Steve Statler, author of "The Hitchhiker's Guide to the Beacosystem", beacon ecosystem consultant and CMO for ambient data platform Wiliot, shares his view on the technology that exists to revitalise Britain’s NHS.
The economy is moribund. Public resources are scarce. The people are worn down, cynical and weary. Administrators are under pressure to do more with less. In 1950s Japan, these were the conditions that gave rise to an almost miraculous reinvigoration of the economy, and a technological dominance that lasted 40 years. It’s a picture that might just as easily apply to the broken-down Britain of the 2020s. Might this be the moment when, instead of a seemingly-inevitable slip into managed decline, we rise up instead to enter a new era of prosperity?
If it happens, it will happen because of technology. It seems astonishing (at least to me) that one of the most consequential developments in human history, which will have a
seismic effect on the way we work, educate our children, and inform and entertain ourselves, was barely mentioned during the recent UK general election campaign – that of AI. Perhaps it’s because the incoming government intends to reap the benefits and present them as miraculous over-delivery. Just days after the election, Sir Tony Blair’s think tank, the Tony Blair Institute for Global change, published a paper claiming the government could save up to 20% of workforce time – amounting to £10bn a year by the end of the current parliament, and £34bn by the end of the next, through the wholesale adoption of AI.
Were the government able to achieve these kinds of savings, the most obvious beneficiary would be the NHS. The incoming Health Secretary Wes Streeting described the service in his first week on the job as ‘broken’. So how might an institution as complex, fractured and unwieldy as the world’s largest publicly funded health service go about reaping the benefits of bleeding-edge technology like AI? Shouldn't we be fixing the basics first?
Actually, it’s with the basics that AI can deliver its most transformative benefits – when combined with another phenomenon that’s evolved with equally dramatic, but less publicised leaps and bounds in the last five years: IoT, or 'Internet of Things'.
Probably one ofthe best known innovations to emerge from Japan’s economic boom was the ‘just in time’ production method pioneered by Toyota. Based on the elimination of waste, the approach maintains a continuous delivery of critical inventory at the exact location and point in time it's needed. Universally adopted across the automotive industry and mimicked in many other industries, the process revolutionised the economics of vehicle production and has proved remarkably resilient, even through once-in-a-century challenges like Covid and a European war.
But producing vehicles is a consistent, predictable process. A service like the NHS spends 98% of its funds on skills. Can the principles of an auto manufacturing process realistically be of any use here?
Before the developments of the last five years, the answer to that question would have been in the negative. But we now have tools at our disposal to address one of the most frustrating and costly challenges for hospital trusts, and which could release millions of hours of clinical time back into patient care – that of asset and inventory management.
Hospital trusts are responsible 1000s of pieces of mobile equipment, ranging from expensive devices like heart monitors and ECGs, to wheelchairs and walking aids. Much of this hardware doesn’t always remain on site, but is loaned out to community organisations. Assets not being available when needed wastes considerable clinical time, causes costly delays to treatment, and can in extreme cases expose patients to life-threatening risk.
Research from the NHS Transformation Directorate found that hospitals using technology to track and locate equipment released over 140,000 hours of clinical time back into patient care. Unfortunately, until recently such technology has been expensive: a reader to track Radio Frequency Identifier (RFID) tags (a radio enabled sticker, commonly used in clothing stores to track inventory), might cost up to £1000. Alternatively, battery powered Bluetooth tags similar to Apple Air Tag don't need an expensive reader, but cost up to £30 each – with the added disadvantage that they rely on a battery and eventually need replacing. Moreover, the software required to manage and track inventory had to be
tailored for each application; an expensive and inflexible process.
However, things are changing, and changing fast. Recent innovations in smart labelling
technology means computing power superior to that delivered by an RFID tag can now be packed into a paper label for just a few pence. Critically, these labels require no battery, harvesting their energy instead from ambient electromagnetic waves. Receivers for these devices cost only around £50, and can track not just the location of the inventory, but its temperature, opening up exciting possibilities around the safe monitoring of temperature-sensitive medicines.
It might be more useful to think of the old world of IoT, where stuff like cars, TVs and refrigerators connected to the Internet, as 'the Internet of Expensive Things'. Handy for those thatcan afford it, but certainly not transformative. We're now moving to a situation where essential but low-cost inventory – from facemasks to fan belts – can be tracked passively, using the background radio waves that surround us (supplied essentially free by consumer devices like phones and smart speakers). Like all tech developments, this one comes with a new name: Ambient IoT. The potential of ambient IoT has been clear for a while, but it's set for a significant new boost with the imminent ability to exploit background Wi-Fi and cell phone signals, making it truly ubiquitous. Combined with the emerging potential of AI to process and organise this torrent of data and translate it into useful action, we're on the cusp of a truly revolutionary new understanding of the world that surrounds us.
For the NHS, this means being able to determine, in real time, the most efficient distribution of hundreds of thousands of assets across an entire NHS trust, and anticipate and plan the most efficient trajectory for each item.
Just like a vehicle manufacturing process, where a part arrives at the production line at the precise moment it is required, equipment would be available to clinicians at the moment they need it, without time-wasting phone calls, emails, paperwork and costly waits. Talk to a layperson about this, and they nod in agreement at the common sense benefit of the approach. Talk to anyone that works in the NHS day-to-day, and their eyes open wide at the game-changing effect such an innovation would have.
The NHS faces the triple threat of years of under-investment, an ageing population and the escalating cost of equipment and treatment. The new government is dealing with a moribund economy and its self-imposed constraint of having promised no increases in VAT or income tax. Something has to give. The one thing that the NHS is not short of is goodwill, and dedicated personnel. Currently, these people spend dozens of hours every month on admin and delays that could be eliminated quickly, effectively and, most importantly, cheaply. The result could very well be the healthcare system this country desperately needs, and deserves.