The NHS has notoriously suffered budget cuts that have restricted quality patient care, and undermined the confidence of its staff. Anish, a cardiology registrar, has started a British campaign, MRImypacemaker, which is expanding to other countries, to right at least one particular aspect of the professional healthcare landscape. The young Founder is raising awareness to ensure that those with pacemakers and other implantable electronic devices have “the same access to MRI scans as everyone else”. Historically, such scans have not been offered to those with implantable cardioverter-defibrillators as the “interaction between magnetic field and the metal device component has obviously been risky.” This means a significant number of the population, “nearly half a million people in the UK, or one in 50 over 65 years” who do have implantable electronic devices have not been able to enjoy easy access to vital medical examinations that help diagnose serious inflictions such as cancer, strokes and musculoskeletal disorders. An aging population, a majority of whom are pacemaker users, are especially prone to accruing diseases over time. However, since 2008, MRI-conditional devices which use less ferro-magnetic metal, alter lead insulation, and replace MRI-vulnerable component parts e.g. reed switches, have allowed scanning to be more straightforward and safer for those with pacemakers. “It was outrageous that options were available, but many of those with pacemakers were still being denied the appropriate care. It’s a question of more training in delivering the service, dropping old practices and spreading the word of new protocol with the technology.”
Among other initiatives then, Anish’s mission with MRImypacemaker has been to “build services through education and service design” which have now been shortlisted for reputable awards in the community: the 2018 Health service journal award for improving the value of diagnostic services, and the 2018 British Medical Journal Award for Diagnostics Team of the Year. “I started the project about three years ago to test the effectiveness of the campaign. We had to bring together the necessary professionals to train and gather experience such as cardiologists, radiologists, radiographers and cardiac physiologists. We wanted to ensure technical quality.” Starting off regionally with small teams to great success, Anish later began to receive calls from locations abroad asking after training methods, equipment use and general advice: “we started getting calls from Ireland and then further abroad such as Singapore and Australia.” The team worked effectively with major developments, confidently and carefully using the newer devices now designed to be safe in MRI machines, and following the stricter protocols that allow older devices to be scanned. “This is also cost-effective,” added Anish. “The early diagnosis that results from wider spread practice reduces the cost of medical intervention, hospital admission and downstream treatment. Additionally, having individual, local teams trained up also means the indiscriminate accessibility to MRI scans can help more people quickly.” Here, Anish elaborated on the technological side of MRImypacemaker. In terms of accessibility, a digital platform has complemented the biotechnological advances in medical equipment. “Our website has had a lot of traffic, and our information pages have greatly helped patients and physicians everywhere. People want to know more, and we’ve been able to put the relevant persons in touch with each other.”
Interestingly, Anish is concurrently conducting research into 3D machine learning for his PhD, continuing to use technology to aid medical innovation: “I’m at the point in my medical studies where I can focus on a specialist area of cardiology, and I’ve enjoyed dissolving the barriers between the world of computer science, and cardiologists and physiologists. I’m developing a machine learning app to better understand how our hearts adapt to stress. Depending on your background, you will be affected differently in the areas of heart pressure or diabetes etc. Someone of a Caribbean background will have different physiological responses to someone of South Asian ancestry. We take complex images by ultrasound and MRI procedures, but don’t appreciate the depth of the information these can give us. Firstly, scanning patients with aortic stenosis and then marathon runners exercising over a period of six months, I trained up a computer to build a 3D model of the heart for better visualization. If you can identify the disease earlier, you can give a clearer prognosis faster. I’ve enjoyed working across different professional fields, combining my medical, technical and even entrepreneurial passions.”
This overlap was useful when Anish was campaigning for more support within the NHS and medical community for support for the MRImypacemaker programme. He used the positive patient feedback, facilitated by online portals, his prior experience in finance and “the clinical experience from an MSC in cost-effectiveness and biotechnology,” to garner attention from higher ups such as the royal societies to obtain the essential funding and far-reaching national endorsement. “It’s been a gradual but rewarding journey. Any great breakthrough is methodical where you chip away at the problem to uncover meaningful solutions.”
However, more than the multifarious academic aptitude, or indeed the online age, Anish passionately asserts that personal resolve has been central to his big campaign: “I’m interested in app development and have an interest in AI etc. but for me, solving the real-world problem has been the biggest driver. I wanted to simplify a logistical problem and give people the access to medical care that they deserved. From useful flowcharts for clinicians worldwide to navigate to patients emailing their thanks, the human aspect is the focus. When we were pitching, the sincerity that came of this was always the biggest appeal too.” Thus, Anish embodies an age where individuals are driving the much-needed social changes, carrying as much impact as bigger bureaucratic structures: “another great part of the campaign has been informing national policy,” he aptly finished. “Effective policy, from diagnosis procedure to discharging patients, is necessary for sustaining the cause and will take it far.” And so, MRImypacemaker works to provide sincere, democratic care as part of a more cohesive, improved future. “For me, it’s not just about being a doctor day to day, but rethinking an entire system.”
What grabs you about medicine?
At the moment, I am doing less clinical work and I miss seeing patients first-hand. My favourite part of the discipline is talking to someone after the procedure and feeling that I’ve really helped them. It’s most satisfying. Interpersonal contact and the little changes you make are everything.
What have been some highlight moments?
Honestly, gaining traction over time through the team’s resilience. We’ve made some strong relationships with medical experts and medical bodies as well as our many patients. We’ve got to know them as people. The cumulative effort has been great.
Finally, what advice would you give to others who wish to start a reformative social enterprise?
If you’ve got a good idea, you must persist. You rarely see solutions to important problems overnight. Also, choose the right way to carry it: it might be traditional or it might mean thinking outside of the box.