The world's health sector has gone digital, with electronic prescriptions, digitised supply chains and personalised medicine the new buzz words.
Earlier this year, the US biotech company Proteus announced that it had raised US$172 million for its pioneering tablets containing embedded microchips. These swallowable devices collect and report biometric data and can tell if a patient has taken their medication correctly.
In a similar breakthrough, Google has recently announced a prototype contact lens which measures glucose in a user’s tears and communicates this information to a mobile phone so that patients can better manage their medication.
Both innovations illustrate the hybrid devices that medicines have now become – and highlight the cumbersome and mostly paper-based current systems that are still being used to deliver medicines.
Dr Tony Cornford from LSE’s Department of Management hopes to make some headway in this area by spending the next two years exploring digital innovations in how drugs are supplied and used.
A £700,000 grant from Research Councils UK will allow Dr Cornford and a team of co-investigators from LSE, the University of Leeds, UCL, Brunel and the Health Foundation to map emerging new fields, such as electronic prescribing systems, intelligent medicines supply chains, new diagnostic and monitoring procedures, and personalised medicines based on individual genomic profiles.
The project will focus on the multiple ways that medicines are digitised, used and regulated.
“The present system of delivering medicines is fractured, often labour intensive and prone to human error. There are many areas where healthcare can be delivered more efficiently and with a greater degree of precision through digital systems,” Dr Cornford explains.
“But we also know that technology that makes practices safer or more efficient involves change. What we are hoping to do is look at the digitisation of drugs through a social science lens that acknowledges these effects and their impact.”
Members of the research team have previously studied the introduction of electronic transmission of prescriptions in the NHS.
“The existing process – where a GP dispenses on a green prescription form that is passed via the patient to a pharmacist – is slowly being replaced by digital messages sent electronically to the pharmacy. The new service may be more efficient, offer better services for patients and collect more data to support research.”
“One of the problems that individuals face is that sometimes when you need a prescription filled, the pharmacist does not have the medicine in stock. It may mean having to go back to the doctor to get a new prescription, visit another pharmacy or wait until the next day for your treatment. This not only wastes time but can delay your recovery and sometimes even jeopardise your health if it’s a serious condition.”
By digitising supply chains and ensuring the supply, prescription and dispensing of medicines is integrated and involves health professionals and patients, these kinds of problems may be avoided, Dr Cornford says.
But the digitisation process also changes the work of GP surgery staff, prescribers and pharmacists and these effects need to be analysed.
Digitising the supply chain could also address the problem of counterfeit drugs. Medicines could be validated at the point of sale or use via a secure digital process, such as a simple SMS text message, which matches a unique on-pack bar code right back to the factory of origin.
The team will also investigate new digital means to assess whether a drug is effective or not, or has adverse side effects for certain sections of the population – a practice known as ‘pharmacovigilance’.
“It’s not easy to capture this information at present because we rely on very specific, labour-intensive research projects and often the information takes months or years to collate, despite access to computerised patient records.
“Digitising medicines should allow more monitoring (potentially) on a national scale and offer results in a shorter time. This could mean that the testing phase of new drugs may be reduced and brought to market sooner.”
Research published in the British Medical Journal in 2004 shows that up to 5 or 6 per cent of hospital admissions are related to adverse drug reactions, of which a large percentage are preventable.
This research estimated that at any one time in the UK the equivalent of up to seven 800-bed hospitals may be occupied by patients admitted because of adverse drug reactions.
By exploiting digital technology in new clinical practices such error rates could be reduced, Dr Cornford says, easing pressures on hospitals.
“There is also a complicating factor when patients with chronic, multiple health problems are admitted to hospital. Their continuity of medicines may be disrupted, leading again to errors and harm. This can be potentially improved by sharing medicine data between primary and secondary care,” Dr Cornford adds.
However, despite the promised gains that digital drugs will bring, he cautions against ‘silver bullet’ thinking. Technology is never a quick solution to social challenges.
“Like most things in healthcare, we can expect valuable and beneficial incremental improvements from digital drugs, but it’s not a case of a one-step transformation.”
Delivering Digital Drugs (D3) is a two-year £694,954 research project funded by RCUK as part of the “New Economic Models in the Digital Economy” programme.
Dr Tony Cornford from LSE’s Department of Management is the principal investigator, supported by LSE colleagues Dr Will Venters, Dr Carsten Sorensen, Dr Panos Kanavos and Dr Ela Klecun; and researchers from UCL, Brunel University London, University of Leeds, and the Health Foundation. The project is part of the Research Councils UK Digital Economy programme.
Dr Ralph Hibberd and Ms Jane Dickson have recently been employed as research officers for the Digital Drugs project.
Posted 27 November 2014