Healthcare For the Common Man?

by Jim Dawton, ‎‎Director at Great Fridays, now an EPAM company

The Quantified Self movement shows no sign of losing momentum. This movement, which uses technology to create a database about an individual’s health, is one that is likely to accelerate now Apple has entered the market.

This phenomenon of self-data and self-tracking is one that Apple has been slow to recognise, but the announcement of its the healthcare app, Apple Health and the HealthKit platform, has led to much hype about how it will revolutionise healthcare.

Naturally, Apple’s reach and critical mass means that it will certainly have an effect on how its customers will self-monitor their health; the numbers alone will do that. But is this a watershed moment or just another one of those promised revolutions that happen to be no more than a very expensive marketing activity?

Healthcare in the UK and the US is a huge problem for governments. Health insurance in the US as well as the on-going travails of the NHS in the UK are issues that are critical to the future of healthcare in these countries.

Whether it’s the so-called obesity epidemic or the institutionalised neglect of the elderly, any type of service that can make an individual more responsible about their health is an apparent godsend. Just as families represent a unit that means governments don’t need to look after children, the notion that individuals can heal themselves is an alluring one.

It would be interesting to know the demographics and consumer data of an ‘average’ iPhone user?How old are they? How fit are they? How obese are they? How stressed are they? Difficult questions, but the one thing that is certain is that they are not poor.

So, step forward, Apple Health and Healthkit and the next step on the road to a fitter, faster, stronger and leaner society. That’s perfect, right? Well, probably not. Those who can afford Apple products and services are the richest people in the world. And that’s without taking into account the growing popularity of Android and other mobile platforms among the rest of those rich people.

Healthcare is also a bold claim. It’s wellness, but it will be a wellness for the elite, and the majority of people without an iPhone will be left to deal with what will almost certainly be dwindling medical resources. If this is really going to be an effective ‘health’ platform, rather an extension of the existing ‘wellness’ platforms of the Quantified Self it will need to engage the masses, not just the exclusive margins.

So is this just more wellness for the elite? Perhaps the FDA’s edit to it’s description, highlighting that it will not regulate apps and services like Apple’s Health and HealthKit implies this is not a serious contender in the healthcare industry.

What healthcare needs is more than a mobile app or a well-intended developer platform. It needs a true transformational service design strategy.

Effective healthcare is not about knowing all our data; research shows that in-activity causes as many deaths as smoking worldwide. In the US for example, 52% of adults do not meet recommendations of physical activity. Do you think iPhone users who are monitoring data are the real problem?

Poor medical adherence is also a huge threat to people. It’s a three-fold problem: people don’t take their medicine, so they don’t get better. (In the US 50% of those with chronic conditions do not manage their medicine properly, costing $100b of avoidable hospitalisations). This also causes diseases to become resistant and the patient needs more medicine, which increases the cost of healthcare.

At present, countries cannot afford the cost of healthcare, and pharmaceutical companies aren’t incentivised to develop new drugs to deal with the new variant diseases. Apple’s Health or HealthKit may even drive up medical costs due to over-diagnosis.

Also, it is one thing for people to have control over their data, but another for them to understand it. It takes a long time for medical practitioners to learn their trade, self-diagnosing patients are going to be wrong a lot of the time. And there aren’t many doctors who I think will be interested in the intricate details of the glucose levels of every healthy patient they meet.

A design lead approach that adopts a consumer-​first mentality could help solve these problems by creating healthcare that actually improves health.

The digitisation of healthcare, products and services and even environments to improve medical adherence, encourage physical activity, help people manage chronic illnesses, empower patients and change the doctor patient relationship to make it equal, for those who need it: these are true healthcare services.

Services that help people really deal with healthcare problems and reach everyone, are what are needed. The NHS in the UK does a pretty good job, not many countries have healthcare for the common man; it’s too expensive.

Understandably, Apple’s healthcare strategy may evolve to become more inclusive, but for now it may not be so much about the Quantified Self, more about the Quantified Selfish and how the well-heeled are likely to prevail, adding another difference to the haves and the definitely have-nots.