Category Archives: Information Technology

With nearly all industries moving toward a more digital presence, it is no surprise that healthcare has taken a similar turn. Patients are demanding greater access to care in the UK, and online service providers are making an effort to meet this growing need. Just like brick-and-mortar health facilities, like dentists, hospitals, care homes, and specialists have an obligation to abide by standards set by the Care Quality Commission – the regulator of all health and social care services in England – online healthcare services must do the same. Unfortunately, a recent report published by the CQC highlights the perils some patients face when trusting the digital trend sweeping healthcare providers.

Dangers in Unsuitable Prescriptions

Errors in prescription medications take place in traditional pharmacy settings and doctor’s office around the world, but the anonymity of online pharmacies creates a higher probability of errors taking place. The most recent CQC report focused on digital healthcare service providers highlights some of the most glaring examples of substandard care in prescribing medications to patients. First, a widely known online pharmacy was found prescribing a large number of opioid-based medications without having a foundational system in place to confirm patients’ medical history or prescription track record. The CQC issued a restriction on the company, forcing it to limit its prescriptions until a sustainable system was established.

Another online pharmacy was cited for prescribing a high number of asthma inhalers, not in line with best practices of traditional providers. The company failed to implement a review system for new prescriptions, putting patients’ lives at risk. In this case, the CQC issued a warning to the online pharmacy to update its practices immediately. Other online providers were cited for not adequately reviewing patient medical histories prior to approving a requested prescription, and accurately identifying GP assessments before prescribing medicine to certain patients. Although the published reports from the CQC are helpful in bringing to light the risk patients face in using online healthcare services, there is only so much the organization can do to stave off potentially fatal issues that arise due to nonexistent safeguards among companies operating online.

How Patients can Help

The risks of using pharmacies and other healthcare services through a digital platform are growing as more individuals seek out immediate care for health-related issues. A representative from a team of medical negligence solicitors dealing with cases of prescription claims and those where harm is caused due to medication mistakes explains the most significant issue online providers present to the public. In essence, the same standard of care should extend beyond traditional settings in which doctors, nurses, specialists, and pharmacists are providing care face-to-face to those who offer medical guidance online. Patients deserve the highest quality care available, and online companies along with the people who work for them have an obligation to protect those who seek their services. That can be done by abiding by the best practices laid out by the CQC, including understanding the medical history of the patient, other medications the patient may be taking, and the recommendations of the patient’s GP.

Patients using online healthcare providers have a responsibility to do their due diligence when working with a primary care, pharmacy, or specialist company. The best step to take is to ensure that the organization is registered with the Medicines and Healthcare products Regulatory Agency, or MHRA by searching the company name, number, or website online. Additionally, any website that sells medicine to the public is required to show the EU common logo for potential patients to see. As the Care Quality Commission continues its objective to maintain a safe and high-quality healthcare environment for patients in England, individuals can do their part by being knowledgeable of the risks they face when conducting medical business online.

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Technology has long been a force for change in dentistry. Think back twenty, ten or even just five years ago, the industry looked drastically different and day-to-day work involved tasks that have since been replaced by processing power and some clicks. The dental industry is advancing rapidly. In this article, we will be discussing the advanced technology in dental industry and its effectiveness.

dental industry

Dentists working from a digital platform can instantly share patient information among staff members, transfer files to the lab, and help increase case acceptance by visually showing patients areas of diagnosis and proposed treatment. With these new capabilities, digital practices are experiencing greater productivity, better communications with patients and a more satisfied staff.

Smart Toothbrush

This technology is made to change tooth brushing habits of children and adults by motivating individuals to brush better through games (for kids) and coaching (for adults) that guide them toward improved dental hygiene. This product includes sensors that can identify the area of the mouth in which the user is brushing. This powerful technology also has the ability to store data, and create a personalized visual check-up to show where the user brushed and missed over a 7-day period.

3D Printing Makes the Digital Physical

A digital platform in dentistry means that all patient information, imaging systems, and CAD/CAM data work together in a connected pattern. Because of the real-time flow of information, the practice with a digital platform is capable of operating more efficiently with the quicker delivery of procedures and a higher level of productivity. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics, and surgery, the manufacturer of dental, craniomaxillofacial and orthopedic implants, and the fabrication of copings and frameworks for implant and dental restorations. 3D printing is also likely to revolutionize the design of dental mouthguards, particularly those that are designed to be worn with braces and fitted specifically to the patient’s mouth.

Lasers

Lasers in dentistry have seen a tremendous rise and fall in use and popularity. All lasers work by delivering energy in the form of light. When used for surgical and dental procedures, the laser acts as a cutting instrument or a vaporizer of tissue that it comes in contact with. When used for curing a filling, the laser helps to strengthen the bond between the filling and the tooth.

Some dentists are using lasers to treat:

Intra-Oral Camera

The camera’s unique liquid lens technology works like the human eye to ensure effortless image capture to deliver clear, detailed images patients can really understand. This camera is having six long-lasting LEDs around the lens provide balanced. Your technology treatment plan will become clear and will be far more customized to your needs than a simple formula for equipment purchases.

Today’s patient is exposed to advanced technology every day and expects to find the same high-tech welcoming environment at the dental office. Advances in dental equipment are rapidly making this high-tech practice a reality, with innovative equipment increasing efficiencies and delivering better services to patients. Digital practices are experiencing greater productivity, better communications with patients, and a more satisfied staff.

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The transformative effects of the world-wide-web and the digital revolution are everywhere. Lives of citizens have been revolutionised as access to the web has completely altered how people connect and communicate with each other. The information technology revolution continues to challenge traditional ways in which human beings trade, communicate, organise, investigate, learn, and how they project themselves. The current political landscape is characterized by at least two interesting developments: political problems such as those surrounding the economy and environment are becoming more transnational, and citizens now have a capability to operate on their own terms rather than as members of traditional hierarchical interest and advocacy organizations.

digital revolution

Against this fast-moving and ever-changing background, in February 2016, the House of Lords agreed to continue the ancient practice of storing all British laws on vellum. Politics and politicians deserve what the digital revolution is doing to them: Western political systems have hardly changed in generations and are ripe for disruption. Cash for questions, expenses scandals, endemic corruption are all expected consequences of power: but enforced austerity by unelected technocrats, international migration crises, and lost opportunities for generations of young people demonstrate that political systems’ behaviours whose roots are nineteenth-century are incapable of identifying, let alone implementing solutions for our age. Narrow self-serving and self perpetuating elites who, in partnership with conventional media, have been peddling their self-interested version of reality now rage against the digital machine.

Some of this is easily explained. Whilst the pace of government is cumbersome and slow, technology is fast-moving and dynamic, making politics seem tired and dull. Political thinking is lame by comparison with the big ideas coming out of the information technology industry. Advances in software have thrown up fresh ways to think about what it means to own something, to share something, to be a citizen, to have a private life, and how to self-identify. These are among the most important questions of modern politics. However, they rarely get expressed by politicians or conventional political parties.

Whilst politicians wrestle with how to “manage” digitization, it continues to produce huge benefits in many parts of the world. In Nigeria phone-based banking for the first time permits money transfers without the physical exchange of cash, massively enhancing wealth-generating possibilities. In China, a billion phone users now pose an existential treat to the monolithic communist power structure. The Arab Spring, Tahir Square, and the Occupy movement: all were driven forward by a new generation of activists exploiting social media. Watch migrants unload in Lampedusa: a few possessions and a phone. Less propitiously, emergent terrorist organisations such as ISIS have understood from their outset that the power and influence of the web – the development of a digital caliphate – is key to dissemination of their violent message and the recruitment of adherents. In some cases, these changes are occurring either despite government opposition or because of bad government; more generally though governments seem not even relevant or incidental to these changes. They are simply encircled by them.

Governments have not though ignored the digital revolution. They have utilised the techniques of e-commerce and big business for their own narrow purposes, spending heavily on algorithm-based data mining to target election campaigning and political advertising with the aim of securing and retaining power. Ironically, of course, as the focus of politicians becomes ever more targeted on the key swing voters, districts, and constituencies, then the greater the distance between politicians and the people becomes, and the more people turn on to digital. Politicians have also been busy, as Snowden revealed, regularizing the mass surveillance of its citizens: listening-in but not listening to. And they have, thirdly, simply blamed and ridiculed digital communities, caricaturing them as short attention span clickbait zealots; populists who don’t understand the complexity of achieving change in a pluralistic system.

Conversely, the digital revolution in politics is another healthy sign that ordinary citizens haven’t given up on politics. In some respects, digital activity has been translated into a proliferation of political activity both within and beyond the traditional outlets. Particularly in countries with more plural systems, the internet has been influential in promoting emergent parties. The German Pirate party and Italy’s Five Star Party make good use of digital technology to manage their message (as ever, the medium is the message).

Nevertheless, it is certainly true that as the membership of mainstream political parties has fallen away and voter turnout has declined across the western world, irregular political campaigning has expanded. Concerned individuals often coalesce around issues that reflect their own interests. The new information technology has been an enormous help in this regard, enabling ad hoc pressure groups to form and allowing like-minded individuals to find each other and share their concerns. But this too creates an imbalance between the political class and the rest. Professional politics is becoming more concentrated – witness the emergence of the modern political dynasties – at the same time citizen politics is becoming more fragmented.

But it needn’t be like this. Democracy functions best when citizens get good information about what their government is doing. Widespread transparency makes citizens better and more active participants and makes politicians more accountable. Democracy, at least in its ideal form, promotes equality of power. Democracy promotes debate. Democracy can bring together individuals with high diverse viewpoints. Debate and deliberation forces people to improve and strengthen their arguments. It is axiomatic to me that many of the major problems facing governments today are complex and multi-faceted, requiring negotiation, compromise, but also clarity about goals. Bringing people together is what the internet does: democracy is the function of harmonising discrepancy, of managing disagreement, and of legitimising leadership and authorising progress. Here are four proposals to unlock the full potential of democracy as a collective decision-making institution in the age of the Internet.

Firstly, the role of technology companies can and should change, but this requires leadership from within. Facebook’s community is larger than many countries, and the magnates running such companies have the power to change them for the better. Do they have the will though? Mark Zuckerberg’s new year message hinted at insight into his personal disconnect from reality. He should take responsibility for the content of what Facebook circulates, and see himself as a leader not a tech geek. Most important, Facebook should not allow such stories to be presented as news, much less spread. If they take advertising revenue for promoting political misinformation, they should face the same regulatory punishments that a broadcaster would face for doing such a public disservice.

Secondly, there is a role every user of digital technology can play. The internet has made us less trusting of our own judgements (and those of experts) and more deferential to the wisdom of crowds. A rebalancing is needed in the way we calibrate our understanding: sure experts get it wrong; but so do mass hysteria crowds. The solipsistic echo chamber that is Twitter and Facebook thrives on selective affinity: “I like you because you agree with me”. Perhaps an individual, helpful response is to be more Socratean, welcoming what we do not know or understand, happy to acknowledge our limitations, but eager to learn.

Thirdly, collectively, we need to recognise that social media is here to stay but that it can also be a huge positive. Social media can shine the light of transparency on the workings of a Trump. Was Hillary Clinton really replaced by an alien in the final weeks of the 2016 campaign? We all need to be able to see who wrote this story, whether it is true, and how it was spread. Rather than seeing social media solely as the means by which Trump ensnared his presidential goal, we should appreciate how they can provide a wealth of valuable data to understand the anger and despair that the polls missed, and to analyse political behaviour in the times ahead. Valuable democratic opportunities are created on social media when people use them to talk to politicians and civil servants, and to each other. Social media radically reduce the cost and difficulty of people organising themselves, forming ‘communities of interest’ united by a shared concern, whether a common complaint about a local NHS service, opposition to a local planning application, or a suggestion for a traffic calming measure.

Finally, and lastly, there is the issue of what government can do. There are emerging expectations for MPs to listen to and engage with people on these channels. Politicians need to use social media to learn more about the needs and views of their constituents, and as a gateway to more sustained contact with their constituents.

Like all successful politics it starts at the local level: social media users are more likely to contact their local politicians – a local councillor or constituency MP – than national politicians. The public debate is on social media and Parliament should catch up. Listening to these gives an opportunity to bridge national institutions with street-level social reality, fashioning new instruments in gathering and understanding social attitudes on politics and policy. Therefore, every parliamentary debate should have a social media element to allow the public to offer their views and opinions for the benefit of the participants. Numerous social media platforms support the streaming of live video, allowing viewers to tune in and comment on debates in real time.

Government can also help prepare the digital users of tomorrow for a world in which facts are contested more than ever. As Peter Hyman wrote recently: “In a world of “alternative facts”, how can we give young people the skills to shine a spotlight on the truth?” We need education to promote questioning, critical thinking and critical analysis of evidence and the news as a defence against the worst excesses of the internet.

In conclusion, a health warning about our fascination with digital: we’ve been here before. The death of democracy was widely predicted with the advent of mass-circulation newspapers and then again with the broadcasting of Parliament. And, of course, not everyone shares that fascination with digital. The explosion of new digital practices has occurred within a social context where many are excluded or unwilling to participate in such practices. Not everyone uses social media – including some of the poorest and most vulnerable in society. Political change is a hard grind, requiring face-to-face contact, and development of political and community relationships over years, not seconds. Technology is not a panacea for the problems democracy faces.

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There are many of us who might suffer from some sort of mental health issues to a varying degree and there are still plenty of aspects we don’t really understand, although we are now in a climate of improved awareness.

This means that there are more self-help options available now than ever before, including some mobile methods that can soothe you wherever and whenever you need it.

Here is a look at some useful apps, including one that taps into the benefits of CBT and a childhood activity that is proving popular with stressed-out adults. There is also an overview of an app that works on improving your sleep patterns plus details of an anxiety management option to download on your smartphone.

Accessible therapy

Some mental health issues are more complex than others and might require some professional intervention as part of your healing process, but there are some apps that can help you to cope with things like depression, anxiety disorders and other issues that you might be trying to contend with.

A method of treatment that has come to the forefront in recent years is cognitive behavioral therapy (CBT) and there are some apps like MoodKit which aim to cover most of the bases surrounding the general concepts of CBT.

You can use the app in conjunction with working alongside a therapist and it teaches you self-monitoring and encourages you to engage in mood-enhancing activities.

Coloring can make you happy

There has also been a real surge in popularity for adult coloring books and it is perfectly understandable when you start to list some of the health and psychological benefits attached to this activity.

If you think back to your childhood you will most likely have some happy thoughts of time spent drawing and coloring your favorite characters and pictures, and you can tap into these positive emotions by returning to this popular pastime.

You can even get a coloring book app on Google Play so that you can improve your mood with an activity that has been used to help with anxiety and other stress-related disorders.

A good sleep is always important

You can’t really expect to function at 100% when you are not enjoying a regular and restful sleep pattern.

To combat this problem there is an app called Sleep that aims to help you improve your sleeping patterns. It uses a combination of CBT methods together with some other customizable programs and even has a virtual sleep expert to consult when you need some pointers on how to get the sleep you need each night.

SAM can help with anxiety management

SAM is the acronym for self-help anxiety management and this is an app that is designed to help anyone suffering from anxiety.

You can self-evaluate your current mood and level of anxiety using this app, and SAM is an app aimed at trying to help you look at things more calmly and patiently, working through any issues in baby steps rather than giant leaps. You should also see progress being made as it records where you are at on the road to recovery.

If you want to improve your mental health issues and work your way through some specifics, there is bound to be an app that can help you with that.

Harvey Woods is a therapist who writes about self-care and managing our feelings and thoughts in today’s fast-paced world where stress is the norm.

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Information technology is increasing the opportunity and roles for citizen and patients within their own health. Electronic health records are becoming available to all citizens and patients. The knowledge and skills necessary for citizens and patients to benefit from access and contribution to their records is emerging rapidly and guidance is appearing. (RCGP guidance and DH work stream) The patient provider relationship is evolving to reflect this within the United Kingdom and in countries in Europe. Information, personal data, knowledge and understanding are becoming ubiquitous. (Bill Gates New Year) Primary education has become a universal experience. Mobile and information technology is becoming easily available to citizens who are empowered to take actions that impact positively on their own and their family’s lives. These actions are at times in opposition to the messages of commercial advertising that citizens receive through the media.  The twentieth century has been described as the century of the self. It was brought in with the early engagement with psychology, global markets, telephony and the motor car. It went out with a sense of uncertainty “all watched over by machines of amazing grace”. (Adam Curtiss – BBC2) 
 
Just as for the extension of human rights and animal rights, the progression of expert autonomous patients has been a long and hard one with obstacles along the way – not least obstacles created by patients themselves. Ivan Illich suggested that doctors had misappropriated patients’ health. To some extent this is true just as Victorian engineers appropriated the right to design and build tunnels, bridges, factories, drains, reservoirs, dams and other engineering projects in the nineteenth century. But it is also true that citizens and patients are happy to accept a passive and fatalistic role in their own and public health leaving what is without doubt their responsibilities to the media, the market and to their highly paid professionals. Professionals will in fact do no more or no less than they are paid for whereas patients and their families and friends are able to do more for themselves than ever before.
 
Public and environmental health is a consequence of behaviour, nature, markets, culture and technology. The developed World is at the end of one stage of its economic growth and is facing recession, mass migrations, global warming, increasing food costs and population growth worldwide. Markets will be required to adapt as the world’s human population increases by two and a half billion people in the next forty years whilst advertising and the markets encourages all people to expect the levels of lifestyle of the developed world. The planet unfortunately cannot support such lifestyles for all.
 
Modern lifestyles are producing new problems to deal with. An older population has more illnesses and incapacity to be helped with. There are less young people to help older people. Urban life is causing more mental health problems. Physical inactivity, over consumption, drug and alcohol abuse, obesity, diabetes and related pathologies are market, culture and lifestyle induced. These problems are to some extent the result of the perfect safe, comfortable life that is afforded by cheap and safe transport, central heating, telecommunications and leisure. It seems that all play and no work makes Jack a sick boy. Bodies have evolved to cope with work and stress and require some regular use to remain in shape.
 
High profit shareholder companies and costly technological medicine are progressing at a time that the WHO (reference) advises responsible authorities to invest in lower cost primary care, health promotion, prevention and public health. 
 
Health management is a biological imperative for all species and for every individual. Each “family’s” day to day life – eating, sleeping, socialising exercising – is driven by biological and cultural behaviour. Lives incorporate healthy and unhealthy behaviours and choices. Secondary health activities occur alongside citizens’ daily health behaviour in modern societies. These include the management of urgent problems, continuing care, preventative care and the promotion of good health and health seeking behaviour. This latter is to reduce the negative effects that environment and lifestyles can have on patients’ lives.
 
One strand of improved efficiency in service provision worldwide may be the introduction of electronic health records allied to the education of billions of confident, enquiring skilled, patients and carers. Citizens will learn to manage and improve their own health data and to work as partners with health commissioners and providers. They will also become experts in their own and their environment’s health and not leave the environment to the newspapers and businesses but become involved and knowledgeable about their own environment and about local business and development. ( Maslow’s hierarchy of needs)
 
Health is not just the absence of disease but it is also the fullest expression of each genome within a healthy environment and on a sustainable planet. Passive consumerism is not the fullest expression of the full potential of the genome active participation represents a fitter expression.
 
The use of the world “global” reflects the similarity of humans worldwide despite differences in languages and creeds. Uniform systems of numeracy, scientific measurement, botany, geography, accountancy and other abstract disciplines have offered solutions to global problems aided by their description, analysis, study and reproducibility.  Electronic health records describe, analyse, study and reproduce too especially as their architecture and coding become consistent, universal and ubiquitous.
 
It seems sensible to address electronic health records issues globally as well as the levels of the 195 separate states since there are such rapid and so many global technological advances that are changing the health IT landscape. There will be national solutions as well as international ones and there are reasons to press forward with both together.
 
Culture changes invoke resistance, mistakes, misfortunes and opportunities. SMS messaging started 20 years ago and has spread around the world. Mobile phones are doing the same. ITC, shared care pathways and shared electronic records have the potential to integrate self and professional care whilst augmenting traditional medicine. Communication technologies allow the care pathways and care records to be shared between patients, families and lay carers.
 
At a time when some old people are living longer than they want to, some younger children have no access to health care. There are an additional two billion people to share the planet in the next forty years.
 
What are changing or need to be changed and where do medical records, intelligence, information, data and data processing fit in with these changes? 
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In this era of busyness, a large number of people have forgotten, “The greatest wealth is Health”. Heaven knows that life is not life without health; it is just a condition of languor and suffering – an image of death. In today’s fast-moving world, most of the people seem very busy as busy bees; in fact, they work from dawn to dusk. Even they do not care about their health. You have to make some space in your life for being healthy.

Do you know an easy way to take care of your health and fitness matters in the shortest amount of time? If no, bear in mind that Fitness Trackers are the best gadgets to take care of your health around the clock. Without having any doubt, whatsoever that inactivity can lead to a lot of health-related issues. Even fitness trackers monitor your level of activity and reveal the data on your Smartphone.

Now you will surely get your tracker as quick as a flash, but how will you find the best one that will perfectly fit your needs. Don’t worry! In this article, you will find some best fitness trackers with ease.

Let’s have a look on some best fitness trackers accessible in the market. If you want to do some in-depth research about the fitness bands, click here.

fitness trackers

  • Garmin Vivo smart HR+

As an activity tracker, it offers automatic tracker. Also, delivers phone alerts and notification on time.   Moreover, it tracks heart rate 24 hours a day and 7 days a week and it can be used with both Android and IOS. In short, it is a fantastic and huge upgrade model.

  • Fitbit Charge 2

It helps you stay active and motivated throughout the day. Furthermore, it has a large display screen, gives a guided breathing exercise, and the most accurate measurement of sleeping tracking.

It gives you good battery timing. Also, it looks utmost stylish due to its sleeker design and silver body polish. In short, it is one of the best trackers for the general use.

  • Apple Watch Series 2

It is one of the best fitness trackers for the iPhone users. Are you looking for the Apple’s smart watch? So, Apple Watch Series 2 is the best option for you without fail. Due to its built-in GPS system, it helps you out to keep track of your workouts without using your phone.

In addition, it has water resistant capabilities up to 50 meters.

Another key thing to remember that Series 2 Apple Watch processor is 50 times faster than the Series 1 Apple Watch, and it has a sensor that tracks the heart rate.

  • Samsung Gear Fit 2

It is one of the best fitness trackers for the Samsung/or Android users. Do you want to get Android smart watch cum activity tracker? So, Samsung Gear Fit 2 is undoubtedly one of the best options for you. It features an appealing slim design with an AMOLED display, and without a doubt, its notification support is excellent. Moreover, it tracks the heart rate with the plenty of fitness metrics effectively, and also, Cost effective. The glorious thing is that it has built-in GPS and able of playing music to Bluetooth headsets.

 

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The NHS is buckling: the scale of the funding challenge is colossal, the service is under unprecedented strain and it is struggling to keep pace with relentlessly rising demand. So says the Commons Health Committee in its recent report into the impact of the 2016 Spending Review on health and social care. Things will only get worse post-Brexit – indeed there is already a ‘financial reset’ in place requiring the NHS to live within its means, including cutting the clinical pay bill.

Can technology be a big part of the solution to this situation? It might seem unlikely given the hi-tech fiascos of the last two decades, notably the NHS National Programme for IT that aimed to reform the way the NHS in England used information – abandoned after costing a staggering £9.8 billion and described by the Commons Public Accounts Committee as ‘one of the worst and most expensive contracting fiascos in the history of the public sector’. And only months ago, the Health & Social Care Information Centre branded IT projects in the NHS valued at £5 billion to be at ‘high risk of failure’.

If there is one lesson to be taken from this it’s that expensive top-down schemes are unlikely to succeed. But what about bottom-up initiatives that utilise the vast array of digital health products now available? From low-level gadgets through to traditional telecare/telehealth and on to emerging digital technology including mobile phones, apps and tele-video, the options are expanding rapidly. All of these make possible the maintenance of independence at home for longer, keeping people out of hospital for longer, discharging them from hospital more quickly, and all at less cost. This looks like a significant win-win for individuals, the NHS, and social care.

health_app

This is precisely the aim of the ‘Test Bed’ programmes in seven localities announced earlier this year by NHS England CEO, Simon Stevens – a move paralleled earlier in Scotland with its Technology Enabled Care Programme. There is good reason to think that building up successful interventions in this way can be highly successful. Reviews and studies suggest that technology-enabled services can indeed improve the quality of life of older people and their carers, reduce social isolation, increase perceived health status and security, and allow carers to balance care and work.

The NHS and social care can’t afford to get this technological option wrong, but like any complex issue there are huge implementation obstacles to be overcome. The first is to secure (rather than simply assume) commitment from the key participants – staff and users. Front-line staff are too often seen as passive recipients of new technology and are not involved in the development of systems’ architecture or user interfaces. Failure to convince them of the virtue of change can lead to all manner of resistance strategies arising from inadequate understanding, lack of time, challenges to established routines and fears around job security.

Users too, have to be convinced of the value of using new devices. Technology varies in the ways in which, and the extent to which, it requires engagement and action on the part of users. At one end of the spectrum, a telecare system based upon monitoring and surveillance may require little more than consent to installation of the equipment; at the other it needs active self-monitoring, self-management and engagement with the technology and with professionals. Where an active role for users is envisaged, issues of digital literacy and resistance come to the fore, and localities will need robust strategies to maximise technological familiarity.  A further barrier will often be found at strategic level – hard-pushed managers and policy-makers stumbling from hand-to-mouth will find it hard to invest time and money in a new and still relatively untriedmodus operandi.

It is clear that making policies and procedures on technology-enabled care work in practice is difficult. This is not unexpected given the multiplicity of stakeholders with different views on what it means, and the relatively early stage of the policy cycle. Currently there are tensions of many kinds – between innovation and tradition, between enthusiasm and digital Luddism, and between policy aspiration and achievement. What can be done to address this? A robust strategy will have three strands:

  • Structure: a stronger central push
  • Knowledge: a stronger evidence push
  • Culture: a stronger behavioural push

Despite the appointment of a new NHS Digital Director on a high salary, central policy remains weak and underfunded. We need to move beyond a small number of ‘test beds’ and set up a properly resourced strategy along with clear (but realistic) expectations of what will be achieved, in what ways, and over what period of time.

Monitoring frameworks like the NHS Digital Maturity Index and Local Digital Roadmaps need to be widened and strengthened to cover entire health and care systems – the future lies in joining up telecare and telehealth, not just having a paperless hospital. Making available free devices and apps to help peoplemanage conditions like diabetes and heart disease (as is planned from April 2017 in England) is a useful measure but overall, current policy still resembles a hotchpotch of initiatives rather than a coherent strategy.

Secondly we need to develop the evidence base to establish whether, and in what ways, technological application can make a difference. Notwithstanding the success of some small-scale initiatives, the evidence base for scaled-up technology enabled support is still thin, especially in the case of telehealth – currently ‘in the foothills of a journey’ according to a comprehensive review by the Nuffield Trust. The last major study in the UK was the ‘whole systems demonstrator’ programme funded by the Department of Health which found mixed results but it should be remembered that this study is ageing and the pace of technological change is quickening.

Finally, there is the need to face up to the enormity of the digital revolution. The rapid growth of Information and Communication Technologies and innovation in digital systems represent a revolution that has fundamentally changed the way people think, behave, communicate, work and earn their livelihood. There is every reason to think this will apply just as much to the way health and care is delivered in the future, yet it tends to be perceived as an optional bolt-on to ‘normal business’. This won’t do.

Going ahead we need first of all a stronger organising vision – one that is informative, plausible, important and distinctive and will serve to legitimise and mobilise a new digital paradigm. This, in turn, must be underwritten by a transformation programme. Organisations will need to invest at least as much into programmes of organisational change as in the technology itself. This is precisely the sort of thing that should be integral to the local Sustainability and Transformation funding and planning process designed to implement the Five Year Forward View, but instead it is tending to be used to simply plug provider deficits. Finding the resources for change management, training and embedding new processes is a big challenge for organisations already operating at maximum capacity, and it would be reasonable to look to the Treasury to find ways to fund an ‘invest to save’ programme.

The prospects for a ‘Digital First’ NHS stand at a policy crossroads. Either we carry on with ad hoc, pump-primed local programmes that may, or may not, add up to more than the sum of their parts, or we take a paradigm-shifting leap. We set out a clear national agenda to be followed by action at local level to achieve what has been described as ‘digital congruence’ – culture, people, structure and tasks all aligned with each other. The challenge is complex and messy; the rewards potentially huge.

This was first published on the British Politics and Policy blog

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Healthcare everywhere has two big IT problems.

Incompatible Databases. Data Re-entry Overload

Both baffle the world’s best brains. Why? The fantasies of those in power, about what computers can, and what they cannot do. And ‘Competitive market forces‘ The result: everywhere we go we have to fill in more forms. And answer the same questions, over and over again. Just so that someone somewhere, at our expense, can enter our info onto yet another incompatible computer.

Sadly. However clever they are, the world’s most expert programmers cannot make different databases talk to each other. Surprise, Surprise, it’s actually impossible. Genuine Inter-operability in the NHS remains a myth.

But amazingly we, the public, now have a unique opportunity to help.

Dr Rupert Fawdry, a “retired” hospital consultant, asks “Where should we start?” His simple answer. “WITH US! “

And now via wisdam.org each of us can, cost-free, download and print out the new globally standardised set of basic healthcare questions. And, when faced with yet another similar but different form, if enough of us insist on using Simple WISDAM®, we can push all the different IT systems towards becoming compatible. All without needing to own our own computer, or to worry about internet security. Because we only need to write and to update what is needed – on our own paper record. Electronic versions – fine – but purely optional – and only if they fit with Simple WISDAM®

So, if we want to make the NHS more efficient, get downloading and get writing both for ourselves; and for any elderly people we know.

Imagine the value to ambulance paramedics or A & E staff if more and more of us had most of the info they urgently need already documented on a piece of paper in our purse or pocket.

Together we can transform the efficiency and accuracy of the whole NHS!

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The alleged crisis in GP recruitment is a political red herring. The bigger issue is the deep need for a change to the structure of commissioning, writes Andrew Haldenby, in a recent report from the right wing think tank ‘Reform’. He goes on to argue that access to general practice via new technology remains in a relative Stone Age. Only 7 per cent of people report that they have booked appointments online.

The current model of general practice is obsolete, it is true, and the Royal College of GPs knows this even if it is uncertain what to do about it. Calls for more funding for more GPs are just part of the NHS’s endless bidding war and not a serious strategy. But I think the problem is more than simply the size (meaning aggregate skills) of practices. Continuity of care, which matters for patients and for good practice, is best served in population groups of around 6000, or about 3 FTE GPs. The challenge for the large GP formations is to combine the back-office efficiency of large organisations with the clinical effectiveness of small work units. We will see how this tension is resolved as more large scale primary care organisations develop, but they will need independent investigation because the champions of large organisations – including the GPs driving them and the commentators (like Reform) promoting them – will be too biased to make sound judgements. 

It is unhelpful to describe the technology of primary care as being in the ‘stone age’; and the choice of online appointment booking trivialises the issue. GP electronic medical records have led the way for creation of large clinical datasets and the introduction of real-time decision support tools. The datasets allow general practice to perform some of its public health functions, like risk assessment and stratification, whilst decision support tools enhance clinical expertise at patient level by standardising probabilistic reasoning. Where the uptake of new technologies is disappointing is in near-patient testing, particularly ultrasound, but even here there is progress in spirometry and oximetry, and in 24 hour blood pressure monitoring. We should not exaggerate the problems of general practice. 

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University of Illinois at Chicago Online

 

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This video from Liverpool vividly points out how essential it is for clinicians to share patient records with each other. In real time, at the point of care. It can be life-saving. It is shocking how so many procedures, mainly in secondary care, can be relatively free of past patient data.

Healthy Liverpool Presents : We Share Because We Care from LittleJeff Productions on Vimeo.

This is well recognised across the NHS and social care and there are a number of solutions out there. The universal solution is the Summary Care Record on the Spine. This is now available to all hospitals in England. It shows the Problem list, Allergies, Medication for all people in England with an NHS number. This is useful in most situations. However, as I understand it, the system is so clunky that hardly anyone uses it. You could have done the appendicectomy by the time the information appears on the screen.

There are also a number of bespoke solutions across the country. One of the problems is that, even within a hospital, there may be many different IT systems: one for cardiac, one for gastro etc. They have usually been developed by smart doctors and work well for that department but the IT systems often don’t talk to each other and won’t talk to GP systems or ambulance vehicles. And many hospitals still do much of their work on paper. In keeping with this fragmented approach, many individual health economies are developing, with IT companies, interoperable processes so that clinicians and sometimes social services in any area can share data. That is the Liverpool solution. It is good, but will still not solve the problem of sharing data between areas. Lots of people move around a lot. In addition, it can involve complex sharing agreements across different sectors.

Of course, in Scotland, they have had an effective, cheap system for years which has enabled everyone dealing with emergency care to share information. The Emergency Care Summary (ECS) is a shared record system offering controlled access to medication and adverse reactions details for 99.97% of patients in Scotland. It holds a secure central copy of these parts of the GP practice’s record and is updated automatically twice daily. 81% of clinicians said that ECS was helpful or very helpful and felt that it changed their clinical management in 20% of cases.

Until we have replumbed the IT system for the whole of the NHS to ensure interoperability (which actually may be possible in the next few years and has been done in Estonia ages ago) there is an excellent solution which will work now and which solves most of the problems, for free and integral to the NHS itself – give the people their GP record and support us to share with clinicians across the NHS. Anyone who wants it in England can have access to their Summary Care Data plus their primary care test results from April 2016. This is funded by the NHS and links in real time to the patient’s GP record. This approach involves the patient, improves trust, encourages self-care, helps people understand what is happening to them in the care system – and shares data with no ethical or confidentiality issues. Work is planned on an ICE-type approach whereby clinicians could break into the system on behalf of an unconscious patient.

This is not currently available in UK countries outside England, but it probably will be soon.

So, patient power is yet again a solution to complex and expensive problems in healthcare. Let’s remember and apply elsewhere.

 

Dr Brian Fisher, is a GP and director of PAERS Ltd , a company on the government Framework to deliver record access and other patient-facing services to the NHS.

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The use of technology in the UK’s hospitals is advancing rapidly. Over the years patients have become used to being connected to a whole variety of pieces of electronic equipment in order to maintain and monitor their health but the development of mobile technologies as well as progressive diagnostic tools mean that our hospital care is set to change still further.

Look to the future 

Hospital beds may change in shape and design, most wards are furnished with ripple beds in order to reduce the possibility of bedsores, but the kind of bed castors here are still attached to these beds for ease of movement. Of course electrical connectivity is a necessary part of the modern hospital castor wheel. Other equipment on the hospital ward will change beyond recognition.

Tricorders may become commonplace

One area that will change is the field of medical diagnosis. A recent article in The Guardian suggested that the diagnostic gadget as used in the US TV series Star Trek might become a commonplace feature within the next five years. The suggestion is that the gadget will be ‘capable of diagnosing a set of 15 diseases without the presence of a medical professional.’ This isn’t quite doctoring by robotics, it’s more a question of computers becoming more adept in the way in which they handle medical information and how they analyse this data.

Remote operations

Dr Peter Diamandis, who is in the forefront of medical technology exploration, believes that robotics will play a greater part in medicine. Already a system exists, known as Da Vinci, that allows surgeons to control a robot used in surgery as part of an operation from anywhere in the globe. Eventually, Diamandis visualises a world where robots will carry out surgical operations without any human input at all.

Changing the present 

Video consultations are becoming commonplace in UK hospitals. The authoritative Kings Fund highlights the Airedale Hospital’s telehub where patients don’t have to physically attend the hospital for an Outpatients’ appointment, the consultation is carried out through a video link. The hospital has recently published figures that show a ‘35% reduction in hospital admissions and a 53% reduction in patient visits to A&E’ as a result of use of the telehub.

Changes in mental health treatment

Online Cognitive Behavioural Therapy (CBT) is already being trialled across the UK. Some detractors argue that patients may self-edit when filling in online questionnaires about their mental conditions, whereas others believe that in the absence of visiting a real therapist at least the patient will benefit from answering the questions and the data amassed online will be analysed by psychological experts. The Big White Wall is another example of how patients suffering from anxiety may be able to access online help.

From keyhole surgery to online diagnostic apps for smartphones, medical technology is changing quickly. Healthcare professionals are learning how to work with these changes in order to improve patient care. As for replacing people with robots, that’s a whole different ballgame….

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