Hardly a new breakthrough, but gadgets relating to health, fitness, and wellbeing are on the increase. Pedometers, sleep monitors, diet apps, and so on, all remain very much in vogue. But, are medical gadgets really the way forward in healthcare? Do we want to be strung up to some monitoring gadget whilst we get on with daily living? Or are they merely a fascination that will pass?
Smartphones are cashing in on the publics want for a “quick fix” with regards to health, targeting its audience with the likes of weight loss apps. The health service may also be wise to embrace these advances.
“Mobile health,” also known, as “M Health” is a term used for the practice of medicine and public health, supported by mobile devices, mainly smartphones and computers. It allows consumers (or patients) to input and participate in the healthcare matrix. It offers the monitoring of physiology and health choices, as well as mass education, and raising of awareness. One of the main advantages of mobile phones is that people have access to them, most of the time. However, there is much more to the use of mobile apps in healthcare than it first seems.
Where heart disease and obesity are all too prevalent, a market of health gadgets is sure to open up a range of possibilities. However, generally speaking, those who are pro-active in caring for their bodies are the ones who are likely to self monitor using the health gadgets available. Hence, the target audience of obese or medically unfit patients may not be so keen to record their poor activity or diet. It is the same principal as asking a patient to fill in a food diary reliably, albeit using more accurate and specific entries. We cannot change the honesty of the general public; but we can use the technology available to the best potential.
An app where the patient simply taps or scans in their food and exercise throughout the day could offer simple monitoring of health choices. But, this still relies on the consumer. An app that would requiring less active consumer participation would be one that automatically registers your weekly food shop or restaurant purchases. Or a device attached to your body, which would accurately monitor your activity levels through movement or heart rate. If such possibilities were implemented routinely, it would allow analysis of individuals. For example, it could highlight areas where food choices are a downfall, or where activity could fit in with the patient’s lifestyle. A GP would simply upload a patients’ data onto a computer and analyse their monthly habits.
The NHS is constantly striving to encourage consumer involvement. Analysing behaviours and highlighting positive aspects of lifestyle, is a way in which we can promote health and wellbeing. Yet, as with most management strategies, compliance is a major factor. It is a success if patients take their medication correctly and comply with health advice, never mind monitor their habits, bad or not. Is this a step towards intrusion of lifestyle and health choices? Not necessarily. But we need to sell it to our patients appropriately. There will be a time in the not so distant future when patients will use telemedicine; including medical consultations over the internet as well as being able to send data from personal medical equipment such as ultrasound scanning, fundoscopy, or basic obs machines. Is this making medicine impersonal? Or even, decreasing the respect our patients have for doctors? It could arguably make the work we do become devalued, as investigations become more accessible. But this may be the risk we need to take as healthcare professionals, in order to remain up to date with technology and accessible to our patient population.
Such monitoring is also a way in which data can be collected for research. A sleep app, for example, could collect a large data set on an arguably poorly researched area. It can monitor how much sleep one is getting, how long it takes to nod off, the quality of the sleep, and then correlate this with certain activities, things one does before going to bed, or with work patterns.
The potential is great, but in reality there are more hurdles to overcome before health apps make a regular appearance in NHS clinics and GP practises. Anyone can launch an online app; which ones are reliable is another issue. Perhaps the NHS should invest in a multitude of standardised health apps, to ensure consistence. This would include an array of evidence based apps, from the mobile monitoring of BMIs in diabetic patients, to examining allergies in patients with food intolerance, or fitness and diet censoring in the management of obesity. It wasn’t all that long ago since the NHS website was launched, which has since been a fantastic resource for both patients and health professionals. It presents standardised information in an easily accessible layout. The use of mobile apps seems to be the next logical progression in embracing technology. It can ensure a permanent record of health data, as well as allowing personalised programmes. With targets for a paperless NHS, such devices will have the potential to play a significant role.
Sarah Welsh is a foundation year 1 doctor at Sunderland Royal Hospital and was a BMJ Clegg Scholar in 2011.
I declare that that I have read and understood the BMJ Group policy on declaration of interests and I have no relevant interests to declare.