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03 January 2016

The Digital Revolution: Eight Technologies That Will Change Health and Care

             Smart drug delivery
The smartphone, at-home or portable diagnostics, smart or implantable drug delivery mechanisms, digital therpeutics, genome sequencing, machine learning, blockchain, and the connected community...

The digital revolution: eight technologies that will change health and care
by Cosima Gretton, Matthew Honeyman, kingsfund.org.uk, 
1st January 2016

The past decade has seen rapid development and adoption of technologies that change the way we live. But which technologies will have a similarly transformative impact on health and care?

The King’s Fund has looked at some examples of innovative technology-enabled care that are already being deployed in the NHS and internationally to transform care. Now, we examine the technologies most likely to change health and care over the next few years.

Some of the technologies we discuss are on the horizon – others are already in our pockets, our local surgeries and hospitals. But none are systematically deployed in our health and care system. Each could represent an opportunity to achieve better outcomes or more efficient care.

1. The smartphone

It’s been eight years since the launch of these pocket-sized devices we now know so well. We take them for granted but our phones combine: computing power that could steer a spacecraft, a connection to the internet, a host of sensors for health-relevant data like movement and location tracking, plus a touch-screen interface.

Two-thirds of Britons use them to access the internet (Ofcom Technology Tracker 2015), and few would regard these devices as ‘new’, yet the smartphone’s potential is yet to be realised in health and care.


App stores already feature thousands of health apps, though their uptake for health and care has been patchy. Efforts to curate the best quality apps, for example in the NHS App Library, have had little success so far (Huckvale et al 2015).

One of the more sophisticated apps in use in health care is Ginger.io. In this depression programme, people track their own mood and this is combined with data collected from the sensors in the smartphone about their movements, social app or telephone use. The data can be shared with clinicians and offers people an intervention when their data suggests they might benefit from support.


Smartphones can serve as the hub for sophisticated new diagnostic and treatment technologies. So, for example, people with type 1 diabetes dissatisfied with the progress of medical technology companies are driving the development of an artificial pancreas. This links continuous glucose monitoring and insulin-delivery systems that are all controlled by the smartphone. It will adapt its algorithms for insulin delivery to a person’s physiology.

Large-scale research

Smartphones are highly effective data collection devices and they can record a lot of detail about people’s lives. As well as tracking their own health status, people can also help researchers gather large amounts of data on health problems and their determinants using their smartphones.

The first long-term and large-scale opt-in disease studies are just beginning. Apple seeks to support large-scale studies using patients’ iPhones by providing its ‘ResearchKit’ software platform for researchers to tackle any research question. uMotif is seeking eventually to build a 100,000-person study into Parkinson’s disease, tracking variables using a smartphone app.

2. At-home or portable diagnostics

Devices cheap enough or portable enough to be transported to people’s homes to provide diagnostic information aren’t new – think of a GP doing home visits armed with a stethoscope. But recent innovations mean that devices previously only kept in a hospital or a GP surgery are now portable or cheap enough to be located in people’s homes, and used by patients themselves.

Hospital-level diagnostics in the home

These include portable x-ray machines, blood-testing kits and other technology that can provide more and more of the diagnostics required to support health care, with profound consequences for the way we configure our health care system.

At a recent conference at The King’s Fund on emerging primary and acute care systems, Dr Michael Montaltodescribed how these technologies and others enable the safe, high-quality acute care service that his team has provided for people in Victoria, Australia, in their own homes for 20 years. One recent innovation in this area is the AliveCOR ECG embedded in a smartphone case that helps interpret test results via an app and facilitates secure sharing with clinicians (NICE evidence review).

Smart assistive technology

Many people with disabilities or long-term conditions use assistive devices to help them perform tasks or activities made harder for them by their disability or their condition. These are often available as part of NHS and social care packages. The prospect of using these to gather information in addition to achieving a specific task is motivating several new developments.

Verily (formerly Google’s life sciences arm) has invested in a tremor spoon already on the market for use by people with Parkinson’s disease, for example. By incorporating sensors and deploying its data analytic expertise, the aim is to provide people or health professionals with information about how someone’s tremor characteristics and severity change over time – and to understand more about the disease across a population. Smart inhalers like those in development by Propeller Health work on a similar idea, passively detecting each use, location and the surrounding air quality, allowing insights into what triggers asthma attacks.

3. Smart or implantable drug delivery mechanisms

We know that between a third and a half of all medication prescribed to people with long-term conditions is not taken as recommended (Nunes et al 2009). Several technologies in development could enable patients and care professionals to monitor and improve adherence to a prescribed drug regime either through automation or providing better information about medication usage.

Smart pills

One company has developed sensor technology so small it can be swallowed and combined with drugs in pill form. When the pill dissolves in the stomach, the sensor is activated and transmits data to a wearable patch on the outside of the body and on to a smartphone app. This enables patients and their clinicians to see how well they are adhering to their prescription.

Proteus Digital Health began the US Food and Drug Administration (FDA) regulatory process for this technology in 2015. The treatment now undergoing review combines the technology with an anti-psychotic drug, raising questions about how health systems could use the technology and how privacy and autonomy for patients will be affected. The company are also investigating other potential applications including assisting those with long-term conditions such as dementia and Parkinson’s disease to remember to take their medications.

Implantable drug delivery

New automated drug delivery technology is under development by a firm set up by researchers and engineers from the Massachusetts Institute of Technology (MIT). They are developing an implantable device with hundreds of tiny, sealable reservoirs that open when a small electric current controlled by an embedded microchip is applied (Farra et al 2012). The team developing the device say it could provide a way to automatically release doses for more than 10 years from a single chip. They are developing the technology for long-term condition medication as well as for contraception.

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