In the midst of a once-in-a-generation public health crisis, our world-leading health service has been pushed to its very limits. Much has already been said about the sacrifice, dedication and commitment of NHS staff throughout the COVID-19 pandemic – and rightly so – but now is the time to look to its future and what lessons can be learned from this experience.
With potentially millions of lives at stake, the pandemic forced healthcare systems to innovate, respond and adapt with a degree of agility and flexibility never seen before. Over the past eighteen months or so we have seen the rapid acceleration and deployment of technologies that aimed to address the immediate health challenges at hand, in order to continue to deliver optimal patient care, reduce suffering and limit fatalities. The pandemic response has shown us that, when time is of the essence, rapid innovation and deployment of novel technology can help us deliver for patients.
Diagnosing vascular disease
Technological advances came to the fore across a range of clinical areas, including use of software to recognise disease through voice patterns, monitoring tools enabling early step-down from high-dependency areas, virtual reality training for advanced techniques when in-person learning was not feasible, and telemedicine tools for remote patient assessment and follow-up. Improving vascular care in the teeth of a pandemic may not necessarily seem a priority, but globally, cardiovascular disease remains the number one killer, responsible in the UK alone for a quarter of all deaths1. During the pandemic, patients suffered and died as a result of being either unable or unwilling to access healthcare with classical symptoms of heart attack, stroke or critical limb ischaemia – and whilst part of this was no doubt driven by the desire to avoid infection, there remains an undercurrent of distrust of health systems to adequately assess and diagnosis vascular disease states.
According to new research by Abbott in its Beyond Intervention 2021 Report, nearly a third (32%) of UK physicians say that “lack of technology or equipment to accurately diagnose CAD/PAD” is a key barrier to diagnoses and, therefore, successful outcomes for patients2. It’s clear that clinicians understand the need for technology and that a more standardised approach to diagnosis can lead to a more personalised triage and treatment pathway for patients. They likewise know that better risk-factor screening tools could have the potential to minimise instances of unconscious bias and over-reliance on individual perspectives – two major ills of the current landscape.
Patients are also beginning to understand and actively desire the need for a standardised diagnosis process, and a streamlined, personalised care plan. Throughout the pandemic, science and medtech stories in the media have featured strongly, extolling the benefits of rapid diagnostics and monitoring tools. Now, better-informed patients are appreciative of the importance of rapid, standardised detection and diagnostic methods driven by tools like artificial intelligence (AI) and, with it, the development of clear, individualised pathways to consultation and treatment. Patients’ expectations are increasingly driving clinicians to acknowledge key socioeconomic factors like age, gender and ethnicity in developing better health pathways that could unlock improved patient care and outcomes.
AI tools such as machine learning are already helping physicians to distil key patient data and improve understanding of individual nuances and variables in presentations to augment their knowledge and enhance management by incorporating health tools used by patients. Access to these technologies, however, must become the norm, and needs to become part of a standardised screening and diagnostic system that allows for a more responsive patient experience, where vascular diseases are spotted earlier, tailored and personalised treatment pathways are initiated and where outcomes can be improved for the next generation of patients.
As things stand, current systems often leave patients frustrated and disillusioned, which for high-stakes, high-mortality vascular diseases, must be avoided at all costs. Frustrated patients may sooner ignore potentially dangerous symptoms rather than try to grapple with a healthcare system that they know may lack coordination, the expected levels of digitisation and face-to-face time with a specialist. COVID-19 has only exacerbated this situation, with wait times increasing across our health service. Our recent report reiterates this and paints a picture of a system where patients often find themselves with no clear diagnosis, even after multiple visits to see a specialist. Investment in a standardised, tech-driven screening process would go a long way to beginning to rebuild patient and public trust.
Healthcare ecosystems must view the COVID-19 pandemic as a turning point, a catalyst that has enabled rapid adoption of novel tools for diagnosis, treatment and for monitoring, and such progress and uptake must be allowed to continue and to permeate throughout patient care for all disease states. Only then can we truly move forward, engage with these novel tools to enable a more holistic view of the patient and all of their seen and unseen individual factors that could influence disease and disease susceptibility – with the aim of creating a more streamlined, effective, quicker and more accurate system to drive patient care.