Pedometers, smart watches and Fitbits, not to mention the tens of thousands of health apps. Add to that health tech start-ups popping up every day alongside established companies spinning off into health. All promising to make you healthy and all trying to get a piece of the trillion dollar healthcare industry. Healthcare is where the next tech push is coming, if we aren’t already there.
It’s no wonder; with an ageing population and more half of adults having a chronic disease, something needs to change. Not only for the health of society but also to reduce the increasing pressure healthcare has on government budgets. Even in countries without universal public healthcare like the US, public healthcare costs are nearly 8.5% of the country’s gross domestic product.
The nature of chronic diseases make technology an ideal fit. Unlike things such as infections and broken arms and legs, chronic diseases can’t be cured and need some form of regular monitoring. Without this monitoring, chronic diseases can get worse making the person sicker.
Much of this monitoring falls on the back of the patients themselves (or their care provider). If you have diabetes, you need to measure your blood sugar several times a day. If you have heart failure, it’s crucial to take your weight daily to see if you’re retaining fluid that might lead to water around the lungs. This monitoring can be a huge burden on patients, so a device that measures if for you and even transmits your results to your doctor can be very welcome.
Then there’s technology to help you monitor your lifestyle and keep you on track. For physical activity, devices will measure your steps, heart rate and calories burned. Apps will help keep track of the foods you eat, telling you what you do and don’t need more of, and some will help you sleep better. It all sounds like a blissful life in which technology can make everything perfect.
More than 15 years ago, I began my foray into the health tech space. I jumped into this arena with great excitement. Eager to show people what technology can do. My group developed and tested a ‘virtual’ cardiac rehabilitation program to allow patients with heart disease to participate in cardiac rehab remotely. We soon developed programs for other diseases too. Patients found these helpful but I remember giving presentations and proudly displaying the flashy websites we created. The audience was mesmerized. They didn’t seem to care if it worked as long as it looked good.
As time went on, I learned that technology wasn’t for everyone. Some didn’t like using a computer and others didn’t know how. Why can’t I just phone the nurse? some patients would ask. Good point. This made me realize that technology was just a tool and not the ends. That may sound obvious, but even today it isn’t. Many companies are marketing technology for healthcare that really doesn’t serve much good other than to make the company money. The telephone has been around for more than a hundred years and works great, yet many consider it too old to be of use in healthcare.
We also shouldn’t forget that technology, in part, is what led to the explosion of chronic diseases. Technology certainly doesn’t give someone heart disease or diabetes, but it does stop us from being active, stresses us out by being ‘on’ all the time and leads to air pollution.
Most technological advances are made with the intention to make our lives easier, or put another way, to do work for us. Gone are the days of putting cars together by hand, using physical printing presses and manually making clothes. For a lot of labour-related jobs, technology has been great in making workplaces safer. But it’s resulted in more of us sitting down all day. It’s not just at work. At home we’re surrounded by technological advances that weren’t present 50, or even five years ago from the toaster to Google turning off our lights for us.
Our research found that owning a car, TV or computer was associated with an increased chance of being obese and having diabetes. Conversely, the amount of obesity in Amish communities that have forsaken recent technology changes is less than a quarter of the general population.
In 2008 the movie Wall-E gave us a glimpse of what life will be like in the future; the Earth is polluted beyond the ability to support life and the remaining people live in a space station fixed into chairs. They don’t have to move as their high-tech chairs move them from home to work and back, and the chairs even provide food.
So, can something that has been a main driver for chronic diseases actually help us?
Most definitely, and no.
The Apple watch arrived with much fanfare and has been touted as a device which can identify life-limiting heart rhythms such as atrial fibrillation. Sounds good, doesn’t it? Although it’s raised concerns that it will needlessly send people rushing to doctors to undergo more tests when they aren’t needed. This can cause unnecessary anxiety in many people. And from the healthcare point of view, the more healthy people that are running to the doctor or hospital, the less time is spent on the people who need it. Only time will tell if the Apple watch (and similar devices) are as good as they say.
It’s important then, with these new technologies that we spend time to figure out how they can improve people’s health, as well as our healthcare system. If these technologies can support patients, keep them at home and avoid needing to go to the hospital, that’s a win for everyone. But as I’ve learned, just because something is flashy, doesn’t mean it can solve the problem.
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