mHealth: Empowering patients through mobile health innovation
In the digital age, mobile healthcare (mHealth) is being hyped by many commentators as 'the next big thing' with the potential to transform global healthcare. Dr Jane Chan, Senior Medical Advisor at UCB, a global biopharmaceutical company and one of the UK's top pharmaceutical R&D investors, assesses the current mHealth environment and calls for improved collaboration across various health and business sectors to enable the technology to fully realise its transformational potential.
In recent years, the ubiquity of mobile device ownership, particularly in the 'baby boomer' generation, has increased discussion about how new digital technology can play a key role in transforming healthcare and alleviating some of the pressures associated with a growing ageing population and the burden of chronic conditions.
In the UK, the NHS already spends around 70% of its budget on the 15 million people who have one or more long term conditions. This trend shows no sign of abating, with health economists anticipating patient numbers will grow by 23% over the next 20 years.1
Jane believes current UK healthcare structures are not optimally designed or resourced to deal with the burgeoning challenges in the management of chronic conditions, and feels mHealth solutions could facilitate innovative approaches to delivering healthcare in a scalable, cost-effective manner. Jane explains: "In some ways, we are victims of our own success. People are living longer, often with multiple chronic diseases. This is placing tremendous pressures on our existing structures of care. The challenge now is to develop and integrate a sustainable model that meets the increasingly complex needs of patients. The ultimate goals must be improved access to healthcare and improved health outcomes. "
The growing interest in mHealth is a very interesting prospect: it offers the opportunity to reimagine the traditional doctor-patient relationship and to re-examine how healthcare set-ups may be augmented by enabling patients to become more active participants in decisions about their own health. It is these changing relationships that Jane sees as one of the most important and exciting aspects of mHealth, allowing clinicians and patients to expand their interaction beyond the traditional scope of patient education and compliance to engage in a collaborative multi-way information exchange, potentially between numerous stakeholders in a given healthcare system.
The mHealth 'explosion' has been mostly been driven by and directed at the consumer market to date, suggesting the public have a genuine interest in self- management of health and wellbeing. There is generally believed to be around 40,000 health, fitness and medical apps for smart phones currently spanning the broad mHealth category.2
"mHealth...offers the opportunity to re-imagine the traditional doctor-patient relationship and to re-examine how healthcare set-ups may be augmented......"
It is no surprise then that there has been an interest in the development of such apps by the likes of NHS Choices, Apple, patient groups and empowered consumers alike. The jury is still out as to which mechanism of curation and recommendation will resonate best with users, and perhaps the reason for this is the difficulty in assessing the real or perceived value that may be derived from such technological solutions.
According to Jane these apps could provide unique insight into an individual's health and lifestyle, helping clinicians and patients to monitor their health and detect early warning signs before a condition escalates. She explains: "This type of remote monitoring is particularly useful to patients managing long term conditions, such as diabetes and asthma, as it empowers individuals to take charge of recording their own health measurements.
Jane continues: "Such contemporaneously recorded data can potentially increase the value derived from clinic consultations at a later date, due to the improved fidelity and quantity of information that can be easily shared between patient and doctor." At a population level, such technology may also "open up a broad reservoir of health information" the aggregated data potentially providing access to rapid feedback and deep insight into how groups of patients are behaving in the real world.
Mobile technology is also transforming the way clinicians work, with an increasing number incorporating smartphones and tablet-based solutions into their everyday working practices (approximately 2 million clinicians already use digital point-of-care resources such as UptoDate or Epocrates).3, 4 Jane states that these "can often simultaneously educate and provide an instant point of reference to help with clinical decision making." There are growing examples in primary care of how text messaging-based solutions can be useful for appointment reminders, medication compliance, and even support for targeted health improvement initiatives such as smoking cessation campaigns. Jane believes that, "as the sector develops, the value of real world consultations could be augmented even further as technology could allow patients to use their smartphones to manage appointments, renew prescriptions or even share selected aspects of their medical records."
"..there needs to be more assertive leadership in order to create scalable and sustainable programs...encourage risk sharing and longer-term project commitment...to marry technological solutions with therapy-area expertise to develop more effective, personalised solutions...."
However, despite the significant interest and investment by those sensing the clinical and commercial potential of the mHealth trend, Jane argues that communication between interested groups is currently too patchy and would benefit from closer collaboration between the technology and healthcare sectors. "The mHealth space is currently flooded with apps. However, these are often developed either exclusively for healthcare professionals, or directed only at patients, with little consideration for the importance of connecting the two or more parties working to provide an elegant solution for real life issues."
Jane admits there is still a lot of work to be done in the space and believes there needs to be "more assertive leadership in order to create scalable and sustainable programs" which address on-going challenges such as data governance, emerging regulatory requirements and practical implementation issues.
Jane also encourages wider support and emulation of UCB's approach to open innovation to help create innovative, scalable and sustainable solutions. She says: "As part of our commitment to raising the standard of care for patients, UCB recognises the importance of engaging in cross-sector dialogue to foster collaborations that may ultimately create the next generation of innovative solutions for the treatment and management of severe diseases.
By identifying and engaging with all appropriate stakeholders, we can encourage risk sharing and longer-term project commitment. The aim must be to marry technological solutions with therapy-area expertise to develop more effective, personalised solutions that really deliver for patients where they most need it."
References
1. Department of Health, 'Improving quality of life for people with long term conditions', March 2013 (https://www.gov.uk/government/policies/improving-quality-of-life-for-people-with-long-term-conditions). Last accessed July 2013
2. Brookings Institute 'How Mobile Devices are Transforming Healthcare Issues in Technology Innovation', May 2012
3. UpToDate clinical reference tool (http://www.uptodate.com/home/uptodate-benefits-patients). Last accessed July 2013
4. Epocrates clinical reference tool (http://www.epocrates.com/who). Last accessed July 2013
About the author:
Dr Jane Chan MA (Cantab) MBBS MRCP(UK) Senior Medical Advisor at UCB, is currently the Epilepsy portfolio medical lead for UCB in the UK and Ireland. Prior to joining UCB, Jane gained clinical experience in a wide range of medical specialties within the UK National Health Service. Jane holds an MA in Natural Sciences from the University of Cambridge and completed her clinical studies at Imperial College, London.
About UCB:
UCB, Brussels, Belgium (www.ucb.com) is a global biopharmaceutical company focused on the discovery and development of innovative medicines and solutions to transform the lives of people living with severe diseases of the immune system or of the central nervous system. With more than 8,000 people in about 40 countries, the company generated revenue of EUR 3.2 billion in 2011. UCB is listed on Euronext Brussels.
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