The digital revolution is a reality that is changing the way in which we live, work and organize our free time. We are facing a progressive transformation that is making itself felt in almost every human activity; however, the fact that this is gradual and progressive does not mean that it is not revolutionary.
For many people it is difficult to imagine how we could have lived in a world without the internet, email and even mobile phones. Beyond the purely anecdotal aspect, the fact is that the different industries that surround us cannot turn a blind eye to digitalization. From the audiovisual world through to the production of products and services, if we were to eliminate the digital technology component, most of them would go into serious decline.
Digital connectivity, through mobile devices, phones and tablets, is empowering the general public. For the first time in the history of humanity, people can exercise a power that would have been unthinkable a couple of decades ago, whether this is as consumers, clients, users or simply by the mere fact of being a citizen with the ability to mobilize the social networks with an opinion.
According to professor Manuel Castells: “Indeed, the current transformation in communication technologies in the digital era extends the scope of the media to every sphere of social life in a network that is both global and local, generic and personalized, according to an ever-changing pattern. As a result, power relationships – in other words, the relationships that form the cornerstone of every society, as well as the processes that challenge institutionalized power relations – are determined and decided more and more often in the field of communications.” (1).
These views are not very far removed from the world of health, and in particular the professionals who offer services related to this field and their patients. The science of life is a complicated world, especially when citizens/patients no longer accept the “I don’t know/you know” dichotomy. Information, which is power in terms of health, flows freely on the internet. Both good and bad.
Perhaps for this reason, what we have come to know as mHealth offers a great opportunity for both healthcare professionals and citizens/patients. Today, the new mobile technologies are converging with life sciences. Proof of this is the fact that there are more than 150,000 apps in the health sphere. Nor should we forget that mobile technologies are a very recent phenomenon: the first smartphone only appeared on the market in 2007, and tablets in 2010.
A novel aspect in this respect is the emergence of preventive care and what is known as “wellness”. First and foremost, prevention. While good health depends on genetics, it also depends on behaviour and the social medium. (2). Health education is the key. It’s not just about physical activity (10,000 steps per day) and eating fruit and vegetables (5 portions a day), but also about quitting smoking and controlling alcohol consumption. Nor should we forget the correct maternal care of new-born infants, including the prevention of post-natal depression, compliance with vaccination schedules and preventive diagnoses. There is no doubt that for all of us (and the healthcare system) the most important thing is not to get sick.
Changes in the organizational model of the sector
Health systems in the western world are facing a series of major challenges and the biggest one is their economic sustainability. Increased longevity, chronic illnesses, new drugs and new treatments, along with a population that is increasingly aware of its rights, are putting the health system under serious pressure. Experts warn that it will be difficult to increase expenditure and the most likely scenario will be the need to establish more dynamic and interactive models for providing healthcare services. In other words, a major organizational shift that takes into account the importance of adequately measuring and evaluating the diagnostic and therapeutic impact, prioritizing those treatments and processes that genuinely contribute to improving patients’ health, aligning incentives for good medical practices and, most definitely, promoting a culture of health; in other words, healthy lifestyle habits.
From this perspective of organizational change, mobile technologies can play a key role as a facilitator for clinics, citizens/patients and political and technical managers. Technologies, in principle, are simply tools. The new paradigm is how these tools can be used to manage the necessary changes in health organizations.
While earlier we mentioned the importance of prevention, the good news is the huge number of apps, sensors and processes available on the market created specifically to encourage healthy lifestyles (exercise, diet, mindfulness, etc.). However, the challenge is who is going to evaluate their clinical impact and who will do the prescribing. The same applies to early detection. There is evidence, especially in the field of mental health, that the emergence of certain diseases, especially depression, can be spotted in time. In a great many diseases, acute phases can be avoided with properly prepared data. The same applies to multiple chronic diseases. In patients with certain chronic diseases, the appearance of new ones is predictable. What we’re looking at is Big Data at the service of personalized medicine. Advances in the field of genomics will allow us to obtain genome maps at affordable prices.
According to Eric Topol, a cardiologist who is professor of genomics and holds the Scripps endowed chair in innovative medicine: “It took ten years and $5 billion to sequence the first human genome, and now it takes less than twenty-four hours and costs less than $1,500.” (3) He adds: “The average person is projected to have between six and seven connected devices by 2020.”(4)
There is huge potential for mobile technologies in the field of chronic diseases. This is particularly true when it comes to monitoring and checking patients’ vital signs. Information and data form an essential element of healthcare. In the case of chronic diseases, it is vital to have the correct information to be able to act in accordance with these data.
One of the areas in which the use of mobile technologies is advancing apace is the field of mental health. There are numerous examples of the use of apps that help the patient and his/her family to monitor progress and take therapeutic action before an acute crisis has the chance to emerge.
Although it must be acknowledged that mobiles and tablets cannot actually provide a cure, they are turning into extremely useful tools for disease prevention, health education, monitoring chronic diseases, connectivity between patients and their clinics, and even inter-patient communications. Furthermore, another area with huge potential is opening up, this being Big Data and personalized medicine based on the scientific advances made in genomics. All of this is possible provided that the necessary changes can be made at an organizational level.
At the mHealth Competence Centre of Mobile World Capital Barcelona we are working with a strategic vision in collaboration with agents in the health ecosystem to establish goals, identify challenges, facilitate teamwork locally and globally and set in motion projects that will enable us to speed up the implementation of mobile technologies in the field of health.
By Joan Cornet, Director mHealth Competence Centre, Mobile World Capital Barcelona
Manuel Castells. Comunicación, poder y contrapoder en la sociedad red. Los medios y la política. Artículo publicado en la revista Telos nº 74. Enero-Marzo de 2008.
Perceptions of the roles of behaviour and genetics in disease risk: Are they associated with behaviour change attempts
Anh B. Nguyena*, April Oha, Richard P. Mosera & Heather Patricka
pages 336-353. Psychology & Health. Volume 30, Issue 3, 2015
Eric Topol, The Patient Will See You Now: The Future of Medicine is in Your Hands
The Patient Will See You Now: The Future of Medicine is in Your Hands