Digital Health and Selfcare

30.05.17

Healthcare has been the last major industry that hasn't been touched by technology in terms of productivity and consumer adoption in the way so many other industries have.

So noted John Sculley, hi-tech investor and former Apple CEO a few years ago. Observing the range of speakers at last week’s Digital Health World Congress, from companies including Philips Healthcare, Johnson & Johnson, GE Healthcare, Siemens Health and IBM Watson Health, it’s clear that interest is high in leveraging digital technologies to create new solutions in healthcare. However, despite the activities of established corporates and startup entrepreneurs alike, the perennial challenge of healthcare funding and stretched resources, combined with the restrictions imposed by regulatory frameworks, has meant that the impact of technology in creating new solutions in healthcare has been almost imperceptible by consumers/patients in comparison to the pace of change in other areas.

Whilst governments, health authorities, regulators and healthcare companies continue to seek to find ways to square the circle of increasing costs and increasing needs, it seems clear that we, as consumers/patients must, and should, take more responsibility for managing our own health. Healthcare business and brands, whether public sector or private, need to work harder and smarter to make health more relevant and compelling to our everyday lives – not just when we are ill. 

Here are five key areas where selfcare will become increasingly important and prevalent:

1. Self Diagnosis

The digital infrastructure for transformative self-diagnostics is already here, in the form of wearables monitoring activity, heart rate and behaviours, smartphones providing communication and computing power, and AI systems interpreting the data and delivering targeted results. We are already seeing a “second wave” of wearable tech solutions focused on healthcare including Clincloud’s stethoscopeAlivecor’s Kardia ECG and Bloomlife’s pregnancy monitor providing professional quality diagnostic tools enabled by the power of consumer smartphones. Just as significant is the growth of on-demand triage services, providing new ways for consumers to access health advice and diagnosis, avoiding the delays of getting doctors’ appointments, or unnecessarily clogging up Accident and Emergency departments. Babylon Health’s service, combining real doctors with AI-backed digital tools is already finding its way into the mainstream by providing the NHS 111 triage service in parts of London, and is proving popular with customers.

2. Self Therapy

We will continue to see a trend towards patients self-administering and self-managing their own therapies. Examples include growth in ever more sophisticated auto-injectors and other drug delivery devices, as well as systems such as the Ambulight PDT and Smith & Nephew PICO, allowing previously hospital-based treatments to be delivered by patients in their own homes. Key drivers for self-therapy are cost, and limitations on staff and other hospital resources. In the area of Diabetes Care, where self therapy is practised by millions of people around the world, the holy grail of a closed-loop self diagnostic and therapy system, combining continuous glucose monitoring (CGM) systems with insulin pumps, is now, technologically, within reach. The challenge is now to make these “automated pancreas” systems sufficiently accurate, reliable and safe to prescribe, but some diabetes patients, hungry for new solutions to better manage their disease, are taking matters into their own hands. The #wearenotwaiting movement encourages tech-savvy people with diabetes to fashion homemade artificial pancreases by hacking their insulin pumps and combining with CGM systems and digital diabetes management tools. Although at the fringes of consumer/patient behaviour, this underlines the desire amongst patients to take matters into their own hands.

 3. Self Management of Chronic Conditions

Chronic conditions, such as diabetes, respiratory conditions, heart disease and cancer, offer great opportunities for improved outcomes as well as consequential reduced cost burdens, through effective used of digital tools in self-management. In diabetes care, there is a strong recognition that device/data ecosystems backed up by AI can provide valuable personalised health management advice, but the challenge is often in capturing manually entered data points. Devices such as Propellor Health’s smart sensor attached to existing inhalers is an example of a digital enabler, turning a dumb device, into a smart, connected one. An important and challenging aspect is how to capture data related to diet, health event and mood. Here, the most successful solutions will be those that best engage and empathise with patients, such as the MySugr diabetes management app, created and run by people with diabetes for people with diabetes, or the Omada system, which combines connected devices, health coaches and smart tools to help achieve behaviour change. Another opportunity in this space is the potential for engaging personal, family, friends and wider social networks to support patients in self-management of their conditions.

4. Wellbeing and Preventative Care

A key challenge for society is to encourage us all to maintain healthy lifestyles and to think about healthcare before we get ill. The first wave of wearables enticed us to maintain more active lifestyles, but, from a business perspective, this has been hard to sustain, with even major players like Jawbone exiting the consumer wearables in order to focus on the health market. Like market leader Fitbit, a key target will be the insurance and workplace group health and wellbeing schemes, where a sense of community, as well as the prospect of lower premiums, will provide a strong element of motivation. One interesting development in wellbeing has been the growth of systems designed to support mental health. Often previously ignored, the increasing acknowledgement of its importance has led to the growth of meditation and mindfulness app Headspace, as well as specilist solutions such as Pear Therapeutics’ digital application and medication systems such for treatment of stress, anxiety and addiction disorders.

 5. Telehealth and Assisted Living

Although in use for many years, telehealth now looks set to generate more significant traction through the greater prevalence and affordability created by smartphones. Whilst the benefits for providing connected care for our ageing population are obvious, the use of telehealth services to significantly augment, or even largely replace, the physical GP visit seems likely. Services such as HealthTap and Doctor on Demand point the way towards a new smartphone-enabled consumer-driven future for accessing healthcare services.

These five areas offer huge potential for innovation, and to creating a new, more consumerised healthcare market. The challenges of safety and compliance imposed by the medical regulatory framework remain, but the opportunities made possible by new digital technologies of enhanced patient/consumer experiences and better clinical outcomes, are too inevitable and valuable to resist. The coming years will see a consumer-driven transformation in healthcare.

Craig Wightman, Executive Design Director at Kinneir Dufort, was speaking at the Digital Health World Congress, London, 24 May 2017