As life expectancy increases, so too do the number of years we can expect to live with ill-health – for women this is 19 years, for men 16 years. With this staggering fact in mind, participants at the My Healthy Future workshop on healthy ageing explored how personalised healthcare technologies could help people stay healthy in later life.
Stakeholders from healthcare delivery, research, health charities and industry envisioned the emerging technologies that could help healthy ageing in 20 years’ time and the issues that will surface as these technologies are brought into play. Out of a wide range of pertinent points raised during the full day workshop – here is a snapshot of four.
My Healthy Future aims to set a vision for the next generation of personalised healthcare. The project will culminate in a set of policy recommendations for how the health system and wider society will make optimal use of emerging technologies.
Personal values
We took healthy ageing to be about more than disease prevention and extending life, but importantly also about creating the environments and the opportunities that enable people to be and do what they value most throughout their lives.
The crucial importance of personal values and preferences – a central tenet of person-centred healthcare – arose throughout the workshop, as indeed it has in all the other life-stage workshops.
It was felt that any perception that new technologies could develop into means for imposing a particular set of values or a mechanism for control on citizens would be unacceptable and detract from the benefits they can offer. Similarly, technology should not be intrusive or erode privacy. Participants felt strongly that technology should rather be a vehicle to support, enable and empower people to achieve what they want for themselves, including healthier outcomes.
So what is a healthy outcome? Older people are not all the same, and a person’s individual values and preferences influence what is a healthy outcome for them – from being able to do their own shopping to continuing in their profession. For most, we should not allow low expectations of health in older people to undermine our aspirations. For technology to improve people’s wellbeing, our workshop participants argued that understanding people’s individual priorities for health outcomes and communicating how technology can help manage and support these is imperative.
Is ageing bad?
A more controversial note was struck when the subject was raised of naturalistic fallacy – that attitudes are shaped by our understanding about what is ‘normal’ ageing versus what is pathological – or disease. Does thinking of ageing as normal, hamper the development and uptake of innovations that can improve health and wellbeing in later life? Whatever one’s perspective on this issue, the fact remains that ageing is intrinsically linked with certain diseases, not least cancer. With 1 in 7 of the population expected to be over 75 by 2040, some participants felt that a shift in how we think about ageing (and the resources devoted to research in this area) need to change more than ever.
A step in the wrong direction?
One major concern emerging from workshop discussions was medical practice turning into a ‘tick box’ exercise that effectively reduces people to the sum of their medical data. This would not only dehumanise the patient, but also risk side-lining the wealth of relevant knowledge and skills held by the health professionals. How to keep the human factor in healthcare is a question that will be well worth bearing in mind as we shift more towards the accumulation and exploitation of ‘big data’ and artificial intelligence in healthcare.
Co-producing technologies
Will we all become the ‘worried well’? Will constant monitoring, knowing that we have an increased risk for certain diseases and potentially having machines track what we should and shouldn’t do to be healthy, preoccupy all our thoughts? Such concerns were expressed throughout the workshop. There was broad agreement that for each technology to enhance our ability to live healthy lives without resulting in us becoming preoccupied with our health needed to be thought about from the earliest design stages.
For technology to work properly for people (of any age) – with their personal values, preferences and capabilities – it must be co-designed with them from inception through to implementation. Workshop participants brought up time and again the essential need for collaboration between patients (with different educational levels, cultural and language needs, sensory and cognitive and physical needs), doctors and industry in developing technologies and evaluating them for implementation. Essential principles for any new technology were said to include that it should be:
- Clear and simple for any user
- Non-intrusive
- Highly personalised if it is to encourage behaviour change – to fit into specific lives and values and lifestyles
- Support for the patient in understanding what the data generated by the technology means for their health
Innovations in digital health and biomedical science are transforming our health and wellbeing throughout life. To maximise the benefits and reduce potential harms to the next generation from emerging health technologies, they must be developed and implemented hand in hand with individuals from all life stages, including older people – who form the majority of patients in many GP surgeries.
Our workshop on Healthy Ageing was one of four life stage workshops (on pregnancy and neonatal health, the health of young people, healthy ageing and the healthy adult) that will inform My Healthy Future, a PHG Foundation initiative that aims to create a vision for the next generation of personalised healthcare.