How a healthcare app is breaking down barriers for better access

Access to healthcare is often cited as a universal right but as costs increase exponentially, that access becomes increasingly limited.

The global cost of healthcare is expected to increase by 5.4 per cent every year between 2017-22 from $7.7 trillion (£5.9 trillion) to $10 trillion with a similar pattern developing in the UK.

In 2000, UK healthcare spending was around £50bn but by March this year, that spend had more than tripled to £153bn. This is the result of successive governments throwing money at structural issues within the NHS compounded by the ever-rising cost of treatment.

But it seems to be dawning on the government that at least part of the solution is to be found in technology, with health secretary Matt Hancock predicting that tech in all its forms will become a “routine, everyday part of healthcare”.

His comments come amid an explosion of health-focused apps with an estimated 300,000 in current use and another 200 appearing every day.

One such tool, claiming to be the world’s most rated medical app, is German-based Ada Health. A strictly diagnostic tool, Ada works like a chatbot, asking users a series of diagnostic questions before suggesting what the condition might be and offering recommendations as to whether to seek medical support or not.

Although very much consumer-facing, Ada started life back in 2015/16 as a support tool for the medical community.

“One of the challenges [for health systems] is the time pressure and the administrative burden doctors are under,” says Ada co-founder and CEO, Daniel Nathrath.

And it was this issue that Ada was developed to address. Following five years of research and development, Ada was tested with more than 1,000 doctors in the UK and Germany and, despite Nathrath’s fears of pushback from doctors, the feedback was positive.

Indeed, the head of one specialist neurology university hospital told Nathrath that a new doctor entering his hospital would have needed six months of experience to get to the diagnostic level that the app provided.

“Their feedback was that it allowed them to make a better diagnosis, but they didn’t have the time to input all the information. So, we thought we’d use the patient as the import source,” he explains.

And by “import source”, he means inviting users to go through the diagnosis process themselves.

“Now we want to connect the two versions. The patient uses the Ada app at home and that is shared with the doctor, so the doctor doesn’t start the consultation with a blank sheet of paper.”

In the three years since making the app available to consumers, Ada has acquired 8 million users and delivered 15 million diagnoses, the kind of growth curve any startup would kill for. Nathrath puts much of that down to human nature.

“Seven per cent of all Google searches are about health, the second-most searched subject,” he explains.

“It is just something people need. A doctor friend of mine says the most common reason people come to see him is to find out if they should see a doctor.”

It is in the app’s ability to act as a more reliable version of Dr Google that the real potential lies. Much has been made of the issue of GP and A&E waiting rooms being clogged up with unnecessary and non-critical ailments and if the testing Nathrath has done is to be relied upon, it could be part of the answer to that perennial problem.

“We conducted an experiment in a large GP practice in London, where we put Ada into the hands of 500 people in a waiting room and asked them if they’d use it again. The response was 95 per cent positive,” says Nathrath.

“And if they had had it at home, 15 per cent said that it would have been enough to stop them coming to the surgery in the first place.”

In the year up to October 2018, an estimated 307 million appointments were made with GPs in England alone. A reduction of 15 per cent could cut that number by 46 million at a stroke.

“The cost of healthcare is spiralling out of control, particularly in the US where it accounts for 20 per cent of GDP. But there is a big opportunity to improve things by making full use of digital technology. It seems a fairly obvious opportunity to create efficiencies and improve outcomes for patients,” says Nathrath.

However, he concedes that embedding such technology in large, national health programmes is not straightforward: “In large organisations, it takes time for these things to be adopted, but I think that is healthy as people should study these things closely before deciding to use them.”

But regardless, his and Ada’s attention is shifting from the development of the tech itself towards commercialisation.

“We are in 150 countries and in some of those markets we are talking to the government about bringing a solution to the entire country and some of those conversations are looking very promising,” says Nathrath.

Nathrath is adamant that there is no intention to try to replace what doctors do, instead likening Ada to a satnav for doctors. But he believes that his system can relieve some of the administrative burden medical professionals are toiling under, help unclog health systems around the world and put the public in greater control of their health.

It seems the inevitable creep of technology, which has touched so many parts of our lives, is finally making its way into the management of our health, and Ada and Nathrath are determined to be at the front of the queue.