Mobile devices linked to monitoring equipment could transform treatment and reduce the cost of care. Yet the prospect of the transmission of vast volumes of health data brings challenges.
The healthcare industry has been relatively slow to adopt mobile technology.
While consumers can do many things on their phone, from booking flights to finding restaurants, few have the option to do something as simple as emailing their health centre to make an appointment.
“We’ve had tremendous innovation in healthcare, but much of it has been siloed in the information systems of hospitals and doctors’ offices,” says Harry Greenspun, an adviser in healthcare transformation and technology at the Deloitte Centre for Health Solutions. “There’s been very little innovation in information sharing among providers or between providers and patients.”
This is despite high demand among consumers, according to research by Deloitte.
The consultancy found keen interest among respondents in using medical devices to monitor their conditions – from 46 per cent in Belgium to 61 per cent in the US and 79 per cent in Mexico.
In the US, as the emphasis for doctors’ pay moves from the volume of care they provide to keeping patients healthier, more remote management of long-term illnesses has come into focus.
And as part of the UK Department of Health’s 3millionlives initiative, the government plans to use telehealth and telecare to improve life for those with chronic conditions and social care needs.
Trials have produced striking results: a 45 per cent reduction in mortality rates, as well as a 15 per cent fall in accident and emergency visits, 20 per cent fewer emergency admissions and a 14 per cent drop in elective admissions.
Consumers want to use their mobile devices to manage and improve their health, as demonstrated by the popularity of an app – designed by Peter Bentley, a University College London researcher, and downloaded by millions of users – that turns an iPhone into a stethoscope.
More than half (52 per cent) of US consumers in the Deloitte survey said they would use a smart phone or personal digital assistant to monitor their health if they were able to access their medical records and download information.
Yet the prospect of millions of users monitoring their vital signs will change the job of healthcare workers that look after them.
“When you train as a doctor or nurse, a lot of what you learn is about visual cues and talking to people,” says Ivan McConnell, a healthcare expert at PA Consulting. “If you don’t have that, you have to use different skills.”
Another challenge will be processing the mass of health data generated by consumers.
“The bottleneck is not in accumulating information but processing it,” says John Guttag, a professor at the Massachusetts Institute of Technology.
“If you are a cardiologist with 500 patients and you’re getting ECG data from those patients 24 hours a day, you’re not going to look at it all,” says Prof Guttag, who co-heads the networks and mobile systems group of MIT’s Computer Science and Artificial Intelligence Lab.
“So, first, we need better tools for analysing the information.”
Moreover, data generated by mobile devices would inevitably include a high volume of “false positives” – false alarms – resulting from incorrect use of the devices, dead batteries or lost signals.
The question for healthcare providers will be how to respond.
“If you have 1,000 patients, you might get 100 alerts, but you might need to respond to only 50,” says Mr McConnell.
Prof Guttag predicts the rise of sophisticated algorithms to analyse data generated by mobile devices.
Another change, as the stethoscope app indicates, could be the collection of more data, not by specialised healthcare industry equipment but by commercially available smart phones, tablets and other devices.
This also raises questions. “Your cell phone can monitor a lot of things,” says Mr Greenspun. “But if it has turned itself into a medical device, is it therefore subject to regulation?”
Such questions – as well as data management challenges – mean the widespread use of the mobile device as a mainstream healthcare tool may be some way off. Yet many believe they could play a significant role in improving care and reducing costs.
First, tapping into commercial computing power could reduce spending on expensive specialised medical equipment. While, as the NHS telehealth trials demonstrate, remote monitoring could reduce costs through fewer hospital and doctor visits.
As pressure increases to reduce costs, making patients more involved in their own care may become a necessity.
“It’s inevitable that it [happens],” says Prof Guttag. “As our population ages, we’ll have to get better at dealing with our own needs rather than running to a doctor all the time – because the resources are just not going to be there.”
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Autor(en)/Author(s): Sarah Murray
Quelle/Source: Financial Times, 24.02.2012
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