The ability for patients to self-diagnose and treat medical conditions with the aid of smart devices and the internet used to be the stuff of science fiction, but no longer. Will this emerging area of technological advancement ever replace the job of trained experts such as doctors and surgeons? Dan Matthews assesses the odds.
Imagine a technology that could fight crime. Instead of Bobbies on the Beat, software would be used to locate crime scenes, gather evidence, question witnesses and interrogate suspects, even fight cases, give evidence and jail the guilty. Once instituted, after up-front costs, it creates an efficient service with lower instances of crime.
The benefits to a cash-strapped police service are astounding: less need for human intervention means savings in human resources; safety would be improved across the board and detection rates would top out. Brilliant in theory, but it’s pie in the sky, right?
Well, yes; but not in the case of the equally cash-strapped National Health Service (NHS), which creaks under the weight of responsibility for the UK’s wellbeing. It faces budgetary constraints and is under the constant glare of ministers, the press and the general public to standards of service and rates of successful treatment.
M-health – the name given to the technologies capable of easing this burden on the NHS – is seen as a primary solution to the growing crisis in public healthcare. Falling under the banner of ‘m-health’ is a range of products and services, from tablets to CRM software, which grease the wheels of the UK’s health service now and in the future.
A long-established and noteworthy example of m-health is the NHS Direct website, launched in 1998 ‘to provide people at home with easier and faster advice and information about health, illness and the NHS, so that they are better able to care for themselves and their families,’ according to a NHS White Paper produced just before its launch.
NHS Direct says it handles 10 million visits each year leading to a ‘saving’ of 700,000 A&E visits and 1.5 million GP consultations*. The service comes into its own during peak hours and, in particular, when GPs are hard to access such as over the Christmas period.
The most compelling reason for m-health is that it puts the control into the hands of patients and helps medical staff do their jobs better, according to Steve Rudland, healthcare industry manager at Hyland Software. “Technology that delivers the right information, about the right patient, to the right clinician, at the right time is crucial to transform healthcare services,” he says.
Outside the UK, giving patients the tools to understand symptoms and monitor their progress is helping people in developing nations with only limited access to healthcare facilities. Mobile phones are the perfect conduit for communications with experts, as well as timely messages about preventing common illnesses such as HIV and malaria.
But the idea is not fool-proof. A study by PLOS Medicine in Africa earlier this year revealed mixed results, with appointment reminders by text, for example, leading to only slightly higher attendances. Meanwhile, the same study showed that using camera phones to capture and relay images of symptoms led to an increase in misdiagnoses.
M-health encounters different challenges in the developed world, with problems surrounding technological advancement in hospitals and implementation currently presenting the biggest hurdles. Another issue is the suspicion that members of the public aren’t the best arbitrators of their own wellbeing.
As Gil Baldwin, CEO of Tunstall, says: “When a patient takes their own readings of vital signs, it has to be using simple, understandable and reliable methods, and the data must be easily interpreted by doctors – otherwise people will not trust the technology.
“Patients have to know that if any of their readings are slightly out of whack, they know a human being is going to pick up the phone and ring them. That reassurance is critical to keeping people out of hospital and giving them the sense of security and well-being that allows them to cope with minor niggles and variations in their condition.”
Cost, education and buy-in on both sides of the healthcare fence will be critical for the future rollout of m-health and evidence suggests the balance is tipping in its favour. A recent study by PWC shows that just under six-in-10 GPs see m-health as ‘inevitable’ even though only 53 per cent say their IT systems are capable of incorporating new innovations.
But separate questions point to the future of patient confidentiality, consent, sharing patient data and data security. Meanwhile, further admin is required on the question of whether a tablet, for example, is designated a medical device if it’s used by staff in a hospital. In other words, how should devices and software be regulated?
M-health isn’t new, nor is it anywhere near fully evolved, but the constant impetus that new innovations bring to the market is giving it credibility like never before. The goal, technologists and medical practitioners seem to agree, is for these updates to help people to judge how ill they are so that only the very sick will seek out a doctor for treatment.
Couple this eventuality with new technologies that help people monitor their health more generally in the form of heart regularity, cholesterol levels and exercise regime, and you have a combination that will empower, not eradicate the human element in healthcare.
* Since its creation, the NHS Direct website has attracted more and more users. The number of visits to the website rose from 1.5 million a year in 2000 and 2001, to approximately 18 million in 2009. These days, the NHS Direct website receives over 1.5 million visits every month. http://www.nhsdirect.nhs.uk/About/WhatIsNHSDirect/History