology will certainly help to integrate, socially organise and therefore interpret all of this data.

Adding to the suite of tools mentioned in previous posts, FitBit is a $100 (£63) device which measures a persons steps and caloric in-take with insight on a daily basis which can be shared with your doctor. The Zeo sleep monitor gives you insight on your sleep, while also costing less than £100, and a whole host of tools still in development such as the medical mirror which checks your pulse rate. 

Not surprisngly, a walkthrough of some of the tools available to consumers reveal that the quantified self stands to benefit most from the latest wave of technological developments.

an·gi·o·gen·e·sis/ˌanjē-ōˈjenəsis/

Noun:

The development of new blood vessels.

(Source: Google Dictionary)

This post is based on an inspiring Ted Talk given by William Li on treating cancer through angiogenic therapy by preventing the growth of blood vessels that feed a tumour. A highlight of the video is the emphasis on eating ‘cancer fighting’ foods as the first and most crucial step to preventing cancer in the first place.

The 20 minute talk is peppered with impressive stats, facts and charts about the successes of angiogenic therapy, particularly the improvements in cancer survival rates in certain types of cancer when compared to an era where there was only chemotherapy or surgery radiation available. However, the modest overall improvements in treating other types of cancer led Dr. Li to investigate preventative measures, rather than treating cancer “so late in the game”, and concluding that the “answer to cancer” lays in the prevention of angiogenesis.

Li, found that diet causes 30-35% of cancers, and rather than looking at what not to eat; he presents a plethora of foods, beverages and herbs that could be added to a diet that boost the body’s defence system. Most fascinating, is not only that certain foods have different potencies of preventing angiogenesis, but when mixed together with other fighting foods, their potency multiplies.

How many of the foods presented in this video are in your diet? 

You might find yourself asking when the last time you had a ‘check-up’ was, and unless you’ve already been diagnosed with a condition, the answer will probably be, not recently. Health checks are a straightforward and cost-effective procedure for picking up health risks before it is too late. Indeed, with the NHS firmly in the red in some parts of the UK, basic health services such as The NHS Health Checks - designed to spot heart disease by looking for high cholesterol or blood pressure - will continue to come in fits and starts. Heart UK, a British charity, found many primary care trusts around the country were ill-equipped to provide these checkups while some had failed to provide even a single check in 2011. 

Primary healthcare services, such as health checks, must be made more widely available so that we can better transition, from the costly reactive healthcare system we practice at the moment, to a society of preventive healthcare based on health outcomes. Finding a more affordable and more accessible solution than the postcode lottery that is provided by the NHS will give patients greater clarity and more control over their health.

Death is avoidable in many health cases. According to Diabetes UK, 24,000 diabetes-related deaths could be avoided, if patients better managed their conditions. Cancer Research UK reports that nearly half of all cancers diagnosed in the UK each year (130,000 in total) are caused by avoidable life choices. A study published in the BMJ reports a direct link between elderly who have difficulty understanding basic health instructions and early death.  All of these recent studies call for greater functional health literacy amongst people.

Patients must better manage their lifestyle, stay well, and out of the hospital. The fact that this will help our beleaguered healthcare system out of bankruptcy should be reiterated, yet the real incentive, the real prize, is better quality of life. Basic health checks, taking medication, keeping to a healthy diet are all activities that can help to avoid up to one third of deaths amongst diabetes patients and over 40% of cancers. Also, doctors and patients are now in an age where a plethora of tools are available that help make managing a healthy lifestyle much simpler than ever before. Healthee provides simple, affordable health checks so that patients are better informed on their health or conditions. Glooko is a unique solution that lets patients monitor their diabetes seamlessly from their iPhone by being able to track their readings and share reports with their doctor and other health professionals. Massive Health is another mobile phone application that lets users input their health conditions and receive insightful feedback especially between doctor visits which can be few and far between. 

Many diabetes-related and cancerous deaths are due to avoidable lifestyle choices. Certainly, patients are required to claim their share of the doctor-patient partnership, and with these new tools and services it is becoming increasingly easier for them to do so, enabling both doctors and patients to approach healthcare more seamlessly and reduce these arresting statistics.

Keeping with the theme of the quantified self, in a retro article from May 2009, The New Yorker attempts to explains the secret of self-control.

The basis of the article is an experiment conducted at the Bing Nursery School, on the campus of Stanford University, in the late 1960’s. It explores a child’s ability to delay gratification and the significance of these results later in the child’s life. The experiment is as follows: a child is offered a marshmallow which they could eat right way, or, if they were willing to wait while the researcher stepped out for a few minutes, the child could have two marshmallows when the researcher returned. While the experiments were conducted over several years, the results showed that children who were able to pass the “marshmallow test” enjoyed greater success as adults. Low delayers, the children who lacked patience for the researcher’s return, exhibited more likelihood to have behavioural problems, both in school and at home. Low delayers were even found to have a significantly higher body-mass index and were more likely to have had problems with drugs.

Walter Mischel and his team, who conducted these experiments, believe that these tests will lead to the neural circuitry of self-control. Mischel believes that raw intelligence as the most important variable when it comes to predicting success in life, is secondary to self-control, and as The New Yorker succinctly puts it, “even the smartest kids still need to do their homework”. More importantly, he believes self-control can be learned - mental tricks can be applied so that children can distract themselves from eating the marshmallow. Hence, as Mischel says, “we can’t control the world, but we can control how we think about it.” Pardon the pun if you will, but this is certainly ‘food-for-thought’ considering our timely series on the quantified self.

To borrow a quote from Edison, and the title of a fantastic blog preoccupied with this theme of self-improvement, “Genius is 1% inspiration, and 99% perspiration.” Indeed, you can find a two-part series in this blog on improving one-self beyond possessing self-control: The Future of Self-Improvement Part I: Grit Is More Important Than Talent and The Future of Self-Improvement Part II: The Dilemma of Coaching Yourself by Jocelyn K. Glei, who explores ‘grit’ - “the perseverance and passion for a long-term goal” - and how this plays a vital part for outstanding achievement. In Part II, Glei explores the difficulties of measuring and analysing one’s own performances and identifying areas for improvement.

The future of self-improvement will certainly gain much from tracking lifestyle metrics, through sharing this information, and therefore introducing the dynamics of social interaction to self-improvement. It begs the question: Is the quantified self able to manipulate his/her own perceived limitations, and therefore successfully achieve all of his/her lifestyle goals?

Quantified-self:

“Lifeloggers (also known as lifebloggers or lifegloggers) typically wear computers in order to capture their entire lives, or large portions of their lives.”Source: en.wikipedia.org/wiki/Quantified_Self

The phrase seems to be dominating discussion topics in healthcare, wellness, and new technology in 2012, but tracking one’s life activities online has been around for sometime. Its proponents have until now typically been fitness and technology buffs, who of course are not mutually exclusive. Examples include new mobile and online apps such as Runkeeper and Livestrong, the iPod nano which lets users keep track of their exercise without any additional apps or hardware, while Nike+ tools have long since been available. 

This year there has been much talk of this trend gaining broader adoption and transcending these demographics. Both Apple and Nike are hotly anticipated to continue to push developments in the fitness-tracking space, but we’re beginning to see start-ups expand into the health-tracking space also. Withings has been blazing a trail in the past year, introducing a blood pressure monitor which connects to your iPhone and uploads your data to a website for you to monitor and share at your discretion. This builds on the success of their first product - a body scale that auto-tweets your weight to encourage crowd-monitoring/motivation. Another hot start-up, Glooko, links to your existing blood glucose meter and iPhone to help you effortlessly monitor your diabetes by giving you anytime access to a logbook on your phone.

While the benefits of personal lifestyle metrics are only just penetrating the public consciousness, we believe the real potential of this movement lies in the power of storing and aggregating anonymised data - in the power of the “Quantified-Selves” rather than the Quantified-Self. This can add relevancy and context to personal metrics, but can also offer real-time insights into macro populous health data which can have a profound effect on health outcomes on a national and international scale. 

The quantified-self movement has swirled around blogs, tech circles and health networks, and uses of lifestyle metrics will continue to swell for the foreseeable future. In the meantime, we at Healthee are looking forward to less “me” and a bit more “we” as this movement continues to blossom.