We watch health trends because they are devastatingly important. As the lucky inhabitants of the Western world, we are relatively well looked after. But western health systems are collapsing under the burden of the ageing Baby-Boomer generation. These people are living up to two decades longer than their parents, requiring medical and social care, and putting pressure on public and insured health systems. Unfortunately, health is the only business in which every happy customer is one who will come back next year to cost you more.
And what about the rest of the world? Innovators are coming up with extraordinary grassroots solutions for clean water or emergency care. The Bill & Melinda Gates foundation is committed to eradicating whole diseases. But equally, HIV is achingly prevalent throughout Africa, and pantomime villains like Martin Shkreli have shown that Big Pharma is still a troubled industry. Health is fast-moving, and with technology and a renewed focus on public health, we all have a part to play in changing clinical outcomes.
Here are a couple of trends to keep an eye on.
Document to Monitor
In the old days, for some afflictions, we were told to keep a written diary – for example a food diary to itemise trigger foods. It was inconvenient, and very few people did. Today, however, thanks to consumer-grade technologies, documenting our health lives is easy – often automatic. Our food diarist is not only free from scraps of paper: a smartphone app will remind him that it is time to do a diary entry. He can select foods from a list (or even pictures). And the nutritional content will automatically be totted up and added to his personal record.
Alternatively, consider a diabetic, who might get a prompt to go for a brisk walk. His Nike Fitbit will monitor his performance and heart rate, and again keep a record. All of this happens in real-time. In the US, Pew Internet Research report that at least 70% of adults are self-tracking some aspect of their weight, diet, exercise, health symptoms and so on. It has even spawned a slightly derogatory term: the “Quantified Self movement”.
Health monitoring is already an advanced business: highly consumerised and used by the healthy as well as the ill. But there is plenty of evolution to come. The future of health monitoring is four-fold. First, complex data connections are slowly being built which will allow us to automatically share the data that is collected with our doctors, consultants and other medical practitioners. Apple’s HealthKit platform is already designed to do this. Second, the breadth of data being collected will increase; and the equipment needed to conduct tests will be consumerised, moved into the home, and become operable by non-professionals on a smartphone. Roche, for example, is about to launch a connected-home INR (blood coagulant) testing service which will cut hundreds of journeys per patient.
Third, the raw data from monitoring will be collated and interpreted in real-time by algorithms or artificial intelligence, to provide actionable medical advice rather than just readings to be used later by a professional. And finally, self-tracked data will be monetised both positively and negatively. You may be incentivised with a discount on a life insurance policy because you maintain a healthy lifestyle. Equally, you may be refused health insurance completely for failing to maintain a health regime which meets the needs of your illness. Either way, health monitoring will eventually become a responsibility for all of us – but technology will make it very easy indeed.
Servicing to Activating
Changing health behaviours is hard. It’s not a logical process. For example, one in 16 people in the UK have diabetes; this is expected to increase to around one in ten by 2025. Yet many diabetics fail to make changes to their lifestyles, even though they are on constant medication and know that the prognosis is anything from a shortened life to painful amputation. We are not good at following advice – especially when that advice comes from doctor’s visits which may be months apart.
One solution enabled by technology is regular and highly personalised prompting from automated systems. This may be as simple as apps which remind us to take complex permutations of pills at the right time. But there is also ample evidence that encouraging behavioural change is an incremental, step-by-step process: for example, we all know that giving up smoking is easier for most people if we cut down first. Especially in healthcare, the need for a nudge is not only because it’s easier. We all know that we need to make sustainable choices to stay healthy; but the complexities of life that keep us in a sedentary lifestyle and the high-budget techniques of marketers persuading us to enjoy sugary drinks mean that all too often we make not bad choices but lazy choices. We need a voice of conscience in our pocket to keep us on the right track.
“Can I eat it”, for example, is a beautifully designed app which allows users to scan a barcode while shopping, to immediately see the nutritional value of any food product. A simple “thumbs up, thumbs down” will show an assessment of the product for salt, fat, sugar and other content. Better still, the data is crowd-sourced, so users know that they are part of a community of health change. Then there’s Runkeeper, which not only offers workouts and challenges starting from the most basic “learn to run”, it also offers discounts from partner brands to make keeping fit a genuinely rewarding experience. It offers audio cues so that users can be motivated on each circuit – and you’ll hear them because you’ll be listening on headphones to your personalised Spotify playlist.
These are only two examples, but they exhibit some of the key factors in making health engagement work. “Can I eat it” makes a hassle simple – it removes some of the complexity of sticking with the program. And Runkeeper is richly personalised to make the experience engaging and fun. These lead to the holy grail: self-management and improvement of health issues in a resource-constrained care system.