An interview with: Dr Naveed Iqbal of Tritone Health
We recently caught up with Dr Naveed Iqbal to hear how he’s using digital tools to bring healthcare greater accessibility and support to people with learning disabilities and autism.
To start the conversation, please can you tell us more about yourself and your journey?
Naveed: I'm a GP from Lancashire.
For the last 10 years, I worked in the humanitarian sector where we used to set up primary care clinics in refugee camps. One of our key objectives was working on prevention. As well as treating sick patients, we used to teach about hand washing, breastfeeding, immunisations, and so on, to see how we could prevent disease.
While working as a GP, I had a special interest in looking after people with learning disabilities and autism. Sadly, they die roughly 20 years earlier than the average population and at least half of their deaths are preventable.
And what was frustrating, was the fact that there was a huge digital revolution taking place with virtual wards and tele consultations… But I asked, “What about people with learning disabilities? They’re going to be left behind, again”.
“Studies have shown that disabled people, in general, are 35% more likely to be digitally excluded. ”
Studies have shown that disabled people, in general, are 35% more likely to be digitally excluded. So, that’s when I met a software team and we banded together. We got in touch with our CCG – which is a clinical commissioning group where they control the budget – and said we’d like to build a digital solution for people with learning disabilities.
We reached out to Lancaster University who helped us with the research and we received a small sum of money. We used all our savings as well, and we said “let’s build something”. And that takes us up until about a year ago, where we started this journey.
That sounds really fast moving. It seems things happened really quickly.
Naveed: They did. They say sometimes you only need to convince one person.
It took a lot of meetings and a lot of convincing. You have really got to have passion because you’ll have a lot of setbacks – and it’s not the fault of the NHS. The NHS is a huge organisation with lots of responsibilities and priorities. You have to build your case to convince the commissioners and senior managers. It took one medical director, who was brilliant, and he said “Let’s do this.”
So, were you coming into this with no tech background? How did you find that?
Naveed: That’s right. I don’t have a tech background. I have some friends with knowledge of software and I thought, why don’t we put two and two together.
When I would do home visits or I visited people with learning disabilities, I saw them using apps like Facebook, YouTube, and playing games. I said, “We can build something for them to monitor their health at home, to encourage positive health behaviours”. I just needed somebody who is good at building apps to take a deeper dive into what kind of unique interface we need.
It’s been a steep learning curve.
You have got that inside lens from a healthcare perspective, but tech is a whole other ballgame isn’t it?
Naveed: It is. But, I think, you’ve got to understand the problem first and that was the advantage. You have to know what the problems are..
For example, I also work with the NHS England’s Learning Disability groups and every year, we will keep producing the same reports such as: autistic people are nine times more likely to die from suicide. And what are we doing about it? There are some amazing initiatives out there.
“I said “why don’t we explore the digital solutions?” because these people are going to be left behind.”
I said “why don’t we explore the digital solutions?” because these people are going to be left behind.
So, it was learning to understand the problem and then working backwards to see how we can get a digital solution to help.
How do you feel that the digital solution will help people with learning disabilities?
Naveed: We want to work on prevention. We already know that they’re using apps at the moment and some of them even use FitBits. The power of digital technology means we will be able to extract data about their mental health, their social well-being, and so on.
That rich data can be used by GPs, nurses, and healthcare providers to provide more personalised care. They struggle to get GP surgery appointments anyway. It’s a scramble. But when they do get there, we focus on one issue and we don’t really know more about that person’s life.
The power of digital tech is that through a tap of a button at home, data such as mental health, what they do today at home, sleep quality etc.. it can be fed into a doctor’s room through our dashboard to give more information about that individual.
Digital technology can capture all of this information within microseconds.
So, all of that data will make it easier for them to get the support that they need.
Naveed: Yeah, absolutely. Data/information has power. When we have all that information as clinicians, you can imagine how we could use that to improve lives. What we’re trying to do is to empower caregivers, families, and individuals with learning disabilities.
For example, people with learning disabilities have health passports. But they’re on pieces of paper and they’re often out of date. We’re going to digitise them so they can be kept up to date and that person can take them wherever they are, if they go to an emergency department, for example, because people with mild learning disabilities are more likely to go to A&E than see primary care doctors.
It lets them show any doctor: This is who I am, this is all about me so that we can reduce that diagnostic overshadowing.
How’s development going so far?
Naveed: That’s a whole other conversation! We’re calling it the Medii Solution. So, there’s the app and there’s going to be a dashboard that will sit in hospitals and GP surgeries that the doctors can log on to.
Because the NHS, as an enterprise, is a huge organisation and things take a while. We, as a small team, can plan as much as possible but ultimately you’re relying on several different committees higher up, interviews and panels et cetera. It has to go through the digital and governance committees. But we’re getting there now.
The traction is there.
We’re going to be approaching almost 50 percent of the NHS health boards across England by December 2023. I’ve just got back from Northern Ireland where there was interest and we’re also having meetings in America with healthcare providers about launching our software.
Things are moving fast but you go with the pace of the enterprise.
How does your digital solution overcome the challenges of how tech impacts people with autism and learning disabilities?
Naveed: We have a lot of focus groups with individuals with learning disabilities. We’ve worked with a charity called Spring Into Action based in Accrington to do this. Every time we launch a new screen or feature in the app, we test it with our user group and do lots of research.
As Richard Branson often says: “you’ve got to get it out there”. So, that’s what we’re doing by introducing it in different regions.
We have to build it together. When introducing a new font, a new screen, new colour, we test it with our focus group. You have to build it together because we make a lot of assumptions as doctors and medical professionals. We say “yes, this will be fine for the individual” but when you actually put it in front of them, it’s quite remarkable.
“If they’re not going to use it or engage with it, we’ve failed. So, we have to make sure that there’s user engagement by co-producing. ”
If they’re not going to use it or engage with it, we’ve failed. So, we have to make sure that there’s user engagement by co-producing.
Even now, I’m still waiting for more feedback from the rest of England when the app goes out because there’s cultural differences within communities. So, we’ll be getting that feedback to see how else we can tweak it for improvement. That’s key. You’ve got to be flexible and iterate.
You’ve just got back from the US where you visited various different clinics. Any learnings from your time over there that you think can shape the UK’s approach to health and how we support people with learning disabilities?
Naveed: One thing I learned is that the health inequalities are the same. And that was not really surprising. But if you look at the different health markets, you might think there would be a difference but there isn’t. The same health inequalities and the same difficulty in getting access to care, and diagnostic overshadowing, exist.
Interestingly, what I did learn that we can bring back to the UK is their collaborative approach. You have doctors, nurses, patients, charities, all sorts coming together and forming a powerful coalition.
In the UK, we seem to work in silos. You’ve got the GPs on one side. You’ve got hospital consultants on the other then you’ve got your charities and the individuals, the self-advocacy groups. We kind of talk to each other but not directly and I feel that’s what we need.
We need a national coalition and then that way, we’ll make much faster progress. That’s one positive thing I learned from the US.
That sounds really valuable.
Naveed: Yeah, it is. For example, data is in silos. Your information will be siloed within a GP surgery, which is good for confidentiality reasons, but how can we make that information available to different people like social workers, social prescribers, all coming onto the same platform to find out what’s happening with the individual’s life. I feel that is going to be the next stage.
And that’s what we’re trying to achieve with our platform where different teams can all log on to the same individual’s life.
What motivated your decision to focus on people with learning disabilities?
Naveed: Throughout my life, I’ve always focused on the ones who are left on the sidelines. Those who are left out in society, which is why I worked in the humanitarian sector. These were the forgotten people.
A refugee once said to me “we were killed twice. Once by the war and the second by the silence of the world”. Giving a voice to the voiceless is something that’s always been in me and here in the UK, I often found, it’s the people with learning disabilities and autism who suffer on their own. They leave this world early but what have we done? It’s like patchwork, there’s a sticking plaster… I might have given that person an antibiotic or painkiller but have I really improved that person’s life?
“I think we’re building a movement and I welcome that challenge.”
I think we’re building a movement and I welcome that challenge.
It’s as if, at the moment, it’s a box ticking exercise.
Naveed: You’ve hit a very important point there – ticking boxes. The NHS requirement is that 75% of people with learning disabilities should have an annual health check. That’s a box-ticking exercise. We want to look at the quality of that annual health check because research has shown that it does improve lives and reduce suffering.
Digital also has the temptation to tick boxes.
However, the more rich the data is, we can start introducing quality and shaping that human being rather than just looking at a few statistics.
Do you have any words of wisdom you want to share with people who want to get into the health tech space?
Naveed: If you are really passionate about the problem that you’re trying to solve you will eventually find the right people.
If you’ve got that perseverance, as long as you’re the expert in your subject and you know exactly what the problem is, the software can always come later.
Build coalitions too. Build local teams, attend events and build trust.
It’s difficult. I’ll be honest with you, it is very difficult. We’ve gone through lots of different processes of building the right team. Now, we’re there but it’s been a long road so be ready for that too.
There are software developers who really want to know what problem you’re trying to solve and the long-term prospects. They’re the best conversations to have because they’re the ones who really want to work alongside you.
I’ll be honest, it adds more pressure. These people are relying on you. But it energises you that other people are joining your mission.
Finally, is there anything else you want to say to Lancashire’s tech community?
Naveed: It was an absolute relief to find Lancashire Digital Hub. There are some really good people there. I work in East Lancashire and the tech scene is not as big as the West side of Lancashire.
Lancashire as a whole would do a lot better if there were more investment companies and more capital coming in from that point of view.
If we have the investment, we can become the Silicon Valley of England. It’s easier living, it’s more relaxed… and that’s how it is in California with that rural environment away from San Francisco. We can really flourish here if we get the investment.
We had a meeting with the second largest healthcare system in the world a few days ago and we’re just a small team in Lancashire. But we had to go for private funding because there wasn’t much Government help. We definitely need more accelerators and financial investment in those small companies that show promise.
There’s lots of people who want to help with business plans, marketing, branding, et cetera, but we want to build. If we can get that seed funding it would unleash a whole new set of potential in the North West.
Unleashing the powers of health tech
Dr Naveed Iqbal is on a journey to revolutionise the healthcare industry and how we use digital technology to provide better care, especially for those with learning disabilities and autism. Learn more about Tritone Health and the work they are doing through their Medii Solution.
If you want to hear more about Dr Naveed’s journey, catch him at this month’s Digital Tech Talk on Wednesday 21st June at Stanley FC Stadium in Accrington. Get your free tickets and just us for an incredible evening with local digital and tech enthusiasts.
As Dr Naveed mentioned, investment in Lancashire is especially important. We are proud to announce the FHundED Investment Ecosystem launch. In collaboration with Northern Reach, this event aims to bring together investors, founders, and business support from across the North West to network in an environment that accelerates tech innovation and growth. Find out more about the FHundED Investment Ecosystem Launch event and get your free tickets here.