Another idea from UK Health Secretary Andrew Lansley published today in The Times. This from a government with lots of ideas which sound great until the proposal is dissected.
I am a great lover of social media and mobile technology. These innovations can be force for good. Yet away from the headlines, the latest proposals for encouraging increased use of smartphone apps to improve health of the national are unlikely to be effective.
1. Increased disparity between healthy and unhealthy, and between the haves and have not. Smartphones cost money. A lot of money. Money better spent on food and clothes and utility bills and rent, especially in the current financial climate.
2. Good use of smartphone apps assumes numeracy and literary skills are adequate. This is a big assumption with so many adults and young people failing to achieve minimum standards of reading and maths skills. The very same population which predicted to have the greatest health needs.
3. Healthcare professionals do not wholeheartedly use smartphones to their fullest potential. How can political desires be fulfilled if the healthcare providers have yet to use smartphones and the many apps already available to improve quality of clinical decisions? The absence of leadership from family doctors in this area is a barrier to widespread use in my opinion.
4. The citizens with the most to gain because they have the greatest disease burden are the older people, and say over 65. Failing eyesight, deterioration in manual dexterity, reluctance to embrace new technology even if it was affordable are all significant barriers to successful implementation of Lansley’s proposals today.
How could they proposals succeed? I think that improved uptake of smartphones may succeed if the politicians facilitate increased use of mobile technology by healthcare professionals. The technology must be seen as much a part of healthcare as the stethoscope. Mobile technology is never going to be the panacea the loudest fans claim. What should not happen is dismissal of currently great applications which already exist to improve the way healthcare providers can work now. There is not space here to enumerate the many great apps already available. I will mention one: Mediquations. This the most comprehensive collection of formulae for clinical care and available for Android and iPhone devices. The programme was created by a neurosurgery resident. It has proved itself countless times in my own practice. It is cheap, it is easy to use. In my opinion every clinician should own and use it as regularly as stethoscope and sphygnomanometer. Clinical teachers will need to be familiar with mobile apps in order to introduce students to them. Medical schools, pharmacy colleges, nursing training and other centres for health professional training must embrace the new technology to ensure students learn to view mobile apps as integral to healthcare delivery. Only when the current ambivalence if not downright antipathy to mobile technology in healthcare is overcome can the vision in today’s proposals be realised.