Innovation for sustainable healthcare.

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Feebris co-founder Adam Bacon had a fireside chat at this year's International Virtual Medical Conference (IVMC). MedAll launched the IVMC last year in a bid to democratise access to high-quality healthcare training and tools for every healthcare professional. Read a summary of the topics that were discussed below as part of this year's theme of 'Sustainable Healthcare'.

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Sustainability in healthcare is essential if we want to ensure that access to healthcare is democratised and that patients get the right care, at the right time and in the right setting. Health systems both in the UK and internationally are facing severe operational and financial pressures, which have only been exacerbated by the pandemic. Globally, it’s estimated that there is a shortage of seven million doctors. As such, it has never been more important to manage our resources carefully.

Sustaining our healthcare system requires re-examining the delivery of care towards more proactive, community-based solutions. These solutions therefore need to focus on optimising the care of the patient in the community and avoiding unnecessary hospital admissions. Innovations in health technology such as virtual consultations, remote monitoring and wearables can augment healthcare and are delivering great value to both patients and the workforce. Critical to this is ensuring the sustainability of these solutions; that is, ensuring they extend beyond simply designing or implementing a new product.

At Feebris, we believe that no one should be suffering from treatable conditions simply because they cannot access a doctor. Our mobile application connects with a range of third-party point-of-care devices (such as digital stethoscopes and pulse oximeters) that are available off the shelf. Our system uses signal processing algorithms to extract important clinical insights from these devices. In turn, these are analysed by our machine learning algorithms to triage patients, detect deterioration stratify conditions, and highlight diagnostic indicators. Our technology integrates with local providers so patients can rapidly access works with local supply-chains in a platform-agnostic manner to deliver essential services and treatments in the community.

We take pride in the usability and intuitiveness of our software, which is centrally important in making sure that digital health solutions are routinised and sustained, particularly in areas with limited health and digital literacy. Take an IKEA manual as an example. Anyone in any country, regardless of language can understand the images and build furniture. Or a smartphone. Anyone can pick one up and use hand gestures to communicate across the globe. When we started Feebris, we asked: why can’t healthcare be like this and serve everyone regardless of location or income status? Now, minimally trained healthcare workers using our platform can be trained within an hour, with check-ups taking place in under ten minutes. Our vision is becoming a reality.

We are especially proud of our work in populations as diverse as the slums of rural Mumbai, to elderly care home residents in East London. In India, vast swathes of healthcare workers are deeply integrated within their communities and are working tirelessly to improve the health of their local populations. These healthcare workers, many of whom have limited diagnostic or clinical training, are tasked with helping patients navigate the minefield that is the informal primary healthcare system. Primary care physicians are rarely situated in rural villages and sprawling urban slum communities, operating instead in clinics in larger cities that are prohibitively expensive and difficult to get to.

Our work in rural India has helped to deliver care to more than 6000 children, and the combination of our algorithm with light, portable hardware has helped to provide spot-check ups and triage patients to determine the need for further specialist input. 86% of our check-ups have led to treatment initiated locally, saving patients on average 600 Indian rupees, in many cases representing more than 10% of the family’s monthly income.

In the UK, through our partnership with BHR CCGs & Care City, we introduced our technology to thirteen care homes in Barking & Dagenham, Havering and Redbridge. We were also awarded funding under the TechForce19 challenge, enabling us to expand our technology across a further ten care homes in East London. As we look to provide even more care in the community and at the hands of our immensely valuable care workforce, patients and carers alike have expressed high levels of trust, confidence and satisfaction in using Feebris to optimise their care. The result has been fewer hospital visits and hospital admissions, as well as increased quality of data transfer between the health and care sectors. This is particularly important given the growth of virtual consultations, as it means GPs are armed with the most up-to-date vital signs and observations in advance of consultations.

Proactive community healthcare is still in an embryonic stage globally. There are lessons to be learned from countries with less developed primary care communities such as India, who are perhaps able to leapfrog the brick-and-mortar stage and directly adopt digital health solutions at pace and scale.

The most important factor in ensuring digital health solutions are scalable and sustainable is ethical and regulatory oversight. At Feebris, our objective is to help non-clinical users make clinical decisions. This is as much a question of culture and relies on our technology being trustworthy, validated, and reliable. Developing AI ethically and equitably is embedded within our DNA at Feebris and we see medical regulation as far more than a tick-box or an obstacle. Furthermore, we have been able to model our algorithms on varied datasets from diverse patient demographics, helping to generalise our findings across populations.

Health systems continue to face severe operational pressures and disruptions to usual service provisions. At the same time, the growth of digital health solutions offers the potential for new and innovative models of service delivery. It is now more important than ever to leverage the potential of technology to provide healthcare that is effective, equitable, and sustainable.