As the cornerstone of the UK’s welfare state, the National Health Service (NHS) is an institution the British public are fiercely proud of. Yet the burden of providing free healthcare to every citizen is enormous, so much so that the NHS seems to exist in a permanent state of funding and resourcing crisis.
With a funding deficit of over £2 billion and mounting pressures on recruitment, NHS leaders and politicians struggle constantly with the conundrum of how to keep free public healthcare both affordable and fit for purpose.
Among all this gloom, digital technology provides a bright spark of optimism. The deeply complex challenges facing public healthcare have inspired waves of collaboration between IT specialists and clinicians eager to harness the power of technology to solve the puzzle.
The fruits of those collaborations have been the emergence of scores of businesses like Proximie, each bringing their own piece of technology to the jigsaw. Our work is focused on using Augmented Reality (AR) to facilitate and enhance surgical and medical procedures, removing the barriers of access to expertise.
With AR technology, complex surgery can be carried out without the need for a specialist in theatre. In a climate where services are being axed because of funding and recruitment issues, this has the potential to spark a complete rethink of how surgery is organised on a local level.
Reconfiguration of hospital services has long been shorthand for concentration and centralisation – or, as the King’s Fund report on reconfiguration from 2011 puts it:
“As skilled specialist staff are scarce and budgets are limited, services have been centralised onto fewer, larger sites, in order to ensure patients are cared for by staff with the necessary skills and supporting specialist equipment.”
This has proved deeply unpopular with patients, who face increasingly long journeys to undergo specialist procedures. A stark example is the centralisation of specialist cancer surgery at two locations in England, London and Manchester, covering all procedures relating to prostate, bladder, renal, and oesophago-gastric cancers.
With AR platforms like Proximie’s, the imperative for this drive towards centralisation is reduced. AR means surgical colleagues can be guided in carrying out specialist procedures by experts from afar. Via an iPad or similar mobile device in the theatre, the specialist can watch and direct the operation remotely, guiding the theatre surgeon through the interactive use of 3D images, computer generated diagrams, audio, video and surgical metrics.
As well as being an extremely efficient way of distributing expertise so specialist procedures can still be delivered locally, it is also extremely cost effective – a key consideration for the financially constrained NHS. As a cloud-based application, the Proximie platform carries none of the high installation and maintenance costs of the healthcare software of old.
As well as helping to share surgical expertise to support efficient and effective local delivery, AR technology can also help to boost specialist skills on the ground, creating more robust local provision in the long term. One of the strategic drawbacks of the reconfiguration model is that it reduces training and development opportunities – with specialists concentrated in fewer and fewer locations, students have less opportunity to learn from them.
Telemedical platforms like Proximie remove that problem. In the same way as a surgeon can be guided remotely to carry out a procedure, so students can learn from experts not just in another city, but anywhere in the world. At a time when senior surgeons are expressing concern that Brexit could lead to the vital flow of overseas expertise being cut off, AR technology has the potential to keep open vital access to specialist expertise and, through remote learning, develop the specialist skills of a new generation of NHS surgeons.