24 November 2017

The digital doctor will see you now

A vast chunk of primary healthcare could soon be provided through a smartphone.

Swedish on-demand doctor app Kry, which was launched in 2015, claims it has more than 200,000 registered users, says it is treating 1-2% of all primary healthcare in Sweden and is growing at 50% month-on-month. Customers can video call or message a doctor late at night and at the weekends, order prescriptions and tests to their homes, and get referrals.

It’s modern medicine in action – a time-efficient, cost-effective and easy way to treat patients using technology – and users are signing up in droves across Sweden, Norway and Spain.

If Dr Ali Parsa has his way, it won’t be long before the UK gets a healthy dose of 21st century medicine and a mass-market modern doctor too. ‘40% of patients don’t need to see a doctor,’ he says. ‘Why waste their time, and the doctor’s?’

Parsa is CEO of Babylon, a UK-based digital doctor app that lets users check symptoms, and message and video call GPs. He is trying a few lines of attack to crack into the NHS – people can register Babylon’s ‘GP at Hand’ app as their GP, and have in-person appointments at six partner GP surgeries in London. It also runs a triage chatbot with several hospitals in north-west London to answer phone calls directed to the NHS 111 phone helpline.

Babylon’s sell is a good one; using digital tools to cut down on the time a GP or a consultant has to spend with a patient asking routine questions or running tests that are administered easily can save the NHS vast amounts on appointment costs. It claims its triage app is 17% more accurate than a nurse, and 14% more accurate than a doctor.

‘In two to three years, at the speed tech is developing, I think it will be unsafe to see a doctor without the help of AI,’ says Parsa. One in eight patients are currently misdiagnosed in the UK, he adds. ‘Diagnosis is a probability analysis. It’s never precise.’

Reaching the masses

Getting that technology into doctors’ hands is the hard part; each of England’s 209 clinical commissioning groups and 7,454 GP surgeries typically need to be approached for partnerships individually. Babylon will also need to disprove criticism that it is ‘cherry-picking’ the patients who are easiest (and cheapest) to treat, which could have a negative impact on GP funding more widely.

Babylon’s growth strategy is three-fold: increase its usage within the NHS, expand to other countries, and sell or license its software – so far, to the likes of Bupa and Bloomberg.

‘The problem of adoption is not one of people; when people use [Babylon], they never go back. We need to make sure all the pieces are in place. Once those are in place, it’ll happen almost overnight,’ says Parsa.

In the next few months, Babylon plans to launch an updated version of its app that will be able to diagnose patients for free. It is also using its latest £46m funding round for a far more futuristic-sounding feature: ‘digital twins’.

The idea is that by simulating users on the app, using information about their physiology, genetics and medical history, in time Babylon will be able to predict a patient’s health in advance. ‘Eventually we’ll do with a model of you what we can do with a model of the weather,’ says Parsa; forecasting say, what would happen if someone ran a marathon, or lost weight.

Despite accruing losses of over £12m, Parsa is optimistic about Babylon’s chances of turning a healthy profit and making healthcare more affordable and accessible with scale. He reckons the efficiencies that come with AI will be central to this mission.

Two remedies

Kry focuses less on technology itself, and more on how it can distribute healthcare provision in smarter and more efficient ways. ‘It’s a waste for people to take time off work, going to care centres and emergency rooms. It doesn’t have to be that way,’ says its CEO Johannes Schildt.

Making it easier for people to take tests at home, with increasingly inexpensive devices, such as ultrasounds or octoscopes connected to smartphones, is one of the company’s goals.

Another is to move those services away from primary healthcare centres to locations more convenient for patients, like a supermarket or pharmacy.

‘With our existing service, we could treat 65% of all primary healthcare,’ says Schildt. ‘When we add in new services on top, we could treat 90-95%.’

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