Smart apps have helped several countries, including Germany and Singapore, to track and trace people infected with Covid-19 and offer support and advice to those with whom they have been in contact. Other apps have enabled academic institutions to map the outbreak and expand our knowledge of possible symptoms. Even countries that have struggled to develop tracking and tracing apps, like the UK, have developed apps to help people self-diagnose and to consult with specialists.
Like so much that relates to the pandemic, many of these apps were launched in desperation. But they have afforded us a peek into a revolution unfolding across health and science that brings with it immense potential as well as new challenges. Dubbed “Health 4.0” or “smart health”, it relies on employing mobile technology and big data, as well as cutting-edge advances in VR, machine learning, genomics and the Internet of Things, to improve our well-being and increase our longevity. Like so much else in the digital world, it also relies on our readiness to share information.
But is that a price worth paying in order to be prepared for – and possibly avoid – another crisis on the scale of the current coronavirus outbreak?
What is Health 4.0?
Smart health starts on the street - and on our bodies. There are watches that measure heart rate and body temperature with a high degree of accuracy. A pioneering Samsung blood pressure monitoring app, pairable with a Galaxy watch, was recently approved by the South Korean Ministry of Food and Drug Safety. A forthcoming watch from Withings, advertised as “the most health-orientated watch ever offered to the public” is reported to be capable of scanning for atypical heart rate, irregular beats and sleep apnoea.
The kinds of information that once necessitated a trip to the GP can now be obtained through affordable home appliances, including hi-tech inhalers and flow meters and glucose monitoring dongles for diabetics.
Inside hospitals, smart health means everything from recording the delivery of pharmaceuticals to imaging organs with augmented reality and cutting-edge sensing technologies. There are myriad practical applications for clinicians, from video consultation platforms to a digital physiotherapy chatbot called Phil, to a whole range of diagnostic platforms that scoop up information from scanners, robots, probes and, of course, patients’ punching in everything from weight and water intake to moods and emotions.
Apps can also solve practical problems
“There’s no single hero device or killer app,” says professor Sumi Helal, chair in digital health at the University of Lancaster.
“A domestic robot dressed as a pet may be the winning technology for an older adult suffering from severe social isolation. A smart watch with an ECG sensing capability would be indispensable for individuals at risk of atrial fibrillation.”
A common denominator of many smart health approaches, he says, is that they are proactive.
“Some health problems went on for decades without adequate solutions such as asthma attacks, where intervention is dealt with after the attack starts. A device which could sense the asthma attack formation from the start so we can intervene before the attack is fully formed would completely change the quality of life of asthma sufferers.
“One thing is promising and exciting about all this, they all shift the care delivery from only NHS and other health and social care institutions to individuals themselves. This will render populations to be actively engaged in their own health and care, a new reality that will help sustain the current healthcare system.”
A smart response to Covid-19
While the holy grail of a “world-class” app for contact-tracing has absorbed most media attention, developers in industry and academia have come up with a variety of downloads to help people get through, or live with, Covid-19. Some are prototypes that will likely only reach maturity after the current outbreak; others are common-sense initiatives that harness digital innovation for humane ends.
Of the former type is an ingenious phone-based app devised by researchers at the University of Cambridge that uses machine learning to analyse breathing and coughs. In Lichtenstein, a lab has repurposed bracelets originally developed by a fertility start-up to screen for early warning signs of the coronavirus. There are apps, such as the one developed by the United Nations Technology Innovation Labs, to facilitate social distancing in the workplace. More controversially, apps can be used to control and impose quarantines.
Smart health software can facilitate human interaction. Many people have engaged with tele-medicine in the shape of phone calls to 111 (the UK’s non-urgent health service number) or Skype consultations with doctors. Care homes turned to Tik Tok to lift residents’ spirits.
“The pandemic is accelerating people having to learn about digital technology to reduce social isolation and improve social outcomes,” says Dr. Cristina Vasilica, lecturer in Digital Health and Society at The University of Salford.
Her own institution established the Kidney Information Network (KIN), a social media, peer-to-peer support network
“It has been an important outlet for local hospitals to disseminate information and for patients to support each other through virtual cake and coffee meetings, reassurance and information sharing.”
A public good?
Part of what is sometimes called the Third Industrial Revolution, smart health presents new challenges. How will all these apps and devices connect? How do you make the data from one source speak to data from another?
“Managing tens of apps and not knowing where the data is, and in general, having no control or easy way to manage one’s own health data is a big problem,” says professor Helal.
“The fragmentation of this technology is a challenge. Users end up with an app for every gizmo and their data is up in some company’s cloud. Democratizing personal health devices and apps is hugely needed and many people are working on ways to enable this in the near future, including my team.”
For civil liberties activists and human rights lawyers, security and privacy are the Achilles heels of smart health. In an article headlined “Inside Google’s Quest for millions of Medical Records”, the Wall St Journal noted that “medical information is perhaps the last bounty of personal data yet to be scooped up by technology companies”.
“Users should be protected from malicious external entities, such as agencies trying to take advantage and collect data through the app,” says Dr Vasilica.
“The public will want to be reassured that data is used for the intended purpose, especially as we have seen data breaches in the past.”
But smart health is not going away. Covid-19 has accelerated the adoption of user-centred health approaches, forcing governments and public health organisations to focus on health not as an occasional private drama but as a matter of public concern that is always with us – which doctors and health experts call the “continuum of care”.
“It took a pandemic for all parties to be impatiently wanting to transform as quickly as possible to a continuum of care,” says professor Helal.
“Technology cannot prevent infections. However, smart health – or digital health, as I prefer to label it – can help provide avoidance and detection solutions. Apps tracing people’s contacts and movements enable both avoidance and detection. There is no doubt, the future of digital health will include a major component on the avoidance and detection of infectious diseases.”