Digital Health

Eli Lilly launches digital health platform LillyDirect for obesity, migraine, and diabetes care

Eli Lilly and Company, a renowned pharmaceutical entity, has unveiled LillyDirect, an advanced digital healthcare platform primarily designed to aid patients in the United States with obesity, migraine, and diabetes management. The official announcement, made on January 4, 2024, marks a significant stride in the field of digital healthcare.

LillyDirect emerges as a multifaceted tool, offering comprehensive services that encompass disease management, support mechanisms, and a streamlined process for medication delivery. A key component of LillyDirect is the LillyDirect Pharmacy Solutions. This feature strategically links users to an external online pharmacy service, simplifying the process of obtaining prescribed medications. This innovation aims to enhance consistency in medication adherence, thereby improving patient health outcomes.

David A. Ricks, the Chairman and CEO of Lilly, expressed the company’s intent behind this launch, emphasising the simplification of the patient experience in a complex healthcare landscape. The underlying goal of LillyDirect is to alleviate patient burdens associated with chronic disease management, ultimately leading to improved health results. LillyDirect presents a novel approach to healthcare access, including a convenient option for home delivery of prescribed Lilly medications, thereby bridging the gap between patients and essential medical resources.

LillyDirect goes beyond just medication provision. It serves as a valuable resource for patients, offering access to a wealth of information and educational materials pertinent to their health conditions. This aspect of the platform enhances patient understanding and engagement with their healthcare journey.

Furthermore, LillyDirect expands the scope of patient support by integrating telehealth services. These digital consultations complement the care provided by patients’ primary healthcare teams. Additionally, the platform facilitates the search for in-person healthcare providers, thereby ensuring comprehensive care management.

Frank Cunningham, Lilly’s Group Vice President of Global Value and Access, highlighted the growing reliance on digital solutions in various aspects of daily life, including healthcare. LillyDirect is envisioned as an innovative solution that caters to the evolving needs of patients, offering an integrated experience in managing health and accessing medications. This initiative reflects Lilly’s commitment to enhancing the quality of life for patients, enabling them to focus on their personal and professional pursuits.

US Veterans Health Administration expands virtual reality therapy for chronic pain relief

The Veterans Health Administration (VHA), a division of the Department of Veterans Affairs, is enhancing its partnership with AppliedVR to increase access to virtual reality (VR) therapy for military veterans suffering from chronic lower back pain. This development follows the extension of their contract to support AppliedVR’s FDA-authorised RelieVRx programme, a home-based solution designed to treat chronic pain.

This collaboration between AppliedVR and the VHA began in 2020, initially focusing on providing comfort to veterans in palliative care and improving the life quality of those experiencing chronic pain, stress, and anxiety in various healthcare settings. The contract was awarded through VA Immersive, a sector of the VHA Office of Healthcare Innovation and Learning (OHIL), which is dedicated to exploring innovative healthcare technologies like VR and augmented reality (AR) in clinical environments. This initiative aims to revolutionise care delivery and patient experiences.

The VHA, responsible for the care of over 9 million veterans nationwide, has noted that more than half of the veterans receiving care at VA facilities suffer from chronic pain. In response, the VHA is actively exploring innovative, non-pharmacological approaches to address this issue, particularly focusing on the intersection of mental health and chronic pain.

Matthew Stoudt, co-founder and CEO of AppliedVR, in an interview with Fierce Healthcare, highlighted the VA’s pioneering role in the use of immersive technology as a medical intervention. The VA’s emphasis on immersive technology, including its use for treating post-traumatic stress disorder, has led to a focused effort to integrate such technologies as a standard of care within the VA system.

AppliedVR was initially awarded a contract with the VA in December 2022, enabling doctors at 18 VA facilities to prescribe the VR-based pain treatment solution for veterans’ home use. The RelieVRx program, AppliedVR’s flagship product, received marketing authorisation from the Food and Drug Administration in 2021 for chronic lower back pain treatment. It comprises a headset and software that guides patients through pain management exercises.

With the funding granted last year, AppliedVR concentrated on establishing pathways for prescribing VR therapy within the VA population. According to Stoudt, this funding was utilised rapidly, indicating a high demand and acceptance for the technology. The extended partnership will now allow doctors at 16 VA facilities to prescribe the VR-based pain treatment solution to veterans.

AppliedVR’s eight-week programme has been clinically proven to reduce pain intensity and interference in the lives of individuals with chronic lower back pain. In a recent clinical trial follow-up study, the RelieVRx programme demonstrated long-lasting effects up to 24 months after treatment completion.

Through various partnerships, the VA has deployed over 2,200 VR headsets across more than 165 VA medical centres and 18 additional care sites in all 50 states. VA Immersive’s mission is to establish national standards for VR use, accelerating the adoption of immersive therapeutics across VA and enabling veterans to access next-generation treatments like RelieVRx.

AppliedVR reports that its VR-based treatments are now utilised by over 60,000 patients in 240 hospitals and 1,500 patient homes. The company faced regulatory and reimbursement challenges typical of prescription digital therapeutics but gained FDA de novo clearance to market its RelieVRx system as a hardware-software device combination. This distinction enabled AppliedVR to secure Medicare reimbursement for its device.

In March, the Centers for Medicare and Medicaid Services (CMS) granted AppliedVR a unique Healthcare Common Procedure Coding System (HCPSC) Level II code for RelieVRx, categorising it as durable medical equipment. This CMS ruling is significant as it creates a reimbursement pathway for providers billing for the AppliedVR device.

Stoudt emphasises that adherence to digital medicine is a critical challenge, and AppliedVR’s high adherence levels are a testament to its effectiveness. The company’s approach positions it distinctly within the digital therapeutics market, which has seen struggles among other companies in gaining acceptance from payers and providers.

AI-enhanced x-ray trials initiated in NHS Scotland for early lung cancer detection

The University of Glasgow has recently initiated a pivotal trial using artificial intelligence (AI) to enhance chest X-ray analysis for the early detection of lung cancer within the NHS Greater Glasgow and Clyde (NHSGGC). This innovative approach, named the Radiograph Accelerated Detection and Identification of Cancer of the Lung (RADICAL) trial, is being conducted at Inverclyde Royal Hospital, Vale of Leven Hospital, and Paisley’s Royal Alexandria Hospital.

Lung cancer, a major health concern in Scotland, accounts for approximately 5,500 new cases annually and is a leading cause of death in the region. Early diagnosis is crucial; if lung cancer is identified at stage 2, over 35% of patients have the potential to survive beyond five years, with this figure rising to 55% if diagnosed at stage 1.

The trial involves the analysis of chest X-rays using the qXR system, a collaborative effort between Qure.ai, NHSGGC-hosted West of Scotland Innovation Hub, the University of Glasgow, and the Scottish government. In this trial, nearly 250 patients across three hospitals have had their chest X-rays analysed by qXR in near real-time.

Qure.ai’s qXR technology functions by automatically sorting standard chest X-rays and identifying abnormalities such as masses or lung nodules. This allows for the prioritisation of patient cases, thus facilitating quicker and more accurate diagnosis.

Following a comprehensive, nationally coordinated evaluation of AI in radiology, this technology aims to demonstrate its clinical effectiveness, cost-efficiency, and enhanced patient outcomes. The qXR system is set to be integrated into approximately 70,000 chest X-ray examinations annually.

David Lowe, Professor of Health and Innovation at the University of Glasgow and Emergency Medicine Consultant at NHSGGC, emphasised the significance of early cancer detection. He stated that identifying cancer sooner can expedite further imaging and subsequent treatment, ultimately benefiting the entire patient care pathway.

Professor Julie Brittenden, Director of Research and Innovation at NHSGGC, highlighted the role of AI in assisting clinicians in treating patients. She noted that AI technology ensures patients are directed onto the most suitable treatment pathway as swiftly as possible.

Furthermore, the University of Glasgow’s Digital Health Validation Lab is providing vital support for qXR as part of the Living Laboratory for Precision Medicine. This initiative offers academic leadership and support to deliver the trial in conjunction with NHSGGC and Qure.ai, thereby furthering advancements in digital health and precision medicine.

New machine learning approach transforms behavioural health medication practices

At the recent AMCP Nexus 2023 conference in Orlando, Florida (16th-19th of October), presenters showcased a groundbreaking machine learning program designed to address medication-related issues in individuals with behavioural health conditions. This program has shown promising results in reducing polypharmacy, enhancing medication adherence, and decreasing healthcare costs.

Behavioural health conditions pose a significant challenge to healthcare systems. A 2020 Milliman study examining commercial healthcare claims data from 2017, which encompassed 21 million people, revealed that although only 27% had a behavioural health condition, they accounted for over half of the total healthcare expenditures. In this context, machine learning offers a potential solution for better managing these conditions.

The presenters highlighted the issue of polypharmacy, a common concern in behavioural health where 60% of adults with a condition are prescribed two or more psychotropic medications. Polypharmacy not only increases the risk of drug interactions and adverse events but also contributes to soaring healthcare costs. Dr. Caroline Carney, Chief Medical Officer at Magellan Health, underscored the tendency for medication overlap and overprescription in treating conditions like depression and anxiety, often leading to unnecessary medication layers.

Another issue in managing behavioural health medications is the multiple prescribers involved, including primary care doctors, specialists, and inpatient clinicians, often resulting in uncoordinated treatment. This lack of coordination can leave patients confused and overwhelmed with their medication regimens.

To combat these challenges, Magellan Health collaborated with Arine, a medication management tech startup, to create inforMED (formerly known as Navigate Whole Health). This AI-driven program identifies prescribers who can potentially optimise patient care, generating comprehensive care plans with treatment recommendations and patient education. The program’s effectiveness is continuously improved by incorporating new clinical outcome data.

Dr. Carney elaborated on the program’s approach, which considers hundreds of parameters, providing prescribers not just with medication change suggestions but also with reasons, implications, and evidence-based support for the recommended changes.

Yoona Kim, PharmD, PhD, co-founder and CEO of Arine, explained that machine learning algorithms are utilised to target prescribers based on their prescribing patterns and the presence of prescribing outliers in their patient panels. The program also considers social determinants of health, using ZIP code data to assess potential barriers to healthcare access, such as low income or lack of vehicle access.

The results of this program have been significant. Dr. Kim reported a reduction in behavioural health polypharmacy by 45% to 55%, a 20% increase in medication adherence, a 20% reduction in average daily morphine milligram equivalents, and a savings of $360 to $840 in pharmaceutical costs per enrolled member annually.

Dr. Carney emphasised the program’s success in providing actionable data and guidance to healthcare providers, leading to improved patient outcomes and stronger, longer-lasting professional relationships. This innovative approach signifies a major step forward in the management of medication for behavioural health conditions.

Vietnam and Australia join forces to accelerate digital health transformation

A pivotal conference in Hanoi, sponsored by the government, has recently brought together health authorities and experts from Vietnam and Australia. This gathering focused on exploring collaborative opportunities to enhance Vietnam’s digital healthcare infrastructure and capabilities.

The conference saw participation from the Vietnam Military–Civil Medicine Association, the Health Strategy and Policy Institute under the Vietnamese Ministry of Health, and the Iverson Health Innovation Research Institute at Swinburne University of Technology in Australia.

The significance of this event lies in addressing the urgent need for Vietnam’s health sector to secure resources for its digital transformation. Deputy Minister of Health, Dr Tran Van Thuan, emphasised the importance of such advancements in improving patient access to medical services. He highlighted the potential role of international cooperation and assistance in achieving these goals.

Vietnam currently faces several challenges in its journey towards healthcare digitalisation, notably its underdeveloped IT infrastructure, which hampers the support for Electronic Medical Records (EMR). Additionally, there is a notable scarcity of funding to integrate new health technologies in medical facilities across the country.

Dr Tran Quy Tuong, chairman of the Vietnam Health Informatics Association, pointed out further obstacles, such as the shortage of IT skills and manpower and the lack of standardised protocols and guidelines for integrating data across various medical information systems.

The Iverson Health Innovation Research Institute from Swinburne University of Technology, which participated in the conference, is actively engaging in collaborations with governments and industry stakeholders. Their focus includes the management of patient health records among other digital health areas. However, there has been no formal announcement regarding a partnership between the research institution and the Vietnamese government.

In the broader context, Vietnam is aiming to establish smart healthcare by 2025 as part of its National Digital Transformation Programme. This initiative encompasses three key areas: smart disease prevention, smart medical examination and treatment, and smart health administration.

Vietnam commenced its healthcare digitalisation foundation in 2019 with the nationwide implementation of Electronic Health Records (EHRs). While all public hospitals have adopted Health Information Systems (HIS), there is still progress to be made in integrating PACS, RIS, and LIS systems.

International collaborations have been crucial in introducing advanced technologies in Vietnamese healthcare. Earlier this year, IT giant Microsoft entered its first technology partnership in Vietnam, teaming up with VinBrain, a local AI healthcare company supported by Vietnam’s leading conglomerate Vingroup. Their collaboration focuses on three primary AI healthcare areas: data sharing, cross-product validation, and research and development.

NHS England’s controversial £330m data deal with Palantir draws mixed reactions

NHS England’s recent decision to award the £330 million Federated Data Platform (FDP) contract to US data analytics firm Palantir, in collaboration with Accenture, PwC, NECS, and Carnall Farrar, has elicited a spectrum of reactions. This announcement marks a significant step in NHS’s digital transformation efforts, with the FDP designed to connect and streamline access to healthcare data across the NHS.

Matthew Taylor, CEO of the NHS Confederation, acknowledged the FDP’s potential in enhancing care delivery by freeing up clinical time and fostering efficient, safer patient care. However, he emphasised the need for substantial efforts to garner public support for the initiative.

Contrasting opinions emerged from within the NHS. Paul Jones, Chair of the Digital Health Networks CIO Advisory Panel, expressed disappointment at NHS England’s decision to proceed despite reservations from trust digital teams and the financial constraints on other NHS digital budgets.

Nick Wilson, CEO at System C, recognised the wealth of experience within the NHS and technology companies in digital transformation but voiced disappointment over the contract not being awarded to a British consortium. He also highlighted concerns about the exclusion of GP data from the FDP, stressing the complexities of interoperability in health and social care and urging Palantir and Accenture to learn from past challenges.

The decision faced criticism from those who had campaigned against Palantir’s involvement. The Good Law Project, a not-for-profit campaign organisation, is preparing legal challenges to ensure proper handling of sensitive NHS data, focusing on maintaining privacy.

Cori Crider, Director of Foxglove, a legal advocacy organisation, raised questions about the FDP’s effectiveness, citing unsuccessful hospital trials of Palantir’s technology. Dr David Nicholl, spokesperson for Doctors’ Association UK, echoed these concerns, questioning the scrutiny around the deal and the preliminary results of NHS trials with Palantir’s technology.

David Davis, MP for Haltemprice and Howden, expressed reservations about Palantir’s suitability for handling sensitive data, citing their background in espionage and concerns about data protection.

In response to these varied perspectives, NHS England has garnered support from several organisations, including the NHS Confederation, National Voices, and the Academy of Royal Medical Colleges. National Voices CEO Jacob Lant and Dr Jeanette Dickson, Chair of the Academy of Medical Royal Colleges, acknowledged the FDP’s potential in driving digital innovation and enhancing data connectivity in the NHS.

To address public concerns, NHS England is developing an engagement portal for the public to learn more about the FDP and submit queries. Additionally, Dr Nicola Byrne, National Data Guardian, and Dr Nicola Perrin of the Association of Medical Research Charities have joined the independent Check and Challenge Group for the FDP, overseen by NHS England.

Furthermore, NHS England has assured that data sharing under the FDP will not commence until new ‘Privacy Enhancing Technologies’ (PET) are developed and implemented, expected by April 2024. Details on these technologies, being developed by a separate supplier, are anticipated to be released later in the year.

Singapore forges ahead with digital health initiatives to address healthcare workforce shortages

In Singapore, healthcare leaders and young professionals are uniting under a common goal: to create a more integrated and sustainable healthcare system, leveraging digital technologies. This ambition aligns with findings from the Future Health Index 2023 report by Royal Philips, highlighting Singapore’s dedicated efforts in digital health transformation. These findings reflect broader trends observed across the Asia-Pacific region.

A critical driving force behind this digital push is the projected need for an additional 24,000 allied health professionals and support care staff by 2030, as forecasted by Singapore’s Ministry of Health. This need arises from the growing demands of the nation’s ageing population.

A survey involving 200 senior healthcare executives and young clinicians in Singapore revealed that 75% are either already utilising or planning to adopt digital health technology. This strategic move aims to mitigate the impact of the looming workforce shortage in healthcare. Technologies such as cloud-based solutions, out-of-hospital care innovations, and workflow technologies like digital health records and patient flow automation are at the forefront of this digital transition.

Artificial Intelligence (AI) is recognised as a key area of opportunity, with a quarter of respondents currently investing in AI technologies. Over the next three years, a significant 84% have pledged investment in health AI, particularly favouring applications in outcome prediction and clinical decision support.

For young healthcare professionals, the prospect of working in an AI-enabled institution is highly attractive. Furthermore, about half of the healthcare leaders surveyed are investing in virtual care, acknowledged for its substantial role in enhancing patient care.

Singaporean healthcare leaders are also adapting to technology-driven distributed models of care, with about two-thirds of respondents considering themselves well-prepared to work effectively within these new frameworks. These models are anticipated to bring improved work-life balance and job satisfaction for healthcare professionals. They are expected to boost patient compliance with treatment, create additional revenue opportunities, and enhance efficiency and convenience for patients.

In the broader context, Singapore’s commitment to integrating AI in healthcare is further evidenced by the recent memorandum of understanding between Synapxe, its national health technology agency, and Microsoft. This collaboration aims to use generative AI to increase clinical productivity, among other initiatives to modernise public healthcare IT in the country.

Additionally, the Agency for Science, Technology and Research, Singapore’s leading research and development agency, has launched a joint AI lab with health tech company EVYD Technology. This lab is designed to foster multi-institutional and cross-border collaborations in digital health, underpinning Singapore’s robust approach towards embracing digital solutions in healthcare.

AstraZeneca launches Evinova, aiming to revolutionise clinical trials with digital solutions

AstraZeneca has initiated a foray into the burgeoning field of health technology with the introduction of its new subsidiary, Evinova. Officially unveiled this past Monday (20th of November, 2023), Evinova is poised to redefine how clinical trials are conducted for biotechnology entities, pharmaceutical corporations, and Contract Research Organisations (CROs). By integrating digital health solutions, Evinova aims to significantly curtail the duration and financial outlay required in the medicine development process.

With Evinova’s debut, AstraZeneca has announced several key partnerships. CROs Parexel and Fortrea are set to incorporate Evinova’s digital services into their operations. Furthermore, Evinova is working in conjunction with Accenture and Amazon Web Services to bolster the adoption of its digital products globally and enhance the scalability of its digital offerings.

Evinova will concentrate on three primary service domains within the health-tech sector. First, it will provide unified trial solutions that streamline the collection of clinical trial data, incorporating innovative digitally-enabled endpoints. This data acquisition will be supported by connected medical devices and sensors both onsite at clinical trial locations and remotely in patients’ residences. These solutions aim to bolster telehealth practices, enable remote patient monitoring, and facilitate direct-to-patient medicine dispatches.

Secondly, Evinova is channelling state-of-the-art technologies such as artificial intelligence and machine learning to architect optimally structured clinical trials. This involves assessing and quantifying a multitude of trial characteristics, from environmental impact to patient experience implications.

Lastly, the portfolio management services offered by Evinova seek to provide clients with a comprehensive overview of their drug development portfolio across various stages. This is achieved through predictive algorithms that forecast crucial milestones and allow study leaders to identify and rectify deviations from planned trajectories.

Cristina Duran, Evinova’s newly appointed president, expressed confidence that this strategic move will significantly advance the digital health sector. The objective is to meet the digital solution needs of healthcare professionals and regulators across the pharmaceutical landscape, ultimately enhancing patient care.

This development aligns with AstraZeneca’s recognition of the digital health market’s potential, which is anticipated to grow at a compound annual growth rate of 13.6% from 2022 to 2032, reaching a valuation in excess of $900 billion by the end of the forecast period. Evinova stands as a testament to AstraZeneca’s adaptive innovation strategy, aiming to navigate and lead in the digital transformation era of healthcare.

OECD highlights digital health as key to enhancing healthcare system performance

The latest Organisation for Economic Co-operation and Development (OECD) report throws light on the financial strains faced by health systems in member countries, driven by the allocation competition for public funds. The report, ‘OECD Health at a Glance 2023‘, unveils that healthcare expenditure in OECD nations represented 9.2% of GDP in 2022, a slight reduction from 9.7% in the previous year. This figure, though higher than pre-pandemic levels, saw a decline in 11 countries compared to 2019.

On average, health spending per person in OECD countries approached USD 5,000 in 2022, with the United States, Switzerland, and Germany leading the expenditure chart. In contrast, Mexico, Colombia, and Costa Rica marked the lower end of the spectrum. OECD Secretary-General Mathias Cormann highlighted the urgent need for health systems to provide more timely and cost-effective healthcare, especially in light of ageing populations and the residual impacts of the COVID-19 pandemic on mental and physical well-being.

Cormann emphasised that digitising healthcare systems and embracing digital health technologies is crucial to enhance system efficiency and effectiveness, underscoring the economic and social necessity of accessible high-quality healthcare.

The ‘Health at a Glance 2023’ report focuses particularly on the role of digital health in revolutionising health systems, a process catalysed by the COVID-19 pandemic. Despite progress, there remains significant work to be done in digital health governance, as outlined by a policy checklist in the report.

Current health indicators reflect a society still grappling with the pandemic’s aftermath, with a general decline in life expectancy and ongoing mental and physical health challenges. The health and social care workforce is expanding, yet staffing shortages and deteriorating work conditions are raising concerns. Salary erosion due to inflation is another challenge, with several OECD countries witnessing stagnant or falling real wages in the healthcare sector over the past decade.

Cardiovascular diseases remain a leading cause of mortality, and nearly one-third of deaths could have been prevented with better healthcare interventions. Despite the widespread adoption of universal health coverage, financial barriers continue to make healthcare inaccessible for low-income groups, with the poorest often foregoing necessary care.

The pandemic has exacerbated waiting times for elective surgeries like hip and knee replacements, and while there has been some improvement, wait times are still generally above pre-pandemic levels. However, there have been gains in the quality of care, particularly in terms of safety and effectiveness, and a move towards more patient-centred healthcare is evident with safer prescribing practices in primary care.

NHS introduces AI solutions to tackle winter healthcare demands and minimise hospital admissions

As winter approaches, the NHS is set to deploy artificial intelligence (AI) technology to identify patients at risk of hospitalisation, enabling community healthcare teams to provide preemptive care and alleviate the strain on Accident and Emergency (A&E) services. This initiative is part of a broader introduction of technological and data-driven solutions to enhance the NHS’s response to the seasonal increase in healthcare demands.

In Somerset, four GP practices have initiated a pilot programme using an AI system designed to identify registered patients with complex medical needs who are at heightened risk of hospital admission or those who seldom contact their GP. The system facilitates proactive outreach for health discussions. Subsequently, individuals identified as high-risk will be contacted by health coaches, nurses, or GPs. These healthcare professionals are equipped to offer an array of preventive services, which include the provision of food parcels for vulnerable patients, intensification of care to specialist doctors, implementation of preventative measures to reduce the risk of falls, or connection to local volunteer organisations to combat isolation.

Innovative use of AI in Buckinghamshire involves it being linked to electronic sensors on household appliances such as kettles and refrigerators. These sensors monitor changes in patients’ eating and drinking patterns, triggering alerts to a non-clinical Onward Care team. The team can address up to 95% of issues raised by interacting with patients directly, escalating clinical matters when necessary. Patients have the option to avail themselves of these community-based, practical support measures that not only offer monitoring but also assistance with household chores, shopping, and the provision of food parcels, which has been instrumental in preventing hospital readmissions among frail patients.

Some regions in Birmingham are trialling a different approach, employing an algorithm that forecasts the top 5% of individuals at risk of potential A&E visits or hospital admissions. The team conducts wellness checks to offer social care assessments, medication reviews, or other community support initiatives to circumvent A&E admissions. Over the upcoming two years, this programme aims to prevent approximately 4,500 non-essential A&E visits, reduce overnight hospital stays by 17,000, and liberate around 23,000 GP appointments for other patients.

These innovative measures are being implemented in the context of an NHS already under significant pressure, with recent data indicating that A&E departments experienced their busiest October on record, while ambulance services reported the highest monthly demand witnessed this year. The NHS has been diligently preparing for winter, guided by the urgent and emergency care recovery plan published earlier in the year. The plan includes strategies to augment capacity and fortify resilience across the NHS, such as the establishment of care ‘traffic control’ centres to expedite patient discharges, the provision of additional ambulance hours, and the increase of available beds.

The NHS has also been expanding its globally acclaimed virtual ward programme, achieving its target of establishing 10,000 virtual ward beds by the end of September. These virtual wards allow patients to receive hospital-grade care in the familiar surroundings of their own homes, surrounded by family, friends, and carers.

Amanda Pritchard, NHS Chief Executive, commended the suite of technological and data solutions being introduced: “These advances demonstrate the innovative spirit of NHS staff across the nation, who are leveraging the latest technology and AI to provide patient care and significantly reduce unnecessary A&E visits. Not only are these strategies more beneficial for patients, who can receive care in the comfort of their homes, but they also support the NHS, especially as we anticipate an incredibly challenging winter season.”

Chris Holt, Chief Transformation Officer at Birmingham Community Healthcare NHS FT, emphasised the crucial role of data and AI in healthcare delivery: “Intelligently using data and harnessing AI is now essential in aiding our most vulnerable patients. Identifying those at greatest risk of hospitalisation during the winter allows us to intervene earlier with tailored support.”

In preparation for the winter season, the NHS recently launched its annual 111 campaign to encourage the use of NHS 111 services for urgent, non-life-threatening medical advice. The campaign, which will run until the end of March across various media platforms, informs the public about accessing advice from a range of NHS professionals, including clinicians, nurses, and GPs, all from the convenience of their homes. However, in emergencies that are life-threatening, the campaign reiterates the importance of calling 999.

Personalised healthcare revolution: The rise of digital twins in medicine

The trajectory of medicine is being redefined by pioneering research into computational models, advancing towards a future where medical treatments are tailored not to the average patient, but to each individual. Envision possessing a ‘digital twin’—a virtual counterpart that can undergo trials and treatments, sparing you the need for direct medication or surgical intervention. Scientists project that within the next decade, we could witness the routine use of ‘in silico’ trials, utilising virtual organs to evaluate drug safety and effectiveness, while bespoke organ models might be employed to customise patient care and avert medical complications.

Digital twins represent sophisticated computer-generated replicas of physical entities or processes, continuously refined with data from their actual counterparts. In the medical realm, this entails the fusion of extensive biological data—including genetic, proteomic, cellular, and systemic information—with individual patient data to craft detailed virtual models of their organs, and potentially, in time, their entire body.

Professor Peter Coveney, Director of the Centre for Computational Science at University College London and co-author of ‘Virtual You’, suggests that much of current medical practice lacks a scientific underpinning. He compares it to navigating by looking in the rear-view mirror—basing treatment for the patient at hand on historical cases. “A digital twin utilises your own data within a model that encapsulates your unique physiology and pathology. It’s a move away from decisions based on potentially unrepresentative population data to truly personalised medicine,” explains Prof. Coveney.

Cardiology is at the forefront of this cutting-edge model. Companies are already harnessing patient-specific heart models to aid in the design of medical devices. Meanwhile, the Barcelona-based enterprise ELEM BioTech is at the forefront, granting companies the capability to test drugs and devices on simulated human hearts. “We’ve conducted numerous virtual human trials on several compounds and are on the cusp of launching a new phase, with our cloud-ready product accessible to pharmaceutical clients,” shares Chris Morton, co-founder and CEO of ELEM.

At the recent Digital Twins conference hosted by the Royal Society of Medicine in London, Dr. Caroline Roney from Queen Mary University of London detailed the development of tailored heart models which could significantly aid surgeons in planning interventions for atrial fibrillation patients. “Surgeons typically resort to average-based approaches, but crafting patient-specific predictions that forecast long-term outcomes remains a formidable challenge,” Dr. Roney stated. She foresees widespread application of this technology in cardiovascular treatments, including decisions on valve selection and placement during replacements.

The field of oncology is also poised to benefit from digital twins. Teams from GSK and King’s College London are joining forces to construct virtual duplicates of patient tumours, amalgamating imaging, genetic, and molecular data with 3D cultures of cancer cells, and observing their drug responses. Leveraging machine learning, researchers can foresee how individual patients may react to various treatments, drug combinations, and dosages. “Conducting repetitive trials on a real patient with multiple treatments isn’t viable. Our aim is to devise a strategy while the patient is still with us, preparing us for any recurrence of cancer,” said Professor Tony Ng from King’s College.

The advent of digital twins extends even to the realm of pregnancy, offering the potential to develop treatments for conditions such as placental insufficiency or pre-eclampsia, and deepening our grasp of pregnancy and labour physiology. Professor Michelle Oyen, Director of the Center for Women’s Health Engineering at Washington University in St Louis, is crafting placenta models from ultrasound scans and post-birth high-resolution imagery to predict complications during pregnancy. “We’re striving to identify measures in a live person that could forewarn us of placental issues, aiming to preempt adverse outcomes like stillbirth,” Prof. Oyen elucidates.

In collaboration, Professor Kristin Myers from Columbia University is modelling the cervix, uterus, and foetal membranes, with the overarching goal to merge these into a comprehensive individual model to predict pregnancy outcomes. “We hope to analyse a simple ultrasound scan to understand how the uterus will adapt and when labour might occur,” Prof. Myers aspires, potentially guiding decisions on interventions like caesarean sections.

Moreover, the concept of digital twins is being expanded to model entire hospitals to enhance patient flow and healthcare system efficiency. Dr. Jacob Koris, a trauma and orthopaedic surgeon and digital lead at Getting It Right First Time, describes how tracking digital footprints left by patient interactions—from X-rays to outpatient appointments—can provide a granular, real-time view of patient treatment pathways. “Such insights could pinpoint areas for improvement and exemplary practices that could revolutionise patient care,” Dr. Koris believes.

This ambitious step forward in computational medicine promises a leap from the traditional, one-size-fits-all model to a future where every treatment is as unique as the patient it serves.

Survey highlights doctors’ concerns with AI influencing medical diagnoses and treatments

A sizable portion of medical practitioners harbour reservations about the burgeoning role of artificial intelligence (AI) in shaping diagnostic and treatment protocols, as indicated by a recent survey’s findings.

The study, unveiled by Medscape on Monday (13th of November, 2023), suggests that a majority, approximately 65 per cent, of the surveyed physicians harbour either significant or moderate concerns regarding AI’s burgeoning role in informing diagnostic and therapeutic decisions. Conversely, a smaller group, constituting 36 per cent, expressed minimal or no concern over the incorporation of AI in these critical areas of healthcare.

The survey also shed light on the varying degrees of receptivity towards AI among healthcare professionals. While 42 per cent of respondents expressed enthusiasm about the prospects of AI integration in their daily work, a notable 30 per cent remained ambivalent, and an apprehensive 28 per cent displayed reservations regarding its future implications.

Echoing the sentiments of caution, former Food and Drug Administration Commissioner Scott Gottlieb, in a July opinion piece, prognosticated that AI’s integration into medical practice could supplant certain functions traditionally performed by physicians, and that such a shift might occur sooner than anticipated.

“Whilst the question of ‘if’ AI will replace some of the doctors’ responsibilities is becoming obsolete, the more pressing issue is ‘when’. For certain tasks, this technologically driven future is closer than we might envisage,” Gottlieb asserted.

The responses to the Medscape survey, however, revealed a more welcoming stance towards AI as a collaborative tool in diagnosis and treatment, with a significant 56 per cent of physicians indicating keen or moderate enthusiasm for AI as a complementary aid. The remaining 44 per cent reported feeling some degree of apprehension towards AI assistance.

Interestingly, the survey highlighted a generational divide in perceptions of AI, with younger doctors, particularly those under 35, displaying less enthusiasm compared to their middle-aged counterparts aged between 45 and 54 years.

This comprehensive survey, which ran from July 12 to August 11, garnered responses from 1,043 participants spanning over 29 medical specialties. The results carry a sampling error margin of 3.03 percent, ensuring 95 per cent confidence in the data gathered.