I had a lightbulb moment last
week. I don’t mean one of those occasions where you suddenly have a great idea
or gain an understanding over something that up until that point had eluded
you. No, not that kind of lightbulb moment, I meant I had a real lightbulb
moment, which involved a real lightbulb. The new house needed an outside lamp
over the front door. Most outside lamps are either very pretty, but don’t have
motion sensors, or are utilitarian, and whilst they do have a motion sensor
they lack aesthetic appeal. Despite this, I had opted for the pretty type of
light and bought a motion sensor to use with it. I had even found an
electrician to fit the lamp. Just as we were leaving the store, J saw something
claiming to be a motion sensor lightbulb. Although I was slightly dubious about such a thing,
I was persuaded to buy it.
The electrician came to fit the
lamp. The bad news was he told me we couldn’t connect the lamp and the motion
sensor together without chiselling out some of the rendering. This was not
something I really wanted to do. So, it was back to the motion sensor
lightbulb. The lamp was fitted, bulb inserted and hey presto the thing only
went and worked. Unbelievable, but true. Someone had invented the perfect
solution to a tricky problem. Well not quite. The light bulb switches on 24
hours a day at the slightest movement detected, and its range is extensive, and
it appears to be highly sensitive. A leaf, floating gently to the ground from a
nearby tree, sets it off. The bulb lights up, stays on for 60 seconds and then
switches off again, before repeating the same action at the next movement
detected. J did ask if we could alter the lightbulb settings, but I guess that
will only be possible with the next generation of lightbulb…
However, even with its
shortcomings, it is still a very useful technological development. Unlike the
so called WaitLess app trumpeted to the world last week by our Secretary of
State for Health and Social Care, the ever-enthusiastic technology advocate
Matt (the app) Hancock. Gleefully announcing that the WaitLess app would be
good for patients and good for clinicians, he believes it will relieve pressure
on A&E departments (or EDs as the rest of us like to refer to them), as
patients could look to see which hospital had the shortest waiting time. Talk
about lighting the proverbial blue touch paper. That day Twitter lit up with
tweets ridiculing the suggestion, or suggesting that more doctors were needed, we
should pay nurses more to retain them, and that our GP surgeries needed to be
open for longer hours and so on.
There were also many, many tweets
reminding Matt Hancock that all patients coming to the ED are triaged and those
who present with the most urgent needs are seen first. My favourite comment about
this announcement, asked would we now see Tesco producing a WaitLess version
for their till waiting times, advising customers that the till queues were
shorter at Asda, or Waitrose? Personally, I think the app might be a good idea, but
like my motion sensing lightbulb, it’s not quite the complete answer just yet.
And that has been the problem for
the NHS and the social care sector and its adoption of new technology. The
Taxpayers’ Alliance reported at the end of April that the NHS could save
billions of pounds each year if it made greater use of robots and artificial
intelligence (AI). Their research posits that the widespread use of digital
apps could transform care, and they note that 90% of people now prefer to use automated
systems to book appointments, order repeat prescriptions and so on. It
estimates that such approaches save a staggering £12 billion a year in staff
time. Millions of patients are already being supported by automation
technologies in areas such as diagnosis and treatment as well as logistical
service administration – much of this support is unseen by most of these
patients.
However, it is in the area of
predictive data analysis that the greatest gains are likely to be found. Many
EDs are still not hitting the 95% of patients seen and treated within 4 hours
target. The main reason for this is accurately predicting patient flow, and the
exponential growth in complex presentations. Advanced AI-powered data science are
used by the likes of Tesco in understanding customer preferences, shopping
habits and responses to environmental and other contextual factors. The NHS should
adopt these technologies to predict patient flow and demand for emergency
services.
We are already seeing such approaches being used in different parts
of the UK to help support the so called ‘frequent flyers’ of health and social
care services. Indeed, the current review into scrapping the 4 hour target is
predicated on using such data analytics. Instead of the crude 4 hour target,
which lead to perverse target chasing, data analytics now allow for more sophisticated measure's. For example, determining the time patients are seen, assessed and
treated, using the so called ‘rapid care measures’ to achieving individual
patient-centred care. EDs will be measured on their overall average waiting
times for all patients. However, those patients with heart attacks, sepsis,
stroke or those experiencing a mental health crisis will now be expected to
receive their care within 1 hour.
Of course, data analytics per se will
do nothing in terms of helping people to help themselves when it comes to
health promoting choices or choosing where to go when they need health or
social care. Much more needs to be done in these areas, but new technology,
particularly digital technologies, can help bring about the changes in
behaviours and expectations required. Let’s hope they are more successful
in action than my motion sensing lightbulb!
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