Mobile-Health - transforming and enabling care
First we had the internet, connecting people to information through emails and websites; then the development of social media and networks, connecting people to each other and encouraging us to reveal more about ourselves than we might previously have considered advisable. And now we are on the verge of the age of connectivity, connecting data analytics to the growing number of smart phones and other sensors that are increasingly second nature in our everyday lives. But with this connectivity comes an increase in personal data about us, both as individuals and as groups, on a scale never experienced before and which we are only just waking up to – both the good and the bad – as seen in the current controversy over the English care.data proposals.
Whether we like it or not, one thing is certain, over the next few years scientists, doctors, and the public will have access to more data about the human body than they ever imagined possible. Much of this has been driven by the development of the mobile health (mHealth) market. The proliferation in mHealth is partly a response to policy makers searching for innovative ways to reduce healthcare spending while improving the quality and quantity of care, and partly driven by patients’ desire for empowerment and convenience to manage their own health.
Indeed, the adoption of mHealth is growing exponentially in developing countries; where the lack of an expensive infrastructure creates freedom to innovate and allows providers to leapfrog obstacles in the use of technology that more developed countries struggle to overcome. These obstacles include cultural, financial and regulatory constraints, and are well documented; yet despite these constraints mHealth technology is slowly but surely changing the way physicians, patients, and other stakeholders interact. Examples include:
- GP e-Visits: Deloitte TMT predictions state in 2014, there will be 100 million GP eVisits globally (an increase of 400 percent from 2012 levels), saving over $5 billion annually compared to the cost of in-person visits. eVisit usage however is likely to be largest in North America where around half of the 600 million annual visits to general practitioners are generally for reasons that could also be solved by an eVisit.
- Remote rehabilitation – or telehabilitation - a relatively novel application that uses a computer game linked to a motion tracking computer mouse allowing patients the freedom to control their physical therapy from home. Use is currently being tested in patients with arthritis and balance and gait disorders and the approach is claimed to increase compliance and, improve recovery and, as a result, reduce costs.
- Using m-health applications to modify interactions between physicians and patients. Our TMT predictions report suggests that the highest year-on-year increases in smartphone penetration in developed countries will be among the over-55s, bringing a population with arguably the most to gain from m-health well in reach of its applications. Uses, in addition to monitoring vital signs, include sending photographs of skin conditions or injuries via smart phones to clinicians.
- Wearable technology, which can provide feedback on patient flow through the system, as well as improving reliability in delivering medication, assessments and diagnostics. It can also be used to support remote analysis of biomedical data for whole segments of the population, particularly the frail elderly, to enable more anticipatory care and patient monitoring to be done at a much larger and more efficient scale.
Whilst m-health can create convenience and possibly cost savings there are inevitably concerns at the impact it will have on quality of care. For example, e-visits have been shown to lead to an increase in antibiotic prescribing, at a time when control over such prescribing is key to reducing antibiotic resistance. But the evidence that better information improves quality is also important.
The case for m-health applications seems clear especially given the need to transform outdated models of working. Most healthcare policy makers and providers are waking up to this, however, confusion as to how to implement such initiatives and a lack of capital or willingness to invest continues to slow the adoption of mHealth. There is also the very real concern around data security and unauthorised access; an unintended consequence of health care’s digitisation and increased networked connectivity.
The question that remains therefore, is just how quickly will the potential of mHealth be realised in an industry that has traditionally struggled to embrace technology in its interface with service users? To realise this potential requires champions and leaders who fully understand the potential of connected technology and be willing to apply this to healthcare and, by taking away the burden of routine and functional aspects of healthcare, truly support staff to work differently.