Expert’s Corner: Healthcare Q&A with John Matheson

May 31st, 2016

What is your prediction for healthcare technology in 2016?

Technology will continue to make a sizeable impact on two broad fronts.  Firstly, most health organisations are still in the process of removing their dependency on paper records and joining silos of information. Organisations will continue to invest heavily in technology that will enable them to create a fully integrated Electronic Health Record to inform better decision making.  For example, a key component in acute care is an Electronic Prescribing System.

Secondly, citizens will continue to make greater use of mobile smart devices and apps to manage their health and wellbeing. Health organisations are beginning to “open their gates” in a managed way to exchanging information between personal devices and health service providers. 2016 will see more examples of this with suppliers of Health systems providing open APIs to manage such an exchange.

This dual-track approach is reflected in Scotland’s national eHealth Strategy.

The challenge will be for organisations to balance scarce resources between two overarching requirements.  On the one hand,  the need to ensure what is already in place is fully resilient and meets increasing demands, focusing on integrating existing systems and filling key functionality gaps to increase the efficiency of current processes.  On the other hand, the need to embrace the opportunities offered by digital technologies and be more innovative and ambitious, and commit to projects that have the potential to be transformative.

How do you see big data changing the healthcare industry?

From a broad range of digital technologies the use of “big data”, coupled with powerful data analytics, possibly has the greatest potential to bring about significant changes.  The possibilities offered for illness prevention, and diagnosis and treatment improvement from “big data” analytics are considerable.

Better informed clinicians and patients make better decisions about their health and care. Information drawn from a diverse range of sources including: citizen-provided and care provider data; research and policy/management data; and broader sources  such as genomic, environmental and socio-economic data; provides the opportunity for consistent feed-back loops ensuring that each decision is informed by the outcomes from earlier actions at any level.  The term “a learning health and care system” has been coined to describe this improvement process.

We have a wealth of information held in digital form in Scotland – possibly the most extensive in the world for some conditions – and with appropriate safeguards on confidentiality we are applying natural language processing and big data analytics to provide insights that were previously beyond us. 

Is the healthcare system ready for personalized medicine and patient-centred care?

Any healthcare professional will state that they endeavour to provide a person-centred approach on every occasion.  But in relation to technology enabled personalised care the answer to this probably both “yes and no”. “Yes” in respect that there are already many good examples around specific conditions where tailored technology enabled care services have been introduced that have improved the outcomes for individuals. However, these tend to be localised and have proven difficult to implement at scale or to apply to other conditions.  Health and care services are generally built around an aim of minimising variation and adopting a consistent approach.  That ethos is often in conflict with made-to-measure approaches to an individual’s needs.

Scotland has achieved some Technology Enabled Care successes with cohorts of individuals with specific conditions such as diabetes and COPD, but the challenge is to scale-up these and make them an integral part of the patient treatment pathway rather than an addition.

Scotland has long recognised the benefits that can be achieved through personalized medicines and has been at the forefront of research into a number of illnesses for many years (eg cancer), and the results of research have fed their way through to treatment approaches. Scotland has recently created a Stratified Medicine Innovation Centre. Its objective is to build up an understanding of the ‘strata’ of responses and the genetics of diseases to enable medical researchers to create more personalised and effective forms of treatment for the individuals and groups of patients that are most likely to benefit.

What are you most looking forward to at the 16th Annual Healthcare Summit? 

The opportunity to share the work being undertaken in Scotland together with networking with conference colleagues to learn from best practice in Canada.

John Matheson - Director of Health Finance, eHealth and Analytics, Scottish Government

John Matheson was Director of Finance, eHealth and Analytics within the Scottish Government Health & Social Care Directorates (SGHD) (£13bn budget) from July 2008 until his retiral in January 2016. Prior to that he was Director of Finance within NHS Lothian for 20 years. He was awarded the prestigious title of Finance Director of the […]

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