Digital health is a nascent field that uses social media and smart phones to help patients keep better tabs on their health and manage their diseases. It can also help the healthcare industry to cut costs and improve treatment. Silicon Valley inventors in digital health are seeking out seed funding to help them grow and scale.
At the dawn of rapid prototyping, a common predication was that 3D printing would transform manufacturing, spurring a consumer revolution that would put a printer in every home. That hasn’t quitehappened — -and like so many emerging technologies, rapid prototyping has found its foothold in a surprisingly different field: medicine.
The following studies and projects represent some of the most fascinating examples of “bioprinting”, or using a computer-controlled machine to assemble biological matter using organic inks and super-tough thermoplastics. They range from reconstructing major sections of skull to printing scaffolding upon which stem cells can grow into new bones.
The latest episode in the American Chemical Society's (ACS') Global Challenges/Chemistry Solutions podcast series features an advance in smartphone-based imaging that could help physicians in resource-limited locations monitor their patients' health. The development converts smartphones into powerful mini-microscopes that, for the first time, can detect individual viruses.
Ozcan notes that conventional imaging techniques for detecting disease-causing bacteria and viruses rely on expensive microscopes with multiple lenses and other bulky components. In places with limited resources, doctors have few options for determining how well a treatment is working. To address this disadvantage, researchers have developed compact microscopes that can be fitted onto smartphones to detect microbes or to check patients' eyesight. Ozcan's team set out to build on these advances and produce a more refined imaging device that can count the number of bacteria or viruses in a sample.
A new breed of physicians is texting health messages to patients, tracking disease trends on Twitter, identifying medical problems on Facebook pages and communicating with patients through email.
So far, those numbers are small. Many doctors still cling to pen and paper, and are most comfortable using e-technology to communicate with each other - not with patients. But from the nation's top public health agency, to medical clinics in the heartland, some physicians realize patients want more than a 15-minute office visit and callback at the end of the day.
In 2012, Dr Shashank Akerkar’s clinic received a call from a 50-year-old patient battling lupus, who wanted to have the butterfly rash that had erupted on his hand checked. Because the consultant rheumatologist’s diary was chock-a-block for the next few days, the patient was given an option: Download Akerkar’s The Lupus App, upload pictures of the symptomatic rash, and wait for the doctor to get back on the treatment.
“By the time the patient saw me, the rash had healed,” says Akerkar, who launched his app in October last year on World Arthritis Day in collaboration with Mumbaibased app developer ZK MediTechLabz. “Apps that help patients make a note of symptoms they are experiencing, and quickly take charge of the problem, were missing,” says Akerkar, who is one of the first city doctors to have developed his own medicare app.
70% of people globally are receptive to toilet sensors, prescription bottle sensors or swallowed monitors. 66% of people say they would prefer a personalized healthcare regimen designed specifically for them based on their genetic profile or biology. 53% of people say they would trust a test they personally administered as much or more than if performed by a doctor.30% of people would trust themselves to perform their own ultrasoundHalf of those surveyed would trust a diagnosis delivered via video conference from their doctor. 72% were receptive to communication technologies that allow them to remotely connect to their doctor. (N=12,000. Countries included in poll: Brazil, China, France, India, Indonesia, Italy, Japan, USA)
Health literacy is defined as the ability of an individual to obtain, understand and process health information and services needed to make appropriate health decisions (Institute of Medicine, 2004). Those with poorer health literacy have poorer health, find medication difficult to manage and have greater mortality rates (Berkman et al., 2011). The Information Standard recently ran a workshop on Health Literacy for information providers, and we were fortunate enough to attend.
Gill Rowlands, a GP and health literacy lead for the Department of Health, presented unpublished data showing that health literacy levels in the UK are generally low, and that low health literacy maps with areas of deprivation. Up to 74% of people in the low health literacy group were not able to understand health information commonly circulated by charities and the NHS. However, even in the higher literacy group, up to 24% of people could not understand the same samples of health information. This suggests that in order to improve health outcomes – aside from initiatives to improve health literacy – health information needs to be made more accessible to the general public.
With the tools acquired at the workshop, we decided to review our BHD information pamphlets. Using the Simple Measure of Gobbledegook (SMOG) calculator, we found that most sections of the pamphlets scored 18 and above, meaning that some of this information might not be accessible to at least 43% of our target audience.
Andrew Spong's insight:
A great project, driven by a coming-to-consciousness of the critical role health literacy plays in effective communication of every aspect of disease information. Hats off to the BHD Foundation.
When somebody says 'mHealth' or mobile health, there can be a tendency to think primarily of fitness wristbands and lifestyle apps to monitor weight, count calories or record the number of steps taken. But we should associate mHealth equally with the steps taken by various governments, international organizations, NGOs and individuals to place mobile technology into the hands of frontline health workers in low- and middle-income countries.
Currently, health systems in developing countries are overstretched and overburdened. A massive global health worker shortage, which is estimated to grow to 12.9 million by 2035 from the current deficit of 7.2 million (as recently highlighted by a WHO report), makes it even more imperative to support frontline health workers through mobile technology that provides education, improves efficiency and enables deliverable health services. Millions of mobile connections are being made every year in regions such as sub-Saharan Africa, Southeast Asia and the Pacific, and capitalizing on this tremendous growth is vital.
Giving frontline health workers access to mobile technology means giving them the potential to address some of the world's most devastating health issues such as malaria, HIV/AIDS and maternal and child mortality. Frontline health workers are the heart and guts of effective health systems and are usually based within the community they serve. Commonly, they are the only link to the health system for millions of people. A WHO study found that training community health workers in Bangladesh reduced maternal mortality by two-thirds and still births by 40%, results which, if applied globally, could save the lives of 120,000 mothers and 96,000 babies per year. These types of results, however, require the provision of quality training and continuing education for health workers, as this leads to better diagnosis and treatment, reduced attrition rates and, ultimately, improved health outcomes. mHealth can facilitate and improve these factors, while also being used to tackle the growth of non-communicable diseases (NCDs) in developing countries, such as heart disease and mental health, which are predicated to overtake those diseases we traditionally associate with low-income countries.
The trajectory of digital health is, in part, driven by Eric Topol. A cardiologist, Chief Academic Officer of Scripps Health in San Diego, author (The Creative Destruction of Medicine) and futurist, Dr. Topol provides some of the essential “glue” to this important health movement.
Patient engagement has no placebo effect. When patients have more access to their health information, they take greater ownership of their healthcare and can make better decisions to improve their outcomes.
Kim Murphy-Abdouch, MPH, RHIA, FACHE, a clinical assistant professor in the health information management department at Texas State University, challenged HIM professionals to facilitate this patient engagement.
During her presentation, "Patient Access to Personal Health Information: Regulation vs. Reality" on Monday at the American Health Information Management Association's (AHIMA) 85th annual Convention and Exhibit in Atlanta, she referenced an idea attributed to healthcare consultant Leonard Kish that, "if patient engagement were a drug, it would be the blockbuster drug of the century and malpractice not to use it."
I've heard anecdotally that doctors and nurses are concerned that in the course of their normal day at work them may be videoed and end on YouTube. Is this likely to happen? How do we prepare students to deal with this situation?
Andrew Spong's insight:
Patients (IMO) have a right to document their experiences in hospital (assuming they can get a signal ;)).
Healthcare professionals have a right to grant or deny their consent to be filmed or otherwise documented... don't they?