For more than a century, the classic image of mental health therapy has been a patient on a sofa sharing problems with a psychologist sitting on the opposite side of the room. But that scene could soon be replaced by fingers on a keyboard pouring out thoughts in a chat conversation to a therapist on the other side of the country. Psychology Online, a Cambridge-based therapy services company, is already doing just that. Backed by a clinical trial and other studies, Psychology Online began treating 100 NHS patients this year and Barnaby Perks, the company’s chief executive,expects that number to grow quickly as British hospital trusts offer more patients suffering from anxiety or depression the option of online therapy. Such patients represent nearly a third of family doctors’ workload.
Psychology Online is part of a wave of technology companies that are redefining the health industry and disrupting existing care and business models as patients, doctors, and hospitals make more efficient use of scarce resources. “It’s quite common now for data to be collected in the hospital sent elsewhere for analysis. That’s now common place because clearly it’s a more effective use of resources,” Perks says. “We’re similar to that in many ways because it’s matching supply and demand — even if the supply of expertise isn’t necessarily co-located where the demand may be.”
Mental health represents only a sliver of the health care pie, Perks says. But the impact of technology on something as delicate as the patient-therapist relationship demonstrates technology’s potential to revolutionize existing care models
In Britain, a new government-backed £180 million fund, Biomedical Catalyst, has been created to encourage small and medium-sized businesses and universities to accelerate the development of innovative solutions to health care challenges. The fund granted its’ first funding November 4, awarding £39 million to 32 projects across the country.
Technology is the main driver behind personalized medicine, defined broadly as replacing one-size-fits-all services with the right treatment for the right person at the right time. The market for personalized medical care in the United States — including telemedicine, electronic medical records and disease management services — is expected to grow to more than $100 billion by 2015, according to PriceWaterhouseCoopers. Information technology companies have only just begun to enter the space, attracted by size of the market and its growth potential.
For Psychology Online, “the right time” part of the personalized medicine equation is simple but crucial. The company’s data shows the highest demand for appointments with therapists is Monday to Thursday between 6 pm and 10 pm, but most local health services do not offer counseling after 5 pm, Perks says. Technology provides flexibility to not only rebalance the mismatch between supply and demand but also to make care accessible to people who might not have been able to seek help before.
The disruption also extends to the treatment itself. For Psychology Online, some are skeptical at first, expecting the absence of eye-contact and body language to make purely text-based therapy less effective. But Perks says the firm’s studies suggest the opposite appears to be true: people are less inhibited communicating by text.
“What is essential to therapy is understanding your thinking and how that thinking is breaking down and leading to your depression or your anxiety and correcting that breakdown,” says Perks, a scheduled speaker at Silicon Valley Comes to the UK, a conference taking place in Cambridge November 15th and 16th, 2012 “Because you can look at the transcript as you’re typing, as in any instant message relationship, you can see how the conversation has been flowing and what you said earlier, which keeps you honest and keep you to the point.” A transcript of all sessions also feeds into another health tech trend of empowering people to manage and measure their progress. Patients, and therapists, can review transcripts between sessions and see how their thinking has changed over the course of the therapy, Perks says.
But bringing ideas to the market in health can be harder than in other tech sectors, Perks says. When it comes to patient care, public healthcare authorities need hard evidence before deciding to adopt a solution. And the need for clinical trials can also make it harder for competitors to take away proven providers’ business.
Psychology Online was founded by two psychologists, Sue Wright and Nadine Field, in 2000. It transformed into the start-up it is today after a decade when the pair approached Cambridge-based biotech angel investor Dr. Andy Richards, another scheduled speaker at Silicon Valley Comes to the UK. Richards brought aboard Perks, an engineer with a background in healthcare software, along with former Glaxo executive Anne Hays and neurologist Paul Goldsmith.
“We’re in the winning hearts and minds stage at the moment,” Perks says, With its first National Health Service contract nearly concluded, the company expects to reach profitability in 2014.
Once it reaches a critical mass of UK clients, the company says it will start exporting its services to other countries, such as Germany, the U.S., Canada and Australia. “Worldwide we think the growth potential’s absolutely vast,” Perks says.
Demand for technology solutions is so strong in the health sector that London-based video chat and webinar start-up Buzzumi has found more than 90% of its business coming from health care, wellness and pharmaceutical companies, founder Daniel Marovitz says.
Buzzumi’s platform includes scheduling and payment services. It is helping an NHS trust provide live video counseling to help patients stop smoking, drink less alcohol and lose weight. Marovitz says the company is exploring how the platform can be used by nurses and doctors to diagnose and screen patients online to reduce the strain on clinics and emergency rooms. “Every country in the world has a health care crisis,” Marovitz says. “Health care costs are spiraling out of control, they need to use resources efficiently, they need to be able to deliver services efficiently and telemedicine is a way to begin that revolution.”
Research advances over the past decade are opening up new personalized care possibilities that extend down to the molecular level. Genomics, the study of our genes, along with the study of the proteins that genes create, are opening up new possibilities that promise to change the way diseases are treated and prevented.
U.S.-based DNA Guide has developed easy-to-use software to help patients manage the data in their personal genome. The software, which can be used to manage medical records and provide consent for personal DNA data to be used for medical research, won the 2011 Kaufman Award for Women in Science and Engineering Business Idea Competition for its breakthrough thinking.
Alice Rathjen, the DNA Guide’s founder anda scheduled speaker at Silicon Valley Comes to the UK, thinks Britain’s health tech sector has the potential to be a world leader in businesses based around personalized medicine.
It is an area with massive growth potential. The molecular diagnostics market is expected to grow to $7 billion in the US by 2015, from $3 billion in 2009, according to PriceWaterhouseCoopers. However, Rathjen says in the U.S., progress has been hamstrung by disagreements over how to monetize data and discoveries.
Britain’s single payer healthcare service gives the government and service providers an incentive to find and support solutions that prevent disease in the population as a whole to reduce overall national healthcare costs. In contrast, the fragmented US healthcare system’s competing interests lacks that common goal, she says. “In the UK, start-ups stand a very good chance of mobilizing patients with their raw genetic data and of patients adding whatever information they’re willing to share,” Rathjen said. “They can then set up some analytics and really getting a handle on what things are caused by … and really optimize health care delivery.” The prospect of digitizing the map of the human body — and entire patient populations — would open a floodgate of opportunities. If Britain can create the right conditions, researchers from around the world will be drawn there, she says.