How times are a changing! In this ‘anytime anywhere’, ‘always-on’, ’there’s an app for that’ information age, the opportunity for digital personal health management has never been easier. However, it does come with some risks.
I recently helped a limping friend visit her GP. She’d spent hours researching her condition and confidently informed the doctor of her diagnosis, a stress fracture. But it turns out she was way off the mark – let down by Dr Google, a YouTube video and an awesome app. Go figure.
Within minutes, the doctor knew she didn’t have a bone injury. It was the combination of pain points, the temperature of her skin, and some questioning that identified a tendon injury, which an ultrasound ultimately confirmed.
Today, it’s not uncommon for doctors to receive these kinds of tips from patients. And it’s likely to increase, too, as more and more health information goes online and appears in apps. The recently released ADA app claims to be ‘smarter than a doctor’ with a database of more than 10,000 symptoms and diseases. While seemingly useful, misdiagnosis when using apps is always a risk.
What do real doctors think of health apps?
If you’re thinking that doctors are wincing about all this activity (certainly they’re a little frustrated with friends like mine), you may be surprised to learn that they’re embracing personal health technology, encouraging it, and even using it themselves.
In fact, , the government body that promotes health in Victoria, recently conducted research along with Deakin University to review 200 of the best health and wellbeing apps. This was research targeted at Victorian doctors, to help them recommend health apps to their patients.
The message to doctors is to use the research so that they can recommend apps to their patients and families. This is in line with recent research that shows most Australians believe digital technologies will transform healthcare outcomes.
The selected apps in the VicHealth list are primarily ones that help motivate and encourage people to make better health decisions, and learn about certain conditions.
Some of the top rated apps include free meditation programs for improving mental wellbeing. Check out the complete . The Australian Government also provides a list of department and agency produced (including a number of health apps) to assist us.
Technology is now central to our health. According to VicHealth, a quarter of Victorians have recently downloaded a health and wellbeing app.
You might be wondering where it’s all heading.
The future is here (already)
A new medical paradigm has already arrived. Known as P4 or Preventive, Personalised, Participatory and Predictive medicine, this new thinking incorporates self-tracking (quantified ), and uses technology and data for proactive individual health management.
At the forefront of P4 is the P4 Medicine in the USA. Its global vision is that P4 medicine is embedded in our lives and healthcare systems. In their ideal world, big data (that’s the collective data of a population) is combined with your own personal data that tracks your health progress, predicts potential problems, and recommends remedies.
While P4 uses technology and data for better health outcomes, it still relies on well-established medical research and treatments, including face-to-face visits with your doctor, who has access to your personal health history.
P4 is a big deal because it has the potential to improve health outcomes while also reducing healthcare costs. An exciting proposition for behavioural economists and governments the world over.
What do scientists think of health apps?
It turns out that scientists are just as excited as others when it comes to technological solutions to good health. Perhaps because they’re playing a major role in it.
We spoke with two leading health data scientists from University of Melbourne to get the low-down on digital health, and to find out how you can get safely onboard.
Meet the experts
Meet Dr Shanton Chang, Associate Professor, Department of Computing and Information Systems, and Dr Mark Merolli, Research Fellow at the Health and Biomedical Informatics Centre. Both are experts in the field of health informatics – that’s the science of health data. As well as teaching, these guys collaborate with both patients and clinicians to create best-practice systems and methodologies to assist in the digital health revolution.
For example, one of their projects involves building an online infertility prediction tool for young women with breast cancer.
Their work has much broader application too, such as devising mathematical calculations – algorithms – so that app developers can create accurate health apps.
Accurate is the key word. While Dr Chang and Dr Morelli are happy about the rise of personal health management, their big concern is that the market is being flooded with poor quality apps. That is, apps that don’t use scientifically robust algorithms, or use data that hasn’t been validated by trusted, unbiased, experts (such as themselves).
For example, an app designed to keep count of your food intake, and measure your cholesterol or blood pressure may provide inaccurate results if the algorithm isn’t scientifically proven, or if the algorithm is outdated, or if it’s something that can’t realistically be measured. Some apps even go so far as trying to predict your likelihood of cancer or diabetes.
Ok, so given that apps can only do so much, what do the experts say about their use in personal health management?
1. Embrace technology
Yes, you need to embrace technology before you can get onboard the digital train. The new reality is that digital tools will continue to evolve, and entwine with our lives. Don’t be afraid. All aboard now.
Dr Merolli has been tracking the impact of the digital world on our health since the mid-2000s. He’s watched online communities connect like-minded people, act as online support groups, and become places where people can exchange views and information.
By embracing technology, you’ll be “more empowered, more engaged and better informed,” he says. Be sure to embrace updates too. That means accepting those boring updates when prompted by your app.
2. Know your sources
It may sound counter-intuitive, but you should try to understand the sources of your information, and whether any bias exists. Is the source trying to sell a product for instance? Be wary of online health and medical products.
Dr Chang suggests using credible sources when looking for apps, such as the Vic Health .
3. Don't be lazy
Quick fixes can be tempting. But don’t go there. Perhaps instead, balance search results or app data with other sources – online and offline. Have conversations with family, friends or trusted sources.
4. Stay cool
Try to keep level-headed about your choice of gadget, app or information. Maintain your balance. Technology is certainly a good motivator, but it’s only one piece of the health pie.
5. Avoid self-diagnosis
Frankly, trying to self-diagnose using apps, gadgets and websites can be hazardous to your health – especially, if the information convinces you NOT to visit a doctor.
So, while the emergence of apps for active health management is a positive trend, you still need to be cautious and exercise common sense. Apart from using an app that may not be accurate, another danger is making a decision or conclusion based on a source that can’t possibly know the nuances of your personal health story, history and circumstances.
Don’t let a website, app or device influence you to self-medicate or forgo essential medication – a risky option.
By all means, use the technology to research your symptoms. Doctors won’t mind if it helps you to better understand your condition and to formulate questions. Summarise what you’ve found (don’t bombard them with multiple pages of information) and prepare a short list of questions.
So, in this advanced age, the message is still the same. If you’re concerned about your health and wellbeing visit a doctor, face-to-face. Learn how to navigate the Victorian Health system and where you can find services and support.
Asked where personal digital health management is headed, Dr Merolli predicts a “future where social mashes up with apps and wearables.”
So far, wearables includes smartwatches, smartglasses, fitness trackers, smart clothing and jewellery. The future indeed looks shiny.
Good luck on your own personal digital health journey. Feel free to share your experiences and any tips by leaving a comment below.