Health 2.0 Europe Keynote Interview: Richard Brady Founder of ResearchActive.com

Pascal Lardier (Health 2.0), interviewed Health 2.0 Europe 2015 keynote Richard Brady (ResearchActive.com) on the adoption of new technologie, opportunities for health care professionals, and how regulatory and peer-reviews affects patient outcomes and consumer trust.0602a71

Pascal Lardier: You’re an entrepreneur, a surgeon, and a digital health early adopter.  How do you use the new technologies in your everyday life and where do you see the biggest opportunities for fellow health care professionals?

Richard Brady: Well, most quality journals, medical societies and organizations provide apps and updates of interesting research, guidelines or articles and the quality of online video-sharing and educational sites has increased massively in recent years.

There are a couple of apps that I have come across in my spare time.  One of them is TouchSurgery, which allows trainees to practice surgical procedures in an app format either on your smart-phone or tablet. The Figure 1 app is also an interesting app. This is a global medical photo-sharing app used by medics  to comment on problematic diseases or cases.  Essentially, this facilitates “crowdsourcing of diagnoses” from a large, diverse and international population.

As to the opportunities that exist, well, we have an amazing chance to revolutionise the way we currently interact with our peers, students and patients. The immediacy, quality and efficiency of mobile technology and apps provides the potential to really improve what we offer,  allowing patient empowerment and transforming the management of many chronic conditions. Efficient and universal electronic medical records could combine information gained from patient wearables, implantables and diaries with traditional medical data to provide much fuller, informed and bespoke treatments and service to our patients – stored throughout our life on a cloud. Integration with massive analytical capacity, such as IBM Watson, could detect new pathways, predictors of disease and provide, in conjunction with data from personal genetic analysis, bespoke treatments for cancer and other conditions – it’s all very exciting. Healthcare workers are the key to spotting the opportunities on the front line and I would encourage them to continue to grasp the opportunities that innovation can provide in this area.

PL: You also have extensive experience in designing, building and delivering online solutions for medical professionals.  How can we get more health care professionals to adopt these new technologies?

RB: At the present time we have a real issue within the field of medical apps.  There are more than a 150,000 medical apps available and half of those apps have been downloaded less than 500 times.  The stakeholders in the app development industry need to do better to avoid the real risk that trust in the whole sector does not become undermined.

We can do that by increasing information and education to frontline physicians and getting them engaged in the design, testing and production of apps. There are really two barriers.  The first is trust and providence.  We really some kind of reputable signal that apps safe, tested and effective. The establishment of a trusted peer-reviewed repository for apps, with clarity around the origin, testing and effect of those apps would provide a lot of reassurance.

The second major issue is that of lack of evidence of effect.  We have, to date, been very bad in producing high quality research to confirm the clinical and cost effectiveness of apps.  We need to prove that patients are compliant with apps and benefit. At present the evidence is conflicting at best and weak generally.

I think the producers, developers, app stores and physicians need to get together in order to make this technology more attractive for frontline clinicians and patients to engage with.

PL: Can you give an example of when an app or digital solution could be unsafe for patients?

RB: Yes. Examples emerge on a weekly basis, but recently my team analyzed apps which assist doctors in the conversion of one type of opioid to another. Of 21 apps analysed, half of the apps had no medical involvement and half of them had no medical source of information declared.  In addition, the variation of the conversion dose supplied by those different apps for the same drug could be as high as 16 times difference. Again, Melanoma is a prognostically time-sensitive skin cancer and therefore it is imperative to treat it early in order to allow the patient to achieve the best outcome. Unfortunately, some of the apps that claimed to detect melanoma, have failed to do so and give the wrong medical advice delaying patients presenting to medical professionals for advice and treatment. This is outrageous and the danger is the wider effect these stories have on patient and doctor trust in the whole field of medical apps  – which can be undermined and increase resistance to engagement. I am sure responsibility for these types of errors will be clarified in the courts in due course.

PL: So, to make sure that these apps are safe and accurate, you’re describing that a consortium should be in charge of that consortium of physicians, apps developers, other health professionals, but who should lead that charge in your view?

RB: Well, given the tsunami of medical apps that we currently face, establishing those which are quality and those which are dangerous or unreliable, is now a really major challenge, I see a multi-partner approach, specifically targeting medical apps. It’s not for the app stores to regulate health apps.  They do not have the clinical expertise or knowledge to do that but they can certainly do much better by accurately classifying apps on their stores and improving the “labeling “ with the rapid removal and sanctioning of developers that produce dangerous or bad apps.

The regulators obviously have an important role in preventing, detecting and dealing with harmful apps and whilst we don’t want to inhibit creativity, we do need an effective police force to weed these out and sanction those responsible. The ultimate responsibility for any doctor who is prescribing apps is with the doctor themselves. They must be very clear that the app is safe, tested and appropriate and from a trusted source or peer-reviewed sites. Patients also have a responsibility to speak and involve their medical professional in order to get information on how appropriate an app is for their treatment and if that app is intended to change or interfere with their current treatment in any way.

PL: You’re very involved in medical training.  Can you talk a little bit about that and how you’re using technologies in that area?

RB: Most surgeons are involved and enthusiastic about training the next generation. With the development of new mobile technologies and social media, we can access high quality educational materials whenever and wherever we want. Gone are the days when I used to crouch over a massive volume of pages with a highlighter. We can also now keep and update a life-long learning record and overturn the traditional models of pay-per-access learning as twitter repositories of high quality, creative and interesting medical education collect around educational hashtags.

There are increasing numbers and varieties of ways in which to educate (including gamification apps) but also the supportive, online communities which have built up in many social media platforms making it fun to learn. The visual technology offered by wearables such as google glass provided previously inaccessible and fantastic surgeons views intra-operatively  -aiding the understanding and teaching of surgery.

PL: You’re going to be giving a keynote presentation at Health 2.0 Europe in Barcelona on May 18th through the 20th.  What are you most excited about and can you give us a teaser of your presentation? 

RB: I’m most excited about meeting early startups and listening to new solutions to the current challenges that we face in medicine, especially in surgery. The line up of speakers is truly international and from key opinion makers in the industry, I’ll be interested in their message.  In terms of my keynote, I’ll be speaking about mhealth apps and the potential pitfalls for developers. The talk will introduce the seven deadly sins of app development and will demonstrate the complexities of establishing a safe mobile health environment for the future.

Richard Brady will be keynoting during Health 2.0 Europe 2015 on Tuesday, May 19th.

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