The growth in popularity of healthcare apps like Babylon and Push Doctor is to many just an obvious next step in the evolution of public access to professional services. It seems perverse that you can use an app for everyday actions like banking, shopping, social interactions or booking a holiday, but not to speak to a GP or other healthcare professional. An NHS Ideas Lab hackathon last month saw over 100 NHS doctors, dentists, technology developers, scientists and health economists explore how smartphone apps could improve services. Artificial intelligence, sometimes described as the possible penicillin of the 21st century, is also pushing the boundaries of traditional care.
Tech-driven innovation is often referred to as ‘disruptive’ – usually in a positive way – challenging traditional approaches and organisations, and putting more power in the hands of individuals and start-up companies. However, given public and political sensitivities around healthcare, there is a greater risk that the ‘disruptive’ element could tip onto a negative for these providers.
Many of these online services have evolved from organisations with a significant history in healthcare, and are managed by and employ former or current NHS staff and clinicians. Despite this, they are operating in a new form, and regulators are playing catching-up. The recent challenge by Babylon to the Care Quality Commission inspection report publication was based on their view that the CQC had significant shortcomings in its ability to regulate innovative services. Interestingly, the CQC has just been given powers by the Department of Health specifically designed to address this by rating GP apps to “bring increased transparency” about their quality and safety.
Many parts of the NHS have also expressed concerns about these ‘disruptive’ online services, raising concerns around patient safety and data protection. Some have raised more parochial concerns about online services cherry-picking the ‘easiest’ patients from established GP practice lists, leaving them with fewer resources to care for older patients with multiple conditions.
Public mistrust over the use of health data, and the political punchbag of privatisation also hang-heavy. Given this, an actual or perceived misdiagnosis or safety issue from a GP offering an online consultation rather than in a physical room will be given far more prominence by the media, politicians and ultimately the regulators.
To secure the many positive aspects of being ‘disruptive’, those driving the use of online health services and artificial intelligence have a tough challenge ahead. They must invest more, and be seen to invest more, in essential training, proactive diagnosis, and robust governance processes and policies to give innovation the time and space it needs to succeed.