A pedometer with smartphone attached

With the 'digitalisation' of healthcare, new possibilities emerge which can further transform our approach to maintaining balanced health. Apple Health, for example, is able to link to and store pretty much the entirety of an individual's healthcare record - a highly complex data set - way beyond the more usual application (let's be honest here) - a pedometer with a smartphone attached. As healthcare delivery organisations' data are largely digital now, new innovations are being driven.

Meet my digital health assistant

In the case of Apple Health this typically means linking to other more specialised apps some of which can be classed as 'digital healthcare assistants'. The host of apps connecting to Apple Health  tend to specialise - diabetes apps, apps which measure vital signs, exercise, mindfulness (namechecks anyone?) - but there is no reason to stop there and no reason why healthcare delivery organisations shouldn't use this space to build out new services to support remote healthcare delivery - the need for which is now plainer than ever.

Out of the box

The NHS has undergone something of a mini-revolution since lockdown. Long planned digital services including online consultation technology, digital care planning initiatives, better interchange of data across healthcare have been accelerated - for the most part successfully and with positive feedback from patients. The NHS is all too aware that this progress needs to be maintained but as ever there is sometimes a tendency to get back in our respective boxes (see, for example, this recent article by Digital Health).

Whatever happens in the NHS, the trajectory of digital transformation of health is set, and it is towards ever increasing digitally driven innovation. The next wave of digital healthcare innovations based on the 'smart' analysis of personal health data is fast approaching. For example,  smart healthcare 'advisors' able to interpret data from healthcare records and associated apps supporting a variety of clinical tasks including:

  • Diagnosis decision support
  • Clinical risk management
  • Advice / onward referral to relevant services
  • Therapeutic recommendations
  • Triggering automated care tasks / bots e.g. medication administration in a smart home environment

Building out

As these data start to flow, other services can be built to attend to identified needs. Automated treatment plans triggered by diagnosis could direct self care actions, process a referral for further services, alert health and medical professionals or directly order indicated treatments/further investigations. Whilst some tasks could be fully automated, for example, re-ordering medicines, sending notifications and reminders for self-care, care would ultimately be under the direction of the person/citizen and should always have a human medical advisor to hand.

Behavioural analysis in serious mental illness

In the case of serious mental illness there is the increasing possibility of extending similar functionality to examine and advise services based on behaviour analysis. He-Yueya et al (2020) recently published a paper in Nature examining schizophrenia symptoms using 'passively sensed measures of behavioral stability'

"greater stability in social activity (e.g., calls and messages) were associated with lower symptoms, and greater stability in physical activity (e.g., being still) appeared associated with elevated symptoms."

The authors conclude: 

"This study provides additional support for the predictive value of individualized over population-level data in psychiatric populations. The Stability Index offers also a promising tool for generating insights about the impact of behavioral stability in schizophrenia-spectrum disorders." (https://www.nature.com/articles/s41537-020-00123-2)

We must all be aware that we have these sensors in our pockets - are largely addicted to them - and that these are not only the healthcare assistants of the future but - to some degree - the commissioning organisation too.

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