Pillcam: The At-Home Endoscopy

This is the fourth and final blog in a series of short articles that explore innovation in healthcare. Click here to read the first post, here to read the second, and here to read the third.

DIY endoscopies may sound like something from the future, but pill-cam technology is already allowing NHS patients to diagnose bowel cancer from the comfort of their own homes.

The pill-sized camera, which takes up to 500,000 images as it passes through the gastrointestinal tract, looks for potentially cancerous polyps – the precursor to bowel cancer. If found and treated early, bowel cancer can be fully curable. The Colon Capsule Endoscopy (CCE) is an innovative solution offering a less invasive and cost-effective alternative to traditional endoscopies.

So how does an at-home endoscopy work?

A patient will book an appointment with their GP. Shortly before it’s due to take place, a Smartbox will arrive at their house via a courier with everything needed to carry out your own endoscopy. The patient opens the lid, and on the inside is a tablet that plays an instructional video explaining how to prepare the bowel before swallowing the capsule, how to wear the belt that stores the images from the capsule, how to spot dehydration, and how to connect with the clinician. Once they’ve followed the instructions, swallowed the capsule, had the appointment with the clinician and completed the endoscopy, the patient boxes everything back up (except for the capsule, which fortunately does not need to be retrieved). The box is collected via courier, or whatever means was used for delivery – possibly even drones.

A complete endoscopy, in a box, within the comfort and safety of your own home.

NHS

However innovative the CCE may sound; the core capsule technology has been around for some time now. The United States Food and Drug Administration approved its use in 2001, allowing patients to carry out a complete endoscopy without the traditional invasive procedures.

The NHS has been generally slower in adopting new technologies, but patient-centric care is on the rise. Exacerbated by the Covid pandemic, more treatments are being offered outside of GP surgeries and hospitals than ever before.

Funding has recently been approved by the Department for Digital, Culture, Media and Sport (DCMS) to trial the delivery of the potentially game-changing CCE Smartbox in the West Midlands. This work is the precursor to a world where remote care is delivered autonomously. This will further shift us from operating a ‘National Illness Service’ – to a more proactive National Health Service, where prevention is at the heart. The NHS needs to get to a point where it is helping people manage their wellness better to prevent people from getting ill. Self-administered Colon Capsule Endoscopy is a step towards this.

With CCE, we have the chance to eradicate bowel cancer. But this will only happen if we can deliver it at scale, and to do this we need to be administering care efficiently within the community.

In partnership with the NHS, SMEs have created Artificial Intelligence (AI) to analyse the images taken by the capsule. It’s estimated that around 20% of polyps are missed by clinicians. This is through no fault of the clinician – it’s due to the limited cognitive resources of the human brain. AI simply picks up the slack, strengthening the procedure by ensuring no polyps go unnoticed.

What we are doing

The Healthy Living Lab is working with Corporate Health, West Midlands 5G and NHS Arden & GEM CSU to bring pill-cam technology to the world in the home.

To find out more about the work the Satellite Applications Catapult are doing, please visit the https://sa.catapult.org.uk/living-lab/