30-31 - Smart People: Dr Nick West

What is your current role and what does your day-to-day job involve?
I started as chief medical officer and divisional vice president of Global Medical Affairs within the Vascular division at Abbott in October 2019 after 20 years as a practising interventional cardiologist in the NHS. My day-to-day job is varied despite the pandemic and allows me to help shape our medical and scientific strategy as well as liaising with peers and colleagues around the world. The first months in the job involved a lot of travel to better understand the needs of our global customers and their patients, which is obviously no longer the case – but even now I can be in the Far East in the morning, Europe after that and finish up in the US in the afternoon/evening – even if only virtually!

Why the interest in vascular disease?
Although I come from a family of doctors, I chose to specialise in cardiovascular disease as it seemed to me to be an area that allowed physicians to make a tangible difference to patient care. I started on this path in the era of the cardiovascular megatrials and ended up subspecialising in coronary intervention just as primary angioplasty for acute myocardial infarction became the norm. One of the principal drivers for this career choice was my grandfather, who was a traditional general practitioner in the pre-NHS era; he sustained his first coronary event in the 1970s, received little if anything in the way of aftercare and died shortly thereafter from a second, fatal heart attack. Things have moved on substantially since then, but we can strive to do better still. My journey led me to Abbott because the company is truly committed to innovation in the vascular space that is focused on improving patient outcomes.

What prompted the Going Beyond Intervention white paper?
Within the healthcare industry, new technologies and opportunities for data-driven insights are being developed and adopted at unprecedented speed. As such, we wanted the Beyond Intervention white paper to address the key question of how we should adopt such technologies to best improve patient care?
It’s important to remember that cardiovascular diseases (CVD) remain the leading cause of death worldwide, claiming around 18 million lives annually and with an ageing global population, the burden of CVD will continue to grow. At the same time, today’s healthcare systems have never been more challenged: the fragmentation of teams and communications, economic challenges and disjointed data streams across the care continuum have resulted in care providers feeling overwhelmed and patients who don’t believe that their unique conditions are fully understood. With these facts in mind, we felt it was paramount to understand what ‘personalised’ healthcare should look like from a vascular patient’s perspective, alongside how technology could help to remove the barriers to optimal tailored care.

To address these questions, we interviewed more than 1,400 patients, physicians and administrators across nine countries to harness insights across global healthcare systems and identify how to unlock innovation in healthcare. Our ultimate goal is to help the healthcare industry better understand the views of these groups, so that we can support them in making improvements that result in better care for patients.

Can you outline the key findings?
Our white paper clearly demonstrates the importance of all health-care stakeholders taking a view of the whole patient, going beyond any single point of contact with healthcare provision to ‘connect the dots’ across the entire vascular care continuum and ensure a holistic view of the individual patient and his or her specific issues.

The research highlights that the full potential of technology is blunted by persistent gaps across the healthcare system: patient respondents in our survey described ‘a lack of data on patients similar to ourselves’, and feel that their doctors are failing to leverage rapidly evolving technologies effectively enough to communicate and share data with other healthcare specialists. As such, data-driven insights are failing to deliver the kind of personalised care that could be attainable.

Additionally, and perhaps unsurprisingly, patients want more time with their doctors, who in turn also feel that their direct patient care time is limited. Meanwhile, administrators acknowledge the potential power of novel diagnostic tools to make early accurate diagnoses and streamline care pathways. The recognition of the role of wearables and remote telemedicine tools for future healthcare is universal, along with an understanding that this field has been substantially accelerated by the current global pandemic.

Were there any surprises?
The most surprising thing to me was that, despite the overwhelming majority of patients acknowledging that data sharing was beneficial for their own tailored care and for others in the future, almost a quarter stated that they did not want their information shared. This demonstrates that trust, particularly when it comes to data stewardship, remains a significant hurdle for doctors and healthcare systems to overcome.

What are the main barriers to uptake of innovative technology in the UK’s healthcare system?
Outside of our research, the Topol Review has highlighted for the UK to adopt a more digitalised healthcare system it would require a significant cultural shift. At the time of publication, the review stated that there could be a five-to-seven-year time lag before the UK fully embraces digital healthcare. A similar report published by the National Audit Office found that NHS organisations face ‘significant challenges’ when it comes to digital transformation. These challenges include outdated IT systems that do not connect to other systems, alongside competing demands on their resources. Although our research identified uptake of innovative technology as the key to overcoming perceived data gaps and enabling personalised care, the issues raised in these reports could provide another barrier.

Although the rise in popularity of fitness trackers and smartwatches has meant that health data can now be found in realms outside of the NHS sector, the ability to use and leverage such data in driving tailored therapies and treatment plans is key, and the wariness amongst consumers and patients around data protection will be a barrier to overcome.

How can these be addressed?
As a result of the COVID-19 pandemic, we have already seen a drastic shift globally towards telemedicine technologies, dramatically increasing patients’ access to tailored medical advice based on personal data. My colleague and digital health futurist Maneesh Juneja reflected on this in our white paper, explaining that the pandemic has ‘accelerated a shift toward new models of care that had already begun’. He added that now is the time to think beyond standard telemedicine by asking: ‘What sensors do patients need in their own home? How do we enable consistent care to be provided across modalities, whether it is from a human doctor, a chatbot or a smart speaker?’.
Harnessing new technologies and their derived data to see the whole patient – and to connect the dots across the care continuum before, during and after any intervention – is essential for precision healthcare. Such efforts should be both supported by, and result in, a greater focus on wellness and prevention, which in time has the potential to lighten the burden on providers and to deliver a higher quality of life for patients at a lower cost.

What are your hopes for the future with regard to improving treatment outcomes for patients?
Placing patients back at the centre of the care equation is a must – this can become a reality by utilising data-driven technologies – and with the whole healthcare ecosystem collaborating in novel and imaginative ways to make this happen. This kind of future will require us to depart from past modes of both thought and activity, and in this regard, our white paper is just the start: it’s critical that physicians, administrators and all other stakeholders can come together so that personalised patient experiences, improved efficiencies and high quality healthcare can become the default rather than the exception.

What keeps you awake at night?
At the moment, and as my first answer alluded to: my job! I’ve been in the UK since the pandemic effectively locked travel down – and have been working US West Coast hours from here, which usually entails a slightly skewed day. Other than that, the usual: how and when Spurs’ league form will improve, whether I’ll ever get to see live music again – and when I’ll be able to order a pint in the pub…

SMART PEOPLE:Dr Nick West

SMART PEOPLE:
Dr Nick West