On the lead up to Valentine’s Day hearts are everywhere. Cards, text messages and cradled by fluffy teddy bears. So, what better time is there to start taking care of your heart? But getting check ups with your physician is not always convenient. You need to take time out of your day, schedule appointments in advance and sometimes wait for weeks to get the results. However, with current technological advances, checking up on your heart has never been easier, especially for those with a high risk of more serious heart conditions.
The Apple Heart Study is an example of how medicine is integrating with technology to provide a reliable, accessible and interactive experience. This study is a collaboration between Stanford Medicine and Apple with the aim of determining whether data generated from the heart monitoring feature of the Apple Watch, can be used to identify irregular heart rhythms, including those with the potential to develop into serious health issues such as atrial fibrillation.
The study was initiated back in 2017 and has recruited over 400,000 participants with Apple Watches. The Watch uses LED lights and light-sensitive photodiodes to measure changes in blood flow and estimates a pulse based on these measurements. Pulse rates over time are then reported as tachograms and an in-built algorithm determines whether participants have regular or irregular pulses. If a subsequent video conference with a physician confirms the Apple Watch readings, participants are provided with an ePatch that generates electrocardiograms for up to 7 days for further monitoring. Relevant care is then provided if required.
This virtual screening process made with the patient in mind is unique in that it allowed for large-scale recruitment in a relatively short period of time while also relieving the burden on healthcare providers and services. However, it also has its drawbacks. Misdiagnosis, unnecessary testing and overtreatment are the main concerns of having a patient-centric screening program like the Apple Heart Study.
Despite these concerns, this study is a major step in understanding the potential of technology in modernising how we approach medicine in the real world. Wearables in particular are becoming more and more popular with wearables dominating major technology events such as CES and even having their own conferences in the Wearable Tech Summit 2019 and Wearable Technologies Europe 2019. Just listen to an interview of Paul O’Donohoe, Scientific Lead for eCOA at MetaData Solutions who describes the current state of wearables and devices in clinical trials.
The digital evolution in clinical trials
The results from the Apple Heart Study are expected to be available in 2019. In the meantime, read more about the Apple Heart Study from Stanford Medicine or the full study publication from the American Heart Journal.
By Ricky Tsang
Meta Title: The Apple Heart Study
Meta Description: A blog on the Apple Heart Study, a collaboration between Apple and Stanford Medicine
Electronic patient-reported outcomes (ePRO) have the potential to improve many facets of cancer patient treatment and survivorship. ePRO may allow quicker identification and treatment of medically significant symptoms and so minimise patient anxiety regarding relapse.1 It could also enhance patient-healthcare professional (HCP) communication to facilitate better treatment decisions and potentially improve the quality of life for patients.1,2 It is hoped that ePRO can achieve these improvements and help HCPs deliver better holistic care for patients.
A group from Leeds comprised of patients, staff and IT specialists, developed a new ePRO technology called “eRapid”, Electronic patient self-Reporting of Adverse-events (AE): Patient Information and aDvice. This is a secure, integrated electronic platform for patients to report AE which can be accessed from any web-enabled device, including tablets and smartphones.3
When a patient accesses eRAPID and enters details of low and moderate AE, advice on self-management is provided. Whereas, entry of a severe AE triggers advice that the patient should immediately contact their hospital. When severe AE are reported the patient’s HCP also receives an email notification.3 This rapid escalation of concerning symptoms could lead to more positive outcomes for patients. eRAPID will be examined via randomised controlled trials in patients receiving systemic treatment for colorectal, breast and gynaecological cancers, so that the value of this new digital technology can be determined.3
In respect to cancer survivorship, ePRO can minimise patient anxiety regarding relapse. Depending on the severity of the symptoms recorded by the patient, reassurance or advice regarding immediate action is provided.1 Another feature of the ePRO system is that it tracks patient mental health so that support can be provided if necessary.1 However, the success of this function depends on mental health services being available.1 It is hoped that greater attention to patient symptoms via ePRO, rather than just clinical recurrence of cancer, will improve the quality of life for cancer patients.4
Innovative ways of tracking patient symptoms can be of particular importance for certain cancer types. For example, relapse of aggressive lymphoma is better detected through symptom monitoring than routine blood tests.4 Therefore, regularly tracking these signs could be invaluable. Additionally, ePRO prompts patients to periodically report symptoms and book tests when needed.4 This allows quicker identification of medically significant symptoms1 and can improve patient-HCP communication, so more informed treatment decisions can be made.2
We hope that the e-PRO will continue to advance, helping to support patients during diagnosis, treatment and survival. With the expansion of effective treatment options for cancer patients it’s important that cancer treatment is holistic and patient individuality during and after treatment is considered throughout the patient journey.
Want to get in involved with World Cancer Day? On the 4th February, #WorldCancerDay and #IAmAndIWill can be used on the day to share your messages of support for cancer patients and their carers.
3- Holch P., Warrington L., Bamforth L. C. A., et al. (2017) Development of an integrated electronic platform for patient self-report and management of adverse events during cancer treatment. Ann Oncol. 28(9), 2305–311.
4- Linder, O. C., Velikova, G. and Stark, D. P. (2019) Digitally enabled patient-reported outcome measures in cancer care. Lancet Oncol. 20(1), e2.
5- Gourd E. (2018) Routine blood tests have low utility in lymphoma surveillance. Lancet Oncol. 19(9), e442.
By Rivka Marks-Maran
Meta title: ePRO for improving cancer care
Meta description: A blog on using ePRO for cancer diagnosis, treatment and survival
How do you future-proof the NHS for the decade ahead? Not an easy question. However, it is one NHS England Chief Executive Simon Stevens sought to address as he launched the NHS Long Term Plan last week. The plan focuses on offering practical solutions to a wide range of key issues from how services will be delivered, to tackling health inequalities and ensuring staff have appropriate backing. But with the ongoing staffing crisis affecting the NHS and the fast-approaching cloud of Brexit uncertainty, will it be sustainable?
The prime minister announced an additional £20.5bn for the NHS over the next ten years. Using this fund, the plan looks to relieve some of the pressure on NHS staff by shifting the focus to earlier in the healthcare journey, to more preventative and community-focused strategies of improving population health. This approach is certainly welcomed. It is hoped that through the commitments set out in the plan to improve prevention, we will start to see increased collaboration between local governments, community services and the NHS.
Also welcomed is the focus on digitally-enabled care. The plan even sets out a vision for the NHS in ten years’ time:
‘The NHS will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it. Primary care and outpatient services will have changed to a model of tiered escalation depending on need. Senior clinicians will be supported by digital tools, freeing trainees’ time to learn. When ill, people will be increasingly cared for in their own home, with the option for their physiology to be effortlessly monitored by wearable devices. People will be helped to stay well, to recognise important symptoms early, and to manage their own health, guided by digital tools.’
It is great to see a realistic and practical approach to digital in the NHS, building on the vision of Matt Hancock, Health and Social Care Secretary, to develop ‘the most advanced health and care system in the world’. The Long Term Plan outlines ten top level steps to drive digital transformation including using decision support and artificial intelligence (AI) to help clinicians apply best practice, and using intuitive tools to capture data in order to empower clinicians and reduce administrative burden.On a more tangible level, the plan explains that WiFi is being installed across the NHS and rollout of the NHS app has begun, which will provide people with online access to NHS 111, their GP record and the ability to book appointments from their phone.
Elsewhere, the plan outlines commitments to drastically improve cancer survival, provide much improved services for mental health and halving maternity-related deaths.
Overall, the NHS Long Term Plan has gained a positive response from many key stakeholders, including Macmillan Cancer Support, Mind and British Heart Foundation. However, there are concerns over long term sustainability. Success of the plan relies on adequate NHS staffing, however recent research by the King’s Fund has highlighted an estimated staff shortage of 250,000 or more by 2030. And, while initiatives have been proposed to solve this issue, attracting essential overseas workers may become even more complex depending on what instance of Brexit is delivered. Waking up to a no-deal reality on 29th March may well leave people asking the question ‘where will the money and the workers to deliver these NHS commitments come from?’
Despite this uncertainty, the NHS Long Term Plan does provide a pragmatic and practical approach to improving health and care services of the next ten years. Future-proofing the NHS is not an easy task, however we hope that this plan will benefit the health of all for the years to come.
 Health Foundation, King’s Fund, Nuffield Trust. The health and care workforce in England: make or break? 2018. https://www.health.org.uk/publications/the-health-care-workforce-in-england
By Alex Teckkam
Meta Title: The NHS Long Term Plan
Meta Description: Blog post on the strengths and weaknesses of the NHS Long Term Plan
At medDigital, we are evolving the dialogue between the life sciences industry, healthcare professionals and their patients to improve healthcare delivery for all.
Due to our continued international growth, we are hiring a Designer looking to progress their career in a dynamic and exciting environment. Working with both our internal team of Scientific Advisors and clients within the life sciences industry, this is an opportunity to take on a varied and interesting role. If you want to use innovation to help improve patient care, then you will fit in well with our team.
Join medDigital to help us evolve communication by:
Collaborating with our team of Scientific Advisors to brainstorm and develop new ideas
Sharing your expertise and creative ideas across therapy areas
Developing storyboards and briefs
Designing PowerPoint presentations, infographics and materials for social media
Editing video recordings to a very high standard to produce material for brands, campaigns and events
Creating and editing motion graphics to an excellent standard using a variety of software listed (but not limited to) below:
Adobe After Effects
Adobe Premiere Pro
What do I need to apply?
Excellent working knowledge of Adobe Photoshop, InDesign and Illustrator
Experience with Adobe Premiere or After Effects
What is desired?
An exceptional eye and passion for crafting pixel-perfect designs
Ability to show your skills with a portfolio that demonstrates range
Excellent organisational skills
Flexibility whilst working under pressure
Familiarity with agile ways of working
Experience and understanding of website design best practice
A scientific background or experience is a plus but not essential as our team of Scientific Advisors will be on hand to work with you
What qualifications or authorisations do I need?
Minimum of 3 + years of design experience
Where will I be based?
You will be based at our office on the London South Bank with skyline views, great events and free beer! Flexible working is also available. You will also need to visit our clients’ offices from time to time which may involve international travel.
6% qualifying earnings employer contribution PQM pension
Private healthcare with BUPA
Life Insurance (5x your basic annual salary)
Generous 25-day annual leave allowance
Team reward activities
Laptop and current mobile phone
How can you apply?
To apply please send your CV to email@example.com and complete our on-line application form: https://www.meddigital.com/hr/entry/
It is incredible to be writing this blog on the day of medDigital’s 10th birthday celebration. It has been an amazing 10 years.
I can still remember our first office in an old attic in Esher. It was so small and the roof so low that the three of us couldn’t all stand up at the same time. The floor was so wonky pens would roll off the desk if they were placed on the wrong perpendicular. We couldn’t even imagine that we’d now be a fantastic team of 20 people with our head office on the beautiful Southbank with free beer and a roof terrace overlooking the River Thames. Who knew what would grow out of such a cramped and wonky start. Auspicious beginnings, indeed.
Does Virtual Reality have a place in the pharmaceutical industry? At medDigital we certainly think so. And as the AR/VR sponsor at this year’s eyeforpharma Marketing and Customer Innovation conference, we were thrilled to see so many presentations, practical demonstrations and discussions dedicated to discussing this question.
Joerg Schaub (Eli Lily) began the discussion, asking “Virtual reality: buzzword or transformative tool?”. Joerg highlighted the fact that human desire for virtual reality is not a new concept. After all, 3D videos were first released in 1961 and the first virtual reality head gear appeared in 1994. Whilst the pharmaceutical industry is not driving the use of this technology, Joerg suggested it should be a potential channel for congresses, face-to-face events and the sales force, stressing that we need to be with our customers when they are using it. He presented a case study of how Lily have been using virtual reality in Dermatology to show HCPs different modes of action under the skin and to help improve their diagnosis of patients. He felt that VR was not a buzzword or a transformative tool but a channel with tangible applications.
Following on from Joerg’s presentation, our very own founder Felix Jackson hosted a round table discussion answering, “Is AI, AR, VR or Machine Learning being applied in pharma?”. This discussion resulted in several potential applications being highlighted for use including:
Education and information showcasing key concepts such as biological mechanisms and mode of action
To enhance the treatment of patients
To provide disease awareness and educate patients about a condition and potential ways to prevent a condition or progression of a disease
To assess a patient’s response to a treatment
There is clearly potential to use these technologies, with many of the above applications falling under the bracket of education. But when considering using VR in education we have to ask ourselves, how does it compare with other training methods? Does it actually help to improve retention of the information?
According to Abby Fleming (Janssen), the answer is yes. VR powered training allows HCPs to learn by doing, a training method shown to result in an average of 75% learning retention rate, far outweighing audio-visual (20%), reading (10%) and lectures (5%).
Janssen introduced their work using virtual reality nurse training in multiple myeloma to improve patient outcomes and minimise delay to treatment. The room was in awe as the Janssen team demonstrated their VR chemotherapy suite with data, prescriptions, graded symptoms and stats as well as in-built sound to hear the difference in patients’ symptoms. Janssen concluded that VR had vastly improved the confidence of the nurses and tackled their apprehension about using the technology.
As the conference came to an end, it was important to revisit the key question: Is VR still a buzzword or does it have real applications in our industry?
Case studies and discussion have shown us there can be powerful application of VR in this space particularly around education, awareness and training but as with all digital activities the channel should be chosen when it meets a need not because it’s a hot trend! Remember, while you may have great content, it must reach your customers in the way that they want to receive it in order to encourage an action, a meaningful engagement.
At medDigital we look forward to working with our customers to use VR to enhance learning and improve the patient experience. Attending conferences such as the eyeforpharma summit is key for us to be involved with the most up to date discussions and hear key learnings from industry experts. We now look to the 17th annual eyeforpharma Barcelona, held on 12th-14th March 2019. When we asked our Scientific Director Jess Thilaganathan for her thoughts on the upcoming conference she said:
‘In Barcelona next year we’re really looking forward to seeing the progress made in the next six months and how we can contribute to the evolution, with our founder Felix Jackson set to be on stage sharing medDigital’s latest insights.’
We hope to see you all there!
By Alex Teckkam
Meta Title: VR in the pharmaceutical industry
Meta Description: Blog post on opportunities of virtual reality in the pharmaceutical industry