Santino (Sonny) Coduri-Fulford took part in the My Healthy Future workshop on adolescent health in his capacity as a Brook Champion. Brook is a sexual health charity for people under 25. Sonny is a medical student at the University of Edinburgh. He is currently finishing his intercalated BSc at Imperial College London in Medical Sciences with Humanities, Philosophy and Law.
In this blog, the first in series from participants in the My Healthy Future life stages workshops, Sonny reflects on how the increasing prevalence of technology in the 21st century will affect health and healthcare.
Digital technology is ubiquitous, with use of digital media increasing across all gender and age demographics above 16 years old. Dependence on digitalised media for communication is increasing and societies are becoming reliant on digitalised means for building and maintaining social networks. This is changing how people monitor their health – more and more people are using their digital devices to inform their life choices. And it doesn’t stop there: the pervasive use of digital technologies is transforming the way healthcare is being delivered. There are powerful examples of how digital technologies can benefit health, but there is also cause for concern.
Keeping a digital eye on our health
Our digital society is increasingly encouraging people to watch their health, mainly through mobile applications. The ‘health’ app, built into Apple products not only monitors step count but also has the ability to record what people eat, how long people sleep, even the number of minutes’ people meditate in a day. While the app cannot force people to investigate their health-related behaviours, the mobile phone is opening up options for people to become aware of their health. Overall, this must be a good thing: people who are more aware of their health may take health-conscious decisions which will be beneficial. However, as voiced at the My Healthy Future workshop, there is concern about the ways in which self-monitoring could feed obsessive behaviours, for example anorexia.
The virtual consultation
Digital media is also helping people organise how they receive healthcare. The NHS recently released the application ‘GP at hand’ which enables people to access a doctor on their mobile phones, swapping their registered physical practice for the virtual clinic. There is no denying that this innovation will benefit many, especially people whose schedules do not fit in with opening hours of GP surgeries. It may also reach a portion of society who are not registered with a GP because access is difficult. In principle with GP at hand, anyone can access a GP at any time from their mobile phone.
But how might this platform sculpt consultations? – will removing the requirement to meet with your GP lead to a less personal service? Something unique about the profession of General Practice is the continuity of care – from the practice if not the actual GP – and the individualised care delivered. Could this be threatened by the rise of the techno-consultation? Isn’t a critical part of a medical consultation the person to person interaction where a doctor can pick up on non-verbal cues as well as the continuity of care that can encourage people to talk more openly about their health?
Other apps are treading a middle path to circumvent such fears. ‘Tess’, a mental health chatbot aimed at caregivers in Canada, is instantly accessible 24/7 through messaging apps (for example, Facebook messenger) or your phone number. While the chatbot acts as a virtual therapist up to a point, the algorithm behind Tess is trained to spot when a more robust intervention may be needed and can connect the user with a human therapist. This technology could actually encourage more useful face to face interactions.
However, if chatbots and similar services are widely implemented then the issue of funding must be considered. Who funds these services? Will only the people who have money be able to access the enhanced medical services which the technology delivers? That these questions need urgent addressing is clear from this recent article on the UK mental health chatbot, Woebot. Currently free to users, its developers acknowledge they may look at charging in the future.
Monitoring the monitors
These are only three examples of many new technologies which affect health in society. Several other technologies were discussed at the My Health Future workshop and what is obvious is that technologies will continue to evolve. There will be a constant flow of new digital technology as we progress through the 21st century making prediction particularly challenging. It is evident that how people monitor their health and receive healthcare is changing and the expansion of the range of digital media and technologies is not set to halt.
That’s not to say we should bury our heads in the sand. The conversation surrounding the changing digital technologies and how they will affect health and services is something which needs to be had, so healthcare professionals can plan or at least consider the future landscape. However, the discourse needs to happen with a lot more people, from different professions, age groups and experiences. The positives and negatives of the uses of technology for healthcare need to be established and the ways in which these technologies may be deleterious to personal health or the authenticity of human consultation need to be addressed.
Critically, decisions are needed as to who monitors the monitors – who is responsible for the standards and quality assurance of the expansive array of digital technologies our health is becoming dependent on?