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Can the mobile phone serve to improve public health service?

Artikkelen tilhører Health and biotechnology, postet 4. jul 2014

Hilde Lovett
KONTAKTPERSON:

Hilde Lovett

Norway’s population is ageing, and increasing numbers of people are suffering from chronic diseases such as diabetes and heart conditions. Sensors and mobile apps may bring upon new, reasonable and manageable ways to track and monitor ones health condition – and connect and communicate with the public health service.

Having assembled an expert team consisting of patient representatives, technology developers, doctors and health care employees; Teknologirådet is seizing to assess the possibilities the mobile health technologies may offer.

-To an increasing extent, people are getting access to medical technology that can measure everything from ECG to glucose and blood pressure. Inexpensive sensors, apps and health equipment customized for the mobile cell phone allow for self-diagnosing melanoma, or monitoring of diabetes in everyday life, says Hilde Lovett, Project Manager at the Norwegian Board of Technology.

Through mobile apps, users can analyze, visualize and share their health ratios and measurements. The sensors may be embedded in the mobile phone, as cameras that captures and analyzes moles, or as bracelets and watches that measure steps, pulse and sleep patterns. Other devices may be phone covers that measures ECG or medical technologies that measure blood pressure and glucose levels.

Rapid development in the mobile health technology

During 2014, the range of health technology solutions offered by actors outside the health care system, like Apple and Google, is expected to increase. As Norway offers a steady mobile broadband connection and the amount of smart phones in the population is high, there is reason to expect that Norwegian patients may be rapidly hooked on the hype.

– In recent years the supply and usage of health- and fitness apps has exploded, and medical mobile apps and advanced healthcare technology options are already in the pipeline. The technology is developing independently of guidelines set by the healthcare sector. This is severe, because the societal and individual human consequences of this development will largely depend on how the health care system chooses to deal with the development – and how early they choose to appear on the scene, says Lovett.

Opportunities in mobile health technology

As medical technology development has accelerated rapidly, we have not yet considered the actual opportunities and challenges this represents in Norway. The Norwegian Board of Technology has therefore highlighted three main fields where mobile health technology has the potential to bring forth great benefits – aspects which will be considered and discussed further in cooperation with the expert group :

  • People suffering from chronic diseases. Patients who are already in a treatment program will have considerable benefits of the new technology. The patients will be able to review and monitor their treatment themselves, by making measurements and communicating the results to the doctor – instead of frequently seeing the doctor, which is costly for both patient and the healthcare system.
  • Diagnosis. By using self-tests, patients will be able to detect and diagnose diseases earlier and more effectively. This means that the patient can start the treatment procedure earlier and get a more accurate treatment.
  • Public Health. Use of mobile health technology will generate large data streams. By compiling and analyzing this information, the health care system will be able to monitor the health status of the population continuously, and easier predict the actual needs and prioritize appropriate actions.

Challenges of introducing new technology

Use of mobile health technology also raises multiple challenges. False positive tests – ie, people who are in a good health condition, but believe they are ill – will lead to people flocking to the health care service. The opposite outcome may have serious consequences as well: if you get a false negative test – ie., you think you are in good health, while in reality you are ill – in which case it might be too late for treatment.

Safeguarding privacy, integrity and sensitive data also poses severe challenges. For instance, people will be be able to collect, store and share highly sensitive personal information with the mobile health solutions at hand. This may cause potentials for information leakage and misuse of personal data.

Policy recommendations

There is widespread political consensus accentuating the involvement of patients as a core concern for the future development of public health care. “Samhandlingsreformen” aims to make services more accessible to people, and encourage greater user participation and interaction in Norway. Health and Care Minister Bent Høies’ vision is to promote «patient’s health», aiming to reform the primary health care in order to refute and safeguard a larger proportion of chronically ill patients in the local communities in Norway.

The public health service in the forefront

The White Paper «One citizen – One Journal» was discussed in Parliament in 2013. It stated that «personal records and data information on health and lifestyle will be possible to upload the Helsenorge.no. Where it is relevant, it should eventually be possible to share information with health care professionals and others.» In the wake of this White Paper, the Directorate of Health started the work costructing a personal Health Archive on www.helsenorge.no. However, the report does not emphasize how healthcare can be organized to fully seize the potential benefits of mobile health, or account for the challenges that technology development may bring to healthcare in the future.

About the project

The outcome of the project will be three short reports comprising policy recommendations. During 2014, the first phase of the project will be focused on mobile health for chronically ill patients, with a particular emphasis on primary healthcare. The next phase will further accentuate diagnostics and public health.

Members of the expert group:

  • Simen Brændhaugen, Managing Director of theThe Society for the Support of Children
  • with Cancer and chairman of “Young disabled”.
  • Ola Dale, Physican and member of the Norwegian Board of Technology, experience from the earlier Patient 2.0 project.
  • Steinar Madsen, Medical technical director, The Norwegian Medicines Agency.
  • Damoun Nassehi, Regular General Practitioner in Eigersund, and developer of mobile-apps.
  • Steinar Pedersen, Director of Telemedisin Consult, former Director of NST (Norwegian Center for Integrated Care and Telemedicine).
  • Susanne Prøsch, Regional General Practioner in Sandefjord and head of reference group for electronic medical records.
  • Ida Trældal Rystad, advisor at Norwegian Center for Interated Care and Telemedicine and Board Member of “Diabetesforbundet” (the Central Diabetes Association).

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