Embracing personalised medicine: digital opportunities by Hilary Burton (PHG Foundation)

PUBLISHED: 15/12/2015

The UK faces a number of well publicised and intensifying challenges to the effectiveness and sustainability of the NHS. Yet for all the concerns, there should also be hope and an eagerness to capitalise on the rapidly expanding forces for change. Whether you call it the ‘democratisation of healthcare’ or a ‘personalised healthcare revolution’, it is undeniable that individuals are not only taking more control over their own health and care but that digital health technology is rapidly expanding both in terms of popularity and applicability. 

From telehealth and telecare to mhealth and health analytics, the nature of healthcare is changing irrevocably, driven by two mutually reinforcing phenomena; namely a new focus on patient engagement and empowerment, and the scientific and technological developments of the twenty-first century. Embracing these emerging forms of personalised medicine is critical to creating a more effective and sustainable health and care service.

The growing need to self-manage our health and care

The increasing pressure on health services is currently unsustainable. The NHS deals with over 1 million patients every 36 hours; performing 44% more operations, admitting 32% more people to hospital and making 61% more patients wait over 26 weeks for treatment in 2013/14 than in 2003/04. 

More specifically, it has been estimated that 70% of total expenditure on health and care in England is used to treat the 30% of the population with one or more long-term conditions, the number of which is projected to increase from 15 million to around 18 million by 2025. It has also been predicted that by 2030, there will be around 50% more over-65s and more than double the number of over-85s alive in England than in 2010. In order to help mitigate the effects of these and many other challenges, the NHS must embrace personalised medicine in general, including digital health technologies.

Capitalising on the demand for digital health technology

A recent governmental report highlighted the rapid expansion of the digital health market and reiterated the central role of digital health to the delivery of the NHS policy agenda and as a key enabler for realising the NHS Five Year Forward View. For example, mhealth, or the ‘the generation, aggregation, and dissemination of health information via mobile and wireless devices’, has grown by 35% in the UK and about 49% globally from 2014-18. There was a 62% increase in activity amongst health and fitness app usage from December 2013 to June 2014 alone. 

The government similarly expects the health and fitness wearables market to more than double from £1.5 billion in 2014 to £3.1 billion in 2018 and the mhealth app market to grow from £75 million in 2014 to £250 million over the next three years. Individuals are currently more interested in and motivated to take control of their personal health and fitness than ever before.

Digital empowerment is more than just hype

Telehealth tools incorporated into traditional healthcare settings can help facilitate coordination of care for patients with complex conditions and reduce the need both for multiple clinic visits and avoidable admissions. 

In a report on digital health technologies (DHTs), the Commonwealth Fund uses case studies to illustrate how such tools could improve the effectiveness and efficiency of health services across multiple specialisms, for example helping chronic disease patients ‘see the connection between behaviors and symptoms better as well as signal providers when a troublesome pattern emerges’, allowing rapid interventions where needed and reducing the burden on hospitals when they are not. Another example cites a digital service that provides a platform to stream multiple sources of information ‘so that patients, their caregivers and teams of providers can share information quickly and ensure any health deterioration is addressed promptly by the most appropriate party’. 

A challenge worth meeting 

DHT is exciting and could revolutionise health services but there is still a long road ahead before it is fully embraced and implemented on a wide scale. There are solutions to the current state of the NHS, including DHTs, the proper application of opportunities for genomic and precision medicine, and many other examples of more personalised disease prevention and healthcare. There is also a need to ensure that health inequities are not widened through the use of new technologies. It is the discussion of such tools and their implications, complexities and possibilities that this APPG hopes to stimulate. We look forward to working with parliamentarians and partners who are passionate about exploring the vast potential of personalised medicine to improve patient care in the NHS.