Mobile Technology (Health Care)

Rosie Cooper Excerpts

Wednesday 21st November 2012 Westminster Hall

[Rosie Cooper (West Lancashire) (Lab)]

It is a great pleasure to serve under your chairmanship for the second time today, Mr Havard. I welcome the Minister to his place. We were occupants of neighbouring offices in this House, but I tend not to see him quite so much now, with his promotion to the Government ranks.

In every aspect of our lives, technology is driving innovation, improvement and increased efficiency. Health care is no different, where the use of mobile communications technology is becoming increasingly important. We are reaching a point where mobile technology can take an increasingly strategic role in meeting today’s health care demands. That is because a number of critical factors are converging, including several extremely demanding health care challenges that, taken together, require new approaches and solutions; the remarkable computing power now available on portable devices such as tablets and smart phones; and the development of specific mobile technology-based health-care focused solutions that can improve quality, efficiency and a patient’s experience of their care. I shall cover each of those in turn.

Our health service faces unprecedented challenges that go way beyond the £20 billion cuts to national health service spending, and most health care systems across the world face similar situations. We are, as a population, living longer. That is undoubtedly a good thing, but it brings with it demands. Older people with multiple and complex health care needs constitute the majority of interactions with the NHS, and their care consumes the majority of health care expenditure, to the extent that health care costs are growing faster than gross domestic product. New drugs, diagnostics and treatments mean that we can treat conditions that years ago were simply considered beyond the reach of modern medicine. They are welcome developments, but they inevitably involve significant financial cost.

A less welcome reason for increasing health costs relates to the increase in long-term and chronic diseases. Over recent years, we have seen the rise in the prevalence of obesity, type 2 diabetes and other conditions that have a significant lifestyle-related component. They contribute directly to health care requirements and lead to secondary complications. For example, the single most significant risk factor to the development of dementia is cardiovascular health. The NHS needs to address all those challenges while delivering an unprecedented 4% year-on-year compound efficiency savings. The Minister, as a former member of the Select Committee on Health, on which I still sit, will be aware that the Committee has correctly pointed out that such a level of savings has not been achieved by any other health care system.

I think we can accept that the face of health care and the challenges it faces are changing. How can mobile communications technology help deal with the challenges? It is worth reflecting that the power of today’s mobile communications technology—they are long words, but we would just call them tablet computers and smart phones—is comparable to some of the faster supercomputers of just a decade or so ago. I was interested in what is termed “always on” connectivity, which means that one can always be reached if devices are switched on, through secure wi-fi, 3G and the emerging 4G technology. Such devices can connect instantly with extremely powerful networks. That means that working practices established 10 or more years ago can be radically transformed. Through harnessing the power and capabilities of mobile communications technology, the health service can better support its health care professionals. Technology can reduce the time spent on administration and give professionals much more needed time to care.

Specifically, modern mobile communications technology can help patients and the public make healthier decisions, enabling individuals to manage their conditions more effectively and therefore to live independently. It can also help health care professionals collect information more effectively, which leads to improved efficiency, patient safety and care quality. I will draw on a few examples that relate to those areas. Mobile technology can help patients take more control of their health by encouraging healthier lifestyle choices; by giving patients more control and information to manage their conditions effectively; and by supporting more comprehensive remote monitoring.

I think the Minister is aware that there is already extensive clinical evidence that shows that patients who take an active role in their care do better. For example, a study in Toronto showed that diabetic patients who monitored their blood pressure using smart phones experienced a 25% drop in cardiovascular mortality. The Government have committed to giving patients the right to book general practitioner appointments, order repeat prescriptions and talk to GP practices online. That represents just the tip of the iceberg. The effect on the population’s health would be much stronger if patients were encouraged to monitor their care with support from their health care professionals.

Much closer to home, Leicestershire’s nutrition and dietetic services and the university of Chester in the UK have pioneered a secure smart phone solution to enhance the approach to adult weight management services. Achieving sustainable weight loss is hard, yet their service, known as LEAP—lifestyle, eating and activity programmes—weight management groups, based on national guidance, has achieved just that. They have found that the key to long-term weight loss is to provide follow-up support. After finishing the initial programme, patients take part in a three-month follow-up programme, focusing on self-monitoring with encouragement from staff via text messages. I understand that they are not alone in doing that kind of thing; the all-party group of which I was formerly chair, Slimming World, does something similar. To ensure patient confidentiality and data security, a BlackBerry smart phone is used with an application that converts text messages to e-mail and vice versa. That creates an accurate record of patient-practitioner dialogue. The results include statistically significant weight loss compared with a control group and an improved quality of life.

Those two simple examples show that by supporting individuals to use smart phones and tablets already at their disposal, people can take more control of their lives and make healthier decisions. There is scope for the NHS to become more proactive in encouraging such approaches without incurring significant cost.

[Bill Esterson (Sefton Central) (Lab)]

I congratulate my hon. Friend on securing this important debate. She is making a point about the importance of technology in preventing health care problems. As she will know, the preventive public health role is being transferred to local government. Does she agree that it is vital for the technology to have the funding needed when the preventive role is transferred, and that it is not left to local government, given the scale of the cuts that local government has suffered?

[Rosie Cooper]

A serious point is being made here: public health is being transferred to local government, and the funds that go with it need to be spent on public health and preventive means. I am worried that councils might use some of the money to do work to which they are already committed. So, yes, they do need support, and we need to ensure that the money they get is spent correctly and wisely. Mobile technology can help to improve public health.

One of the perennial challenges of modern health care is to keep accurate, comprehensive records without detracting from the care-giving process, which is quite difficult. Too often the supposed solutions feel burdensome. As a result, clinicians can sometimes be difficult to engage—in fact, there is a view that sometimes clinicians rarely engage—and the accuracy and completeness of records suffers as a result.

We can show that there are tried and tested solutions developed by and in partnership with NHS organisations that have been shown to work. For example, digital pen-and-paper technology, supported by mobile connectivity, can be used to complete patient records. In turn, that can improve patient safety, care quality and efficiency. That technology is pioneered by Portsmouth Hospitals NHS Trust and allows mums-to-be to keep their paper records as normal, and because the records are made using a mobile-enabled digital pen and paper, the maternity department instantly receives an easily accessible electronic copy of the expectant mum’s paper records. That happens while the midwife is still with the expectant mum in her home. As well as improving safety when mums arrive at the hospital without their notes, the technology’s deployment has brought about real efficiency by halving the time that midwives spend on administration.

As well as solutions that can help health care professionals in the community, we need to recognise that most acute hospitals are large complex buildings that, all too sadly, often span several sites. There is strong evidence that the accuracy of patient records and the quality of clinical decision making may be improved if clinicians record information themselves and have access to it when they are with their patients, rather than leaving the process to administrators who are removed from the care. Realistically, that can be achieved only by making it easier for clinicians to record and access information wherever they are.

I am told that organisations such as University Hospitals Birmingham NHS Foundation Trust are making real progress in mobilising information so that clinicians have real-time, secure access to patient records. The foundation trust is using tablet devices and smartphones to achieve such improvements. As the NHS looks to implement new solutions, we need to encourage people to focus on secure approaches that patients and clinicians trust, which means designing privacy into the entire system, with security measures built into mobile devices. We also need reliable connectivity, which is fundamental for effective mobile working. Even in areas with the most advanced mobile infrastructures, bandwidth can sometimes be limited, so it is essential to choose hardware that can switch seamlessly between different mobile protocols and wi-fi connections. Such functionality would minimise bandwidth-related costs. We need to focus on approaches that complement patient-clinician interactions and that make the most of existing technology. Mobile solutions that can be rapidly deployed and that integrate with existing infrastructure would ensure investments that have already been made can be enhanced rather than discarded.

As the former chair of Liverpool Women’s hospital, I know there are now solutions to some of the problems in enabling midwives to spend the maximum amount of time out on the front line. Such improvements are a godsend and enable our professionals to deal with patients efficiently and effectively. I am aware of the Government’s plan to introduce a fund for technology to improve midwifery and nursing care, and I very much welcome that. As the plans for the fund are developed, it is essential to learn from those trusts that have already pioneered new approaches. I ask the Minister, therefore, to meet me and some of the professionals who have been involved in developing the examples I have cited so that he can hear about their experiences. That might help future implementation. The truth is that mobile communication technology will be a core strand in the 21st-century health service. We very much need it, and working together we can deliver for all the people who depend on the health service to deliver their care.