This week an NHS kite mark for health-related smartphone apps was announced as one of several new technology initiatives being supported by NHS chiefs in England. Policy Exchange welcomes the move, which is expected to increase doctors’ confidence in prescribing apps as a powerful addition to other forms of treatment.
There are now a bewildering array of apps (some 97,000 according to the European Commission) claiming to support healthier lifestyles, whether it be through encouraging exercise, helping with diets, or connecting with wearable technology to monitor blood pressure and other vital signs. Yet, as Sarah Fink argued back in June, the benefits of these kinds of technology are being held back as users have to rely solely on online reviews, rather than on a proper assessment by medical professionals. The key to making the new kitemark work will be ensuring that testing is done in a medically rigorous manner that gives the public confidence.
An important first step
Embracing the use of health apps is certainly no cure-all for the NHS’s woes, but it is without doubt a step in the right direction. The more patients who can find information and support themselves through apps and online services, the better. Every 1% reduction in face-to-face interactions with the health service could save up to £200 million. Enabling patients to monitor their own health also marks an important shift towards promoting a mind-set of prevention rather than cure. As I argued in a recent blog, we need to move away from a model where our first interaction with medical professionals is when something has already gone wrong. Doing so makes conditions more harmful to the individual and more expensive to treat. Apps could offer one route to spot potential problems at a much earlier stage. It is also true that 70% of NHS spending – equal to around £77 billion – goes towards treating long term conditions. People with these conditions can lead more independent lives with less need to visit their doctor if they can self-monitor from home.
Of course, if the NHS wants health apps to have a real impact, they need to make sure they are not treated separately from wider technology-enabled reforms. The government has made a commitment to give patients online access to their medical records by 2017. From 2018 these records are expected to be available across the health system, provided that the individual’s consent is given. The real value of wearable technology and health apps will come when data from them can be uploaded to, and combined with, a patient’s electronic health record. Better still, when all that data can then be shared not just with medical professionals but with any third party an individual chooses. This will be essential for having a truly joined up healthcare system that gives patients real choice. How that could be achieved will the subject of a Policy Exchange Technology Unit report, expected to be published in March.
A question of data
As technology and the rise of the quantified-self play ever greater roles in healthcare services, there will inevitably be concerns from some about data privacy. A recent BBC article noted the ambiguity about who owns the data apps produce – a question that may need to be addressed as part of the kitemark strategy. The furore over Care.Data likewise highlighted just how sensitive attitudes towards health data can be, and provided some sobering lessons to policy and healthcare professionals. Furthermore, there is understandable scepticism both from the public and politicians about the benefits that big IT can bring to the NHS after the well-publicised failings of the Connecting for Health programme. It must be hoped that the appointment of independent expert Dame Fiona Caldicott to the new role of National Data Guardian for health and care can help lead to a model that encourages innovation while also giving patients appropriate protection.
Encouraging the use of apps may help send a small but important signal that technology can be used in a different way. Instead of health services just using technology and data to change things at a macro level with a top-down approach, today individual patients can be empowered to use them for themselves. The truth is the NHS will need to do both. But by giving patients more visibility and control of their own information, they will be more likely to support the much bolder technology initiatives that will be necessary to transform healthcare in the UK.