How digital health takes away patients’ boundaries

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Fiona Laing looks at how innovation is transforming rural healthcare

In modern life there are few areas that have seen more of a transformation through technology than healthcare. From help alarms to helicopter rescues, technology has changed our lives and nowhere more so than in the Highlands and Islands.

CorporateHealth's pill camera is swallowed by the patient. Picture: CorporateHealth

CorporateHealth's pill camera is swallowed by the patient. Picture: CorporateHealth

“With almost 100,000 people on 93 inhabited islands, digital health is not just about phones in an emergency or retrieval by helicopter,” says James Cameron, head of health and life sciences at Highlands and Islands Enterprise (HIE).

“When we think of digital health, it’s about projects and services that are being delivered in remote and rural communities.”

The projects and services Cameron is talking about are pretty remarkable, such as the one that uses a camera in a pill swallowed by a patient at home instead of going to hospital for an endoscopy. CorporateHealth International’s capsule endoscopy is currently being used in Broadford and Ullapool.

Then there are the businesses across the Highlands and Islands developing new health products which are having an impact further afield.

Here, Cameron points to the creation by Sitekit in Portree of a digital Redbook to track children’s health and development which has been clinically validated by the Royal College of Paediatrics & Child Health and is already being rolled out to parents in London.

HIE has a key role in nurturing these innovations. “We highlight the opportunities in the sector for businesses and then connect them to the wider innovation ecosytem or NHS health market.

“As an organisation, HIE has been around for 50 years and we have always been involved in supporting innovation across all sectors,” Cameron adds.

Now there is a very clear commercial focus on helping companies engage with the health and social care avenues.

This is made possible by HIE’s close relationship with the Scottish Innovation Centres, Innovate UK and the NHS.

In addition, established life sciences companies such as BASF Pharma at Callanish, Sitekit on Skye, ESPL on Shetland and marine-focused companies in Oban, together with the growth of Inverness Campus, make the HIE area an attractive location to other companies in the sector.

Development of the campus is being led by HIE and there is already a strong research and development (R&D) presence, with academics and companies there working in digital health technology, disease management and animal health.

The Scottish Government has awarded Life Sciences Enterprise Area Status to the campus and it has two dedicated buildings for life sciences businesses.

It is home to the University of the Highlands and Islands (UHI), the Centre for Health Science, Inverness College UHI and Scotland’s Rural College.

It is adjacent to LifeScan Scotland, as well as Raigmore Hospital. One of its recent tenants is CorporateHealth International, the Danish company which is running the capsule endoscopy project.

At its base on the campus, CorporateHealth is setting up a £5.7 million diagnostics centre which will create 30 jobs over three years. HIE is supporting the company with investment of £600,000.

The decision to create a UK base in Inverness dates back to company founder Dr Cornelius Glismann hearing Professor George Crooks [chief executive of the Digital Health & Care Institute] address a conference in Düsseldorf, about NHS 24.

“I was very impressed by the vision that every patient gets the access they need at the right time. I showed him the camera pill…” and the rest is history.

“In Denmark, like in the Netherlands and UK, national screening programmes for colon cancer are generating so many patients who show possible signs of cancer and need a colonoscopy to analyse their symptoms further,” says Glismann.

“We use a camera capsule which is swallowed like a vitamin pill. It films everything going through the system in about six to eight hours and then you just flush it away.

“The video is sent to a recorder worn by the patient, uploaded and transferred via our secure platforms to be evaluated by our physicians and nurses.

“Then the results are sent back to Raigmore Hospital and they use them to determine what the final diagnosis is and send it back to the GP.”

For now, the analysis is being done in Hamburg, but ultimately that will be done in Inverness.

Glismann admits that it is the application of the technology which is innovative. “The new thing is that we have built the whole process around how you run this from end to end.

“Even in a remote setting – a patient’s home – we can give support to the patient, as well as to a nurse practitioner or GP.

“All of a sudden the secondary care expert procedure is available in a primary care setting.”

Glismann has been impressed by the support he has had in Scotland. “HIE has been guiding us through the processes involved in becoming a provider to the NHS, setting up our pilots, getting the company registered in the UK, as well as the financial support,” he says.

CorporateHealth is not the only company getting the HIE treatment. “Another important part of HIE’s focus has been the Pathfinder initiative, which has supported companies over the last years,” says Cameron.

“Pathfinder is one of the many HIE company support programmes designed to help innovative life sciences and technology companies achieve their growth ambitions.”

Scientific developments

Life sciences companies in the Highlands and Islands include:

Sitekit, Portree, Skye

Sitekit is working on projects that help individuals and health authorities engage with digital services that are trusted and secure. Its personal health record platform allows patients to share data collected and stored in an app with their GP or carer – allowing others to keep an eye on the patient’s self-reported data remotely. Meanwhile ERedbook is the digital version of the Personal Child Health Record, or “Redbook”, given to all new parents in the UK to manage the health and development of their child.

BASF Pharma, Lewis

BASF Pharma (Callanish) produces highly purified omega 3 rich fatty acids. Using patented processing technology and sustainable oil supplies, the products are used in pharmaceutical and dietary supplements, most of which are exported around the world. It has been operating for more than 20 years as a dedicated lipid development plant and can deliver commercial quantities of fatty acids in a variety of forms. The company is a subsidiary of the BASF Group, the world’s largest diversified chemical company.

OpenBrolly, Elgin

OpenBrolly’s digital health projects include work with the NHS, Macmillan, Highland Hospice and CorporateHealth. OpenBrolly ROC (Remote Outpatient Care) is an app which allows patients to keep a diary of their symptoms, and shares that data with clinicians so they can track changes and anomalies to ensure patients are getting help when they need it most. Current variants in use include My Cancer Portal, IBD ROC, Virtual Hospice and Mental Health Connect.

ESPL Regulatory Consulting, Vidlin, Shetland

ESPL Regulatory Consulting provides the pharmaceutical industry with a European regulatory affairs consultancy, training and procedural and submission support. Clients are supported by a multidisciplinary team at each phase of any regulatory procedure, from product development, clinical trials or device testing to regulatory affairs and compliance.

Aseptium, Inverness Campus

Aseptium is an R&D and manufacturing company specialising in infection control technologies that make reusable surgical instruments and healthcare environments safe. Aseptium, which also develops and delivers training on medical device decontamination and infection control, recently hired two graduates through HIE’s graduate placement programme.

Business accelerator

The Pathfinder Accelerator provides an intensive programme designed to equip early stage companies and entrepreneurs working in life sciences and technology with skills to develop an evidence-based business model. Designed and delivered by HIE, it offers further coaching and mentoring support.

One company which successfully completed the Pathfinder programme is MIME Technologies, a spin out from Aberdeen University.

The initiative it took to Pathfinder is called MIME (Managing Information in Medical Emergencies) which uses digital real-time wireless technologies to support the first person on the scene in a medical emergency – community first responders, Red Cross volunteers or GPs who don’t often deal with emergencies. Keen to take the product to market, the academics at Aberdeen University’s Centre for Rural Health turned to Pathfinder for support.

“It helped us change our mindset and break away from traditional academic research to address the practical applications of the idea from an end-user perspective,” says Dr Alasdair Mort, MIME’s chief executive.