By the end of this decade it is predicted that the NHS will face a funding gap of £34 billion, only £5 billion less than we spend on defence as a whole today. In order to overcome this, the NHS faces multiple challenges. From diminishing resources, to changing population demographics, to increasingly complex chronic diseases and the rising costs for treatment and diagnostics; the list seems endless. With this in mind, the need for change, vision and urgency is clear.
At EMC, we feel passionately that a ‘Wellness Model’ is key to tackling this challenge. The solution is to reduce demand and increase efficiency by harnessing the power of information technology and implementing the necessary cultural and technological changes in the health service. We recently worked with industry analysts IDC to review the ‘Burden of Chronic Disease Management in the Hyper Connected Patient Era’. What became quickly evident is mobile computing, telecare, social media, wearable devices and other third platform technologies are transforming the patient experience. In particular the report highlighted how patients suffering from chronic diseases can now be constantly connected with a network of formal and informal caregivers that can supervise and support their daily routines. It’s imperative that healthcare systems make smart use of these new opportunities to improve patients’ lives.
Considering this, we launched a report, with Volterra Partners, looking at how making better use of information could sustain universal healthcare. The report exposed the lack of electronic records, predictive analytics, collaboration and effective monitoring of patient and treatment outcomes. In addition, it raised issues surrounding personalised care delivery, leading to failures and financial inefficiencies that are unsustainable in the long-term. It illustrates that more fundamental reforms are required to preserve the spirit of the NHS: universal healthcare for all, free at point of delivery, based on clinical need and not the ability to pay. With talks of a fresh ‘NHS tax’ after the General Election in 2015, the NHS’ founding principles of providing free universal healthcare are under serious threat today.
But what is not realised by many is that we have a window of opportunity – the potential for care records, the cornerstone of administrative, demographic and clinical information processes, to yield more analysable data that can be used to sustain health; prevent ill-health; improve patient outcomes; and deliver healthcare more efficiently. There are already pockets of excellence across the UK and Europe where predictive data analytics has been effectively employed to deliver better quality of care for patients. Some examples of these trials and initiatives include:
A&E attendance: A risk-profiling tool, which was used across GP practices in Wigan CCG to identify high risk patients, reduced A&E attendances by 40% and emergency admissions by 20%. If the reductions were rolled out nationally, the NHS could save £840 million a year.
Diabetes: Scotland has used informatics technology to provide an integrated care model for the treatment of diabetes, resulting in a 40.7% fall in major amputations and 30% fall in total amputations. If the same improvements were made in the UK, this could result in a saving to the NHS of £37 million per annum. If the approach was widened to include foot conditions, the savings could rise to £200 million per annum.
COPD: Finland has set the bench mark for effective programmes for treatment of COPD. If the UK achieved the same results over a 10 year period, the saving could be £126 million per year.
Cancer: Better informatics would be able to reduce admissions by 30% with a saving of £60 million per annum or £600 million over a decade.
Emergency readmission rates: A Liverpool Big Data study showed that the use of data analytics had the potential to reduce hospital readmission rates by between 8% and 12%. This could save the NHS between £17 million and £32 million per annum after year two.
NHS staff efficiency: Better use of data could raise productivity of NHS staff by at least 10%, since at least 10% of time is currently being wasted by lack of access to information. This could result in £5 billion of staff time that could be saved, allowing staff to provide patients with higher quality care or provide care to more patients.
The NHS has long been amongst the global leaders in healthcare but we are falling behind. If these examples were implemented nationally, this would result in the potential to save the NHS at least £16.5 billion per year. Educational leaders must stress the importance and value of accurate data to promote wellness, deliver preventative patient information and integrate care when illness supervenes. The academic and commercial communities are also hungry for clinical data, but it will only be of value if it is accurate.
We require an architecture that can make solutions sustainable in the long term - even as specific mobile and wearable devices come to market and others become obsolete - by ensuring relevant patient data remains “liquid” for clinicians, administrators, policymakers, patients and their informal caregivers to consume. Sustaining universal healthcare in the UK means speeding up the accessibility of data and communicating the benefits to patients and GPs ahead of time to build trust and buy in. It will involve collaborating at a local level with health institutions and academia, plus an investment in appropriate skills, to really drive the shift needed to deliver the Wellness Model.
By James Petter, Vice President and Country Manager for the UK and Ireland, EMC