All shook up: The NHS Confederation looks for disruptive innovations

The NHS Confederation holds its annual conference in Manchester this week. One of its strands will discuss where change is likely to come from over the next decade. Attention will focus on a new report on disruptive innovation, produced with support from Microsoft.

Technology that allows people to manage their own records, health and care will be one of the major drivers for change in the NHS over the next decade, according to a report from the NHS Confederation.

A paper on Disruptive Innovation, produced with support from Microsoft for debate at the Confederation’s annual conference in Manchester this week, reviews a number of technologies that could have a significant impact on the health service over the next ten to 15 years.

It argues that there will be advances in areas such as genetics, diagnostics and robotics, but they may not have a significant impact in the short term.

However, it argues that technology that allows people to access their own records and manage their own healthcare could result “in a change in the balance of power and knowledge between patients and professionals” that could be “enormously significant.” “Could new providers overtake the NHS Care Record or HealthSpace?”

Tomorrow’s change today

The report singles out the recent development of platforms such as Microsoft ‘s HealthVault for special attention. “The power of these databases for research, marketing and tailored solutions is very significant,” it argues. “Could new providers overtake the NHS Care Record or HealthSpace [the online organiser that is due to give patients access to their summary care record]?”

The report also notes that home testing, tele-health and web 2.0 technologies will allow the NHS and other healthcare providers to reach new patients and help them stay healthy. Bill Crounse, Microsoft’s health director, was one of the experts involved in discussions for the paper.

“[He] identifies digital TV as one innovation which, when widely adopted, will allow for two way audio and visual streaming,” the report says. “Advanced mobile phones could also be used for this (and are far less susceptible to power cuts).

“But games consoles and plug-ins for PCs could completely disrupt the market. And implantable Bluetooth monitors could achieve even more, particularly if they were connected to medication pumps, call centres and home self-management systems.”

Disruptive Innovation notes that the cost of caring for an aging population is likely to be one reason that such innovations are adopted. However, the report says: “Our interviewees thought this technology may not produce major savings [but to] have a radical effect on where it is spent, shifting it from hospital to out-of-hospital care.” “It is important to start with what people and patients want from services rather than what technology can do.”

Games of consequences

Indeed, the report sees much innovation as something of a two-edged sword. It warns that as new diagnostics are taken up, commissioners may see testing and treatment thresholds drop for little real health gain and at the risk of “creating a nation of people who are health obsessed to the point where they are suffering continuous, low-level anxiety.”

On the other, it says many people are not as health obsessed as planners tend to assume, and the NHS will need to compete with other IT-enabled services for their attention. It also warns that “time poor” users may expect – and be willing to pay for – services to do some of the work for them, worsening health inequalities.

The paper says technological change is likely to have an impact beyond staff. It argues that it will have a big effect on the design of healthcare buildings, and that the NHS estate may shrink as healthcare is delivered in new locations, including retail sites and homes.

But overall, it stresses that IT should not be used to “industrialise” healthcare but to “leapfrog to a post-industrial, personal service providing care, support and knowledge, along with the personal interaction that makes it special.” "Respondents identified growing consumerism as the most significant external opportunity for future development of the NHS.."

Nigel Edwards, director of policy at the NHS Confederation, said: “It is important to start with what people and patients want from services rather than what technology can do.”

Seizing the opportunities

The theme of this year’s annual conference is Delivering the Future Today. Mr Edwards said that NHS leaders surveyed in the run-up to the event identified with many of the issues raised in Disruptive Innovation, which was compiled from interviews and expert discussions.

“Respondents identified growing consumerism as the most significant external opportunity for future development of the NHS, with competition and choice, new technology and telemedicine identified as the top internal opportunities,” said Mr Edwards.

“To benefit from these opportunities, healthcare organisations need to become even more flexible and consider how to create new ways of working with their patients and professionals using the growing power of technology.”

Related Links

- Find out more about the NHS Confederation and Disruptive Innovation: what does it mean for the NHS?