The U.S. is currently enjoying some envious glances from across the Atlantic.
British experts eager to modernize the country’s famed National Health Service are looking to the U.S. for inspiration as they begin building a digital healthcare system. The UK is a relative newcomer to the field of digital healthcare, or telemedicine, as the practice of supplying medical services online has become known. The largest digital platform was released in the latter stages of 2017 and has attracted around 26,000 members–by comparison, the U.S. Department of Veterans Affairs alone conducts more than two million telemedicine consultations annually.
What the UK wants is not a smartphone app to put individuals in touch with a virtual doctor, but an entire healthcare system of digitally connected medical practitioners, hospitals and facilities, and online databases that improve the delivery, accessibility, and costs of healthcare at a national level.
It’s a lot to ask for, and the U.S. hasn’t fully achieved the such a system either, but the UK is right to be envious of how far telemedicine has evolved here.
Dreaming of a Digital Healthcare System
The NHS is the largest health care system of its kind in the world. Made up of four distinct branches that cover each country within the United Kingdom, it offers free medical and emergency services to all citizens. Established in the years immediately following World War II, the NHS has become a national icon–in 2016 it topped a list of “things that make us most proud to be British” and it received a special tribute during the opening ceremony of the 2012 London Olympics. If you’re partial to dancing nurses and their patients you can watch the footage below:
The NHS has not, however, been at the forefront of digital healthcare. A report released by the Royal College of Physicians in November this year called for digital technologies to be introduced into the system to align it with “modern-day living and expectations.”
In response to that report, other British experts have argued that the NHS should follow the example of the U.S. in working toward delivering digital healthcare solutions at a large scale.
The NHS did enter the digital realm last year with the introduction of GP at Hand, a smartphone app that allows patients to consult doctors over a video conferencing connection. The service is free, regardless of how long an appointment lasts, but it is available from a limited number of clinics and patients can only consult participating doctors that live within 40 minutes of where they live or work. The app has attracted the ire of London doctors, who say it is stealing their youngest and most profitable patients. This is a sign that it is winning favor with digitally native Millennials and members of Gen Z, but its limited range means it is far from a system-wide digital healthcare system.
Real telemedical change means taking established, large-scale services online.
Digitizing the NHS
The British Government has begun to recognize the need to modernize the NHS. In July 2018, it pledged nearly £500 million (about $627 million) to begin digital transformation projects across the service. The specifics of the investment have not been released, but the funding will target patient safety and increasing data efficiency. The funding follows an earlier pledge to invest in artificial intelligence to improve early diagnosis of cancer and chronic disease.
Research has consistently shown that medical services delivered by online, remote pathways, such as video conferencing, can be as effective as in-person consultations.
What a digital healthcare system can really deliver, though, is a nationwide web of both services and data connections. Research has consistently shown that medical services delivered by online, remote pathways, such as video conferencing, can be as effective as in-person consultations. That opens up possibilities to deliver remote healthcare services to underserved population across dozens of medical fields.
Moreover, embracing digital connections can result in centrally operated healthcare hubs that can reduce patient wait times, improve record-keeping, and increase the value of specialized services by better distributing key resources.
In that regard, the U.S. is a good digital role model.
Telehealth in the U.S.
Of course, the U.S. hasn’t adopted a digital healthcare system that covers the entire nation. It has, however, created several large-scale platforms that distribute medical resources across entire cities and states.
In addition to the telehealth contribution from major healthcare organizations such as the VA mentioned above and private sources like the Mayo Clinic’s telemedicine network, individual health groups have been quick to adopt remote platforms.
Here in the U.S., we’re (albeit gradually) putting our money where our mouth is when it comes to telemedicine.
The Mercy Health system has a virtual care center in St. Louis that provides remote support to 38 hospitals in states like North Carolina and Oklahoma. Similarly, video conferencing vendor Vidyo has built a central command unit that allows doctors to simultaneously monitor patients in intensive care units across 15 different hospitals.
These kinds of networks can theoretically be expanded across state borders to create super digital health clinics–it just requires a centralized source of coordination and cooperation. Here in the U.S., we’re (albeit gradually) putting our money where our mouth is when it comes to telemedicine. More than 30 states have laws mandating that health insurance covers telemedicine services and around 20% of employer-sponsored healthcare plans now include digital health options.
The NHS does have an advantage over the U.S. in that it already has a system that covers an entire population. That should make rolling out digital changes easier and should reduce gaps in service delivery to populations that can benefit most from telehealth. Change will be slow, but acknowledging the need for a digital healthcare system is the best way to start.