Monthly Archives: April 2024

Which technologies offer the biggest opportunities to save time in the NHS?

The National Health Service in the UK as part of an annual analysis of resource and budget planning, looked at clinician views on which technologies offer the biggest opportunities to support staff capacity and release time.

Given that the change enabled by technology depends on the staff who use it, this review decided to center on clinical perspectives and insights that are crucial to achieving the coalition and leadership for change required to transform NHS care now and in the future. 

Gathering Info from Stakeholders

The research draws on an anonymous online survey of clinical staff across the UK and semi-structured qualitative interviews with experts on the use of technology and AI in clinical practice. 

The survey targeted eight professional groups in which there are workforce shortages and thus particular hopes for technology to save time and support staff capacity. To reach and represent each group, researchers worked directly with the relevant professional body: Anaesthetists, General Practitioners, Intensive Care physicians, Nurses, Obstetricians and Gynaecologists, Physiotherapists, Psychiatrists, and Radiologists and Oncologists.

Survey Question #1: Which technologies are widely used right now?

Survey respondents chose from a list of options which technologies they have used in their work. The top three selected were: electronic health records (EHRs; chosen by 87% of respondents), videoconferencing to speak to colleagues (86%) and digital messaging tools for communicating with colleagues (73%). This suggests widespread usage of technologies supporting staff communication and interaction. In contrast, videoconferencing to speak to patients and digital messaging tools for communicating with patients were each selected by around one-third of respondents. Unsurprisingly, more novel technologies ranked much lower. Only 3% of respondents selected virtual or augmented reality to train health care staff or treat patients, and only 1% reported using robotic helpers and care devices.

Survey Question #2: Which technologies are saving time right now?

Question #3: Which technologies might save time in the future?

What About AI?

Survey respondents were also asked to what extent they thought AI will save them time in their work within the next 5 years. 57% said this is either somewhat or very likely. This indicates reasonable optimism among clinical staff about the potential time-savings from AI in the near future. Similarly, among our interviewees, while AI technologies were not perceived as making a significant difference to work in the NHS right now – largely because their use was seen as patchy and uneven – there was hope about realizing benefits in future. 

AI will also play a significant role in the other two technologies ranked highest by respondents as likely to save them time within the next 5 years: clinical documentation tools and software for the analysis of images and test results. One example of the former is AI-driven ambient voice technology (AVT), which uses voice-to-text software to auto-transcribe patient consultations and then natural language processing to turn these transcriptions into summary notes and letters. Voice recognition technology was predicted to offer ‘a massive reduction in the admin burden for front-line clinical staff’. 

Survey Question #4: What challenges do staff face in using technology?

Survey respondents were asked to choose up to five main barriers to using technologies effectively that they have encountered in their work. More than half of respondents chose a lack of IT support and expertise (55%) and a lack of funding to implement new technologies (53%). Other commonly cited challenges were poor internet connectivity (41%) and not having the right equipment (37%), as well as difficulties with passwords, permissions or access (36%) (see Figure 4). This suggests major barriers that include underlying infrastructure and capability, as well as implementation and usage. 

It is notable that, in the survey, staff and patient concerns about or resistance to technologies were among the lowest-ranked challenges. When presented with a list of barriers, only 12% of respondents selected staff concerns about patient safety and clinical effectiveness, while 10% chose patient resistance to using technologies and 8% chose staff concerns about data protection and security. This does not mean that these issues do not present challenges, however. There is an ongoing need to both secure staff support for the use of technologies and provide training to improve digital skills and confidence across the workforce. In our survey, 28% of respondents chose ‘lack of time for staff to train’ as a major barrier to using technologies effectively, followed by almost 1 in 5 who said there was ‘not enough training available for staff’. 

Further challenges cited in our interviews included the ongoing need for rigorous testing and evaluation of technologies. Several interviewees also raised concerns about a lack of clinician involvement in technology development and procurement, with the consequence that the solutions being implemented are not always best suited to the needs of the NHS and clinical practice. greater engagement with staff. It would be positive to move towards a future where technology is seen as ‘something that is developed with clinicians and patients rather than something that is kind of developed for them and then applied to them’.

Source: OnHealth Foundation [Link]

First FDA Approved ‘Digital Therapeutic’ for Major Depression

The first prescription ‘digital therapeutic’ authorized for the treatment of major depressive disorder (MDD) symptoms has been approved by the US Food and Drug Administration (FDA). It has been cleared for use as an adjunct to clinician-managed outpatient care for adult patients with MDD aged 22 years and older who are on antidepressant medication.

The smartphone app, named Rejoyn, was developed via a partnership of Click Therapeutics, a company that makes software-based medical treatments, and Otsuka Pharmaceuticals.

The FDA cleared the app based on a 13-week study of 386 people ages 22 to 64, in which participants showed improvement in their baseline depression symptoms when using it, compared to a sham app as measured via established clinical scales. The trial also showed continuing improvement a month after treatment, and reported no adverse effects.  Rejoyn aims to further reduce MDD symptoms by complementing standard-of-care drug regimens, with a six-week digital treatment schedule that provides cognitive emotional training exercises and therapeutic lessons. The app also offers personalized reminders and messages to encourage adherence to medication.

Unlike therapy apps that are currently available as a “treatment for depression” or “supplemental treatment” and can be downloaded from smartphone App Stores, a prescription from a healthcare provider is needed to access Rejoyn. 

The app is not meant to be used as a standalone therapy nor as a substitute for medication.

The website https://www.rejoynhcp.com/ states that the app will be available in Summer 2024.

Otsuka Press Release