Health Tech and You: Helping to reach a tipping point

By Matt James, Senior Researcher at 2020health

In our previous blog we were looking at the value of the personalised health agenda. But having vision and developing policy based on that vision is one thing. Identifying the ‘how to’ steps to achieving it in reality is quite another.

Re-reading Malcolm Gladwell’s bestseller ‘The Tipping Point‘ recently and reflecting on the first year of HT&Y has got me thinking about the future of both health tech and the HT&Y initiative.

Gladwell helped to popularise the term ‘tipping point’ as that seemingly magical moment when ideas and trends reach a certain point and spread like wildfire.

What lessons can we learn from this as the HT&Y initiative develops?  How can we achieve a tipping point which goes beyond just a deluge of new tech to one which ushers in a revolution in people using technology effectively in order to take responsibility for their own health and well being?

In his book Gladwell identifies three key factors which help to achieve the Tipping Point, two of which I think have relevance to the health tech revolution:

  • • The Stickiness Factor
  • • The Power of context

A) The Stickiness Factor
In any form of epidemic, the messenger matters. The message is important but if the messenger is not effective in communicating the message, it will not spread.  Messengers are what makes something spread.  In Gladwell’s words, the message becomes sticky.

LightBoxIn the health tech revolution we are witnessing this in a very clear way. Once health advice and support becomes practical and personal, be it through an app or piece of wearable technology, it becomes memorable. It can help create change so much so it can spur someone to action.

In response this calls for a radical rethink of the role of clinicians and the expectations of the public of them. The traditional doctor-patient relationship is changing from patriarchical to more of a dialogue marked by joint decision making.

Technology should certainly not ended up replacing the GP but a new form of relationship needs to be established based around the clinician and patient partnering together. With more information at their fingertips the patient is becoming more proactive as opposed to passive, entering into a dialogue with the clinician as opposed to just acting upon the advice given. As an expert, the clinician has a key role to help bring understanding and educate the patient as to what the information and data really means for them.

This represents a significant change in the way medicine is practiced and will inevitably be seen as a challenge by some clinicians. However if the move to more personal responsibility for health and well being is regarded as the only effective way to respond to the corresponding demographic, economical and social changes in our world then this change needs to happen. It will involve a shift in culture which promotes the active participation of patients, supporting them to manage their own health – staying healthy, making informed choices of treatment, managing conditions and avoiding complications – and the use of health tech to do this in the most appropriate way.

b) The Power of Context
Put simply humans are sensitive to and strongly influenced by the environment in which they live. Cultural attitudes influence health care behaviours and if there is no clear sense of what actually motivates people to engage in a particular behaviour, there is no point in introducing new technology, however innovative it might seem, that is thought to change behaviour.

Research indicates that innovation in healthcare can only work if people are in a position to change their behaviour. Behaviour modification specialists say this requires capability, opportunity and motivation.

This calls for change. Change not only in how the NHS operates and is designed but how the clinical workforce is trained and equipped so that they can help maximise the capability, opportunity and motivation that health tech solutions can offer.

It is difficult to imagine the NHS prescribing health and well being tech devices to patients today. Looking to the future though, this could become a NHS_Logoreality but requires a change in the model the NHS uses and combines technology to deliver care, a point highlighted by the recent NHS
Five Year Forward report. The National Information Board’s report Personalised Health and Care 2020 recognises that better data can help to “transform innovation, helping to create new collaborations between the NHS, technology companies and patients to unlock the potential of data, technology and digital to create products for smarter, faster and better healthcare”. ¹

As the Chief Executive of Proteus Digital Health – creators of digital medicines which promise to connect each pill you take to the wealth of information available online –  tweeted just this week, “Innovation in digital health is about value to the patient, not the developers”.

It’s not just a case of more new tech, it is identifying and recognising the value it brings to peoples’ lives.

Skating to the future
Health Tech & You has only just begun. In order to realise its full impact and reach the tipping point it will be crucial to look to the future and try to interpret where it is going.

When asked the secret of his success, the great ice hockey player Wayne Gretzky famously said:  “I skate to where the puck is going to be, not where it has been”.  The HT&Y initiative is positioned to play its part in helping us all skate to where the puck of health tech is going, rather than merely where it has been.

¹National Information Board. 2014. Personalised Health and Care 2020: Using Data and Technology to Transform Outcomes for Patients and Citizens. A Framework for Action.  p. 43

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Health Tech and You: Leading in the personalisation of health care

By Matt James, Senior Researcher at 2020health

AXAPPP-21The weather might have not have been particularly spring like but the Design Museum certainly lit up the waterfront beside the Thames in a vivid display promoting the Health Tech and You Awards (HT&Y) ceremony.

Inside the atmosphere was no different: bursting with life and buzzing with anticipation of the announcement of the various category winners. The evening really was a celebration of some of the best in personal health technology innovations. Thanks to the dedication and skill of the curation team the HT&Y exhibition celebrates a unique mix of innovative entries from individuals, designers, developers, entrepreneurs and healthcare professionals from the UK and around the world.

Where do we go from here?

But as the initial fervour of this year’s awards dies down and the public exhibition continues to run at the Design Museum until 26 April 2015, what next for HT&Y? Where do we go from here?

ExhibitionAs the text on one of the exhibition walls boldly declares: “This is a health tech revolution”. Revolutions speak of an overthrowing of an existing pattern of doing things in favour of adopting a new approach. This is a revolution that we are all still very much living through with new devices and solutions coming onto the market every month. This is precisely one of the reasons HT&Y will continue to champion the and inspire entrepreneurs be they designers, clinicians or the public to reach new heights of innovation.

The underlying values of the HT&Y initiative is that advances in digital technology will create a greater sense of patient autonomy and professional accountability, helping to empower citizens and patients to become more active participants in their medical care. Digital health becomes more than just delivering more efficient care, but better quality care as well.

Take for example mobile devices which are playing an increasing role in the digital economy. Experiencing more growth than computer sales worldwide, mobile devices are  helping to drive the digital economy ever further. In 2013 mobile phone subscriptions worldwide reached nearly 7 billion in 2013 so it is perhaps not surprising to think that most people have a mobile phone. What is more astounding to read is that the number of mobile devices that exist in the world already exceeds the world’s population. Where once mobile web usage was one of the primary functions of the mobile phone (alongside the obvious making and receiving of calls), this has been superceded by the growth in mobile app.  Exercise, body weight and dieting apps are amongst the most popular downloaded health apps. As Miah & Riches note, the increasingly ubiquitous presence of mobile devices ensures their place as a core driver of health engagement.

Transforming the digital divide

But is simply having greater access to new technology helping to bolster people’s health? Not necessarily and this is my key point. Whilst technology has closed one divide, it has opened up another. It is to this scenario that the HT&Y initiative can respond.

Greater access to technology has reduced the digital divide, but the transformation in digital platforms from Web 1.0 (passive receiver of information) to Web 2.0 (user generated content, interoperability, collaboration) has opened up the digital literacy divide. Depending upon a person’s digital literacy skills will help to determine their capacity to experience that greater level of autonomy, personal insight and understanding of health and professional accountability which digital health was supposed to usher in.

Acknowledging this helps to pose exciting possibilities for the future.  The health tech revolution is not just about more tech per se. It is also about recasting our learning and understanding of the body and health beyond the traditional sites this has occurred in previously.  As Miah & Riches comment, “What took place in each of these areas of society was locked behind institutional systems, such as schools, universities, doctor‘s surgeries and hospitals”. This has relevance to not just citizens but also clinicians, tech developers and innovators.

The mobile device and its growing capability power represents the democratisation of health in a way we have yet to understand or truly articulate.

In the next blog we will explore the conditions required to make that transformation.

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The next government must make high quality cancer care a priority during, and after, the upcoming general election

Guest Blog by Ellie Rose, Public Affairs Manager, Macmillan Cancer Support

Ellie RoseThere are now 2.5 million people living with cancer in the UK. By 2020, this is estimated to rise to 3 million. And by the end of next year alone, it is estimated that around 1000 will be diagnosed with cancer every day. How will the health and social care system cope with these growing numbers when people’s needs are not being met today?

This is a colossal challenge, and one which cannot be met without urgent action from political leaders. With less than two months to go until the General Election, it is time for all political parties to make a choice about the future of cancer care in this country. So Macmillan is calling on all Westminster parties to commit to making changes in three key policy areas in order to improve the lives of everyone affected by cancer.

1000-people-alternativeThe first is delivering cancer outcomes that match the best in Europe. In the UK survival rates for almost all common cancers lag behind European averages. Addressing this will require increasing the number of people who are diagnosed early; ensuring that everyone is able to access the right treatment for them, irrespective of age or location; and supporting people to live well with and beyond cancer. Only with action on all three fronts will we make the significant improvements needed to achieve the best cancer outcomes in Europe

Secondly, urgent change is needed on improving the culture of compassion and transparency in the NHS. Whilst the majority of people with cancer receive good care, we know that there are still too many examples of people not being treated with the dignity and respect they deserve. The latest Cancer Patient Experience Survey (CPES) showed that patients affected by rarer cancers, younger patients, older patients, ethnic minorities and patients treated in London hospitals report a worse experience. To address this Macmillan believes that more accountability is needed. NHS Trusts should be required both to put actions plans in place based on their annual CPES result and to report on progress. This will reduce inequalities and ensure that everyone with cancer is treated with dignity and respect.

The last (but by no means least) area where change is needed is at the end of life. We know that while around 79% of people want to die at home, only around a third of people are able to. Providing free social care to support people at the end of life would ensure that people have the necessary support to die in the place of their choosing. It would also help to prevent family members and loved ones who are caring for people at the end of life reaching an emotional or physical crisis point in their own lives. Research has shown that this would not only improve the quality of care received, but would also save around £345m for the NHS.

The cancer challenge facing the UK is growing every day. It is vital that all political parties ensure that cancer is prioritised in their manifestos. They must commit to delivering the best outcomes in Europe, dignity and respect for all patients, and free social care at the end of life. Together this package will help us avoid the looming cancer care crisis.

Time-to-choose-headerTo find out more about how you can support our campaign please visit

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Equal treatment for Depression needs legal force

2020Health claims legal enforcement of key measures are necessary to ensure ‘parity of esteem’ and for Britain to tackle depression in the workplace.

2020depressionthumb2020Health has today published a new report, ‘Whole in One – Achieving equality of status, access and resources for people with depression’, which calls for the legal enforcement of “parity of esteem”, the term used in the NHS for valuing mental health equally with physical health. Around one in six working age adults suffers from a mental illness such as depression, anxiety or mood disorder at any one time and one in four will experience such illness during the course of a year.

The Rt. Hon. Norman Lamb, Minister for Health said, “Following the All-Party report on ‘Parity in progress’ last week, I welcome 2020health’s ‘Whole in One’ report which highlights ways to legally embed parity of esteem for people with depression. I am passionate about improving prevention and services for people with mental illnesses and know that we need radical improvements to ensure people get the help, support and treatment that they need, when they need it.”

Key recommendations from the report include:

• NICE to ensure legally-binding recommendations become standard for mental illness treatments to achieve parity with treatments for physical illness.
• Healthcare bodies to have a legal requirement to fund a range of services to meet local population mental health needs.
• Promote employer’s obligations under the 1974 Health and Safety at Work Act to support mental wellbeing in the workplace.

2020Health’s report argues that achieving parity of esteem is not just a point of principle but critical for UK plc. Mental illnesses are estimated to cost the UK business economy around £30 billion a year. Self-reported depression is the single most important cause of workplace absenteeism in the UK.

Julia Manning, Chief Executive of 2020Health, said “Parity of esteem has been talked about since the last election, but to become a reality requires legal force behind it. In addition to this, while we continue to treat mental illnesses such as depression as separate from physical illnesses, we perpetuate the myth that ‘mental’ illness isn’t physical, despite many symptoms being experienced physically. Continuing to use the term ‘mental’ conjures up images of people being mad, sad or bad, when the reality is that they are simply ill, just like someone with arthritis, diabetes or ‘flu.”

Emer O’Neill, Chief Executive of Depression Alliance said, “It is well documented that spending on mental illness is not proportional to the devastating impact that mental health problems can have on people’s lives. However, what is particularly worrying is that the gap between spend as a proportion to burden has been increasing since parity of esteem was enshrined in the Health and Social Care Act. We need to do something radical to turn the tide, and using legal force to employees’ rights are protected, and guidance and guidelines for health authorities are created and followed, would be a crucial step.”


11.3.15 – Health 
Julia Manning keeps her finger on the pulse of the NHS

This 2020health report is being funded by an educational grant from Lundbeck, within the guidance of the Association of the British Pharmaceutical Industry code of practice.
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British Heart Foundation creating ‘Proud Quitters’ this No Smoking Day

Guest Blog by Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, a member of NHE’s editorial board and a part-time GP in Cambridge.

NSD_ProudToBeAQuitter_logoToday, on 11th March, I expect nearly a million smokers in the United Kingdom will try to quit for good on No Smoking Day.

It’s taken a long time, but with initiatives like No Smoking Day and significant progress on new measures to tackle smoking, we could finally be in sight of a smoke-free UK. Although there are still more than 100,000 deaths caused by smoking each year, smoking prevalence is at its lowest level since records began in the 1940s. In 1954, around 80% of adults smoked, but current levels are now at just 19%.

While this has been great progress, recent years have seen smoking rates stagnate and we must now crack the ‘final fifth’ of adults who are still smokers, many of whom are desperate to quit.

England bans smoking in cars with children

0832_NSD_poster_England2Just last month, a ban on smoking in cars carrying children in England was passed by MPs. The ban will come into effect on 1 October, and is a welcome measure. Most exposure to second-hand smoke happens in the home, and it is very harmful in enclosed places, such as cars – particularly to children.

Every week, thousands of children are exposed to second-hand smoke in cars, putting them at greater risk of respiratory infections, asthma, and sudden infant death. I would urge families to consider this risk when smoking in cars or the home, with children present.

Introducing standardised packaging

The MPs at Westminster recently heard they will be given the option of voting on the 0832_NSD_poster_England4introduction of standardised packaging, before the General Election in May.  Current branded packaging is a ubiquitous form of tobacco advertising, used by tobacco companies to attract people to smoking, particular new young smokers.

Australia introduced plain packaging in December 2012 and smoking rates have since plummeted. Before the measure was introduced, daily smoking prevalence stood at 15.1%. Now just 13% of people aged over 14 are daily smokers. This is why I would like to see standardised packaging urgently introduced here in the UK.

We now need governments across the UK to urgently commit to standardised packaging and there needs to be greater efforts to support communities where smoking continues to be a problem. Smoking is an addictive, toxic and deadly habit and it is not our aim to take away freedom of choice, but to help protect people and save lives.

Support for quitting smoking 

This No Smoking Day, we’re urging smokers to visit their GP, pharmacist or local NHS stop smoking service to receive information, resources and advice to help them quit smoking.

For more information on the No Smoking Day campaign visit

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Serious underestimation of a disease that is risking women’s lives

Guest Blog by Alexandra Holden, Director of Communications,
Target Ovarian Cancer

Target Ovarian CancerPortraitsResearch published this month shows widespread misunderstanding and a lack of awareness surrounding ovarian cancer. Over one in ten UK adults surveyed estimated that fewer than 100 women are diagnosed with ovarian cancer per month in the UK; in reality, the number is almost 600. Over a quarter of people estimated that fewer than 100 women would die from ovarian cancer in a month; in reality, around 350 women will die from ovarian cancer during Ovarian Cancer Awareness Month, this March.

As the UK’s leading ovarian cancer charity, Target Ovarian Cancer has published these figures – not to suggest that the UK population should be able to accurately assess the number of people affected from a range of diseases, but to highlight a serious underestimation of a disease that is risking women’s lives.

Copy TOC logoThree quarters of the women surveyed were not confident in spotting the symptoms of ovarian cancer. If women don’t know the symptoms, they won’t visit their GP with concerns. If GPs don’t know the symptoms, they won’t refer the women for the correct diagnostic tests.

Late or delayed diagnosis is an enormous issue for ovarian cancer, with 15 per cent of women dying within two months of diagnosis. Women need to know that ovarian cancer exists, and to take their symptoms seriously.

Target Ovarian Cancer works alongside health professionals, women with ovarian cancer and volunteers every Ovarian Cancer Awareness Month to raise awareness of the symptoms with women and GPs. We’re also urging the government to lead a national symptoms awareness programme for women with ovarian cancer, which would have the potential to save hundreds of lives.

Early diagnosis is absolutely vital for improving a woman’s chance of surviving ovarian cancer. We need all women and GPs to know and act on the symptoms.

The symptoms of ovarian cancer are:symptoms

  • persistent bloating;
  • needing to wee more urgently or more often;
  • pelvic or abdominal pain;
  • difficulty eating or feeling full.

Symptoms will be frequent (usually happening more than 12 times a month), persistent and new.

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Politicians should focus on child health

Guest Blog by Dr Iseult Roche

A focus towards children’s  health and well-being, both physical and emotional has been called for following research initiated by The Royal College of Paediatrics and Child Health  – which highlighted concerns that children’s health is being pushed “to the wayside”, while health issues relating to older people were being well addressed.

The president of the college, Dr Cass,  is reported as saying: “We often see policies hitting the headlines that are targeted at the ageing population ….”

“But whilst caring for our ageing population is important, it shouldn’t mean that children’s health falls to the wayside.”

This may be true, and certainly no one would suggest that one age group’s care should be promoted at the expense of the other. Interestingly for any age group, the health agenda has to be a combination of public health, education and clinical intervention.

The research highlighted important public health initiatives and research poll data of over 2000 people showed Considerable support to stop fast food advertising during typical child viewing times, it also highlighted the importance of school cooking ( and presumably nutrition ) lessons and very importantly reducing speed limits.

Interestingly, their research highlighted over 80 % of people polled wanted compulsory personal, social and health education (PSHE)  in schools.

PSHE may have previously been overlooked by some,  when considering the overall health and well being of children.

wellbeingthumbnail2020health addressed wider health and well being issues even further in the policy group and report “fit for school“, my involvement with this and in my role as  Public Health Advisor in Local government , both make we wonder why it has taken a report to highlight these needs. Surely these are issues we ( and politicians) should be already addressing readily. After all, the future socio-economic outcome and burden will be inextricably linked to the next adult generation’s physical, emotional and psychological health and well being.

In Local Government,  I have helped drive  health initiatives directed towards children , and , I cannot help but think now public health is back in the hands of Local Government, the potential for good public health outcomes, especially for children, will potentially increase as they may  be better targeted group and will have time to benefit from the evolving public health structure at a ‘local’ level.

Dr Cass continued “I call on the next government to listen to the facts and listen to the public – make child health a priority. Not only does it make strong moral sense, it makes economic and political sense too.”

I agree, who wouldn’t, this is sensible, realistic and above all achievable….. Let’s just hope this incredibly important agenda is taken up thoroughly and does not simply become the next match of political health football.

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