Apps, AI & Androids: Can mobile health solve global health challenges?

Technology and health have been entwined throughout human history — discoveries in one lead to developments in the other. Now with universal access to the internet in the least developed countries by 2020 as a United Nations goal, ‘telehealth’ has the opportunity to shape health systems on a global scale.

The Swasthya Slate is one tool being used in regions that would typically lack healthcare. Funded by the Public Health Foundation in India, the health tablet has been in use since March 2014 to great success in community health centres. The Swasthya Slate is a portable diagnostic tool; users only need a simple box, power source, test sensors and a smart device using Android OS. As 80% of phone users in India use Android, this device can utilise the infrastructure already in place to aid those who lack a coherent health system, with the ability to scale up quickly. Already in place in all community clinics in New Delhi, the Slates are able to run 33 diagnostic tests, from blood glucose levels for diabetics to HIV status. This allows doctors and community health workers to diagnose and monitor chronic illnesses at the point of care – reaching many patients very quickly and exceedingly cheaply (only $1.25 for 10 standard tests). The Swasthya Slate is a clear example of how mobile devices enable healthcare to reach low resourced areas effectively.

It is not just developing countries that are utilising mobile technology to ease resources. There are many apps for clinicians to use, allowing them to receive results, track symptoms and communicate with specialists faster than ever. Private and state doctors across the world are increasingly using their devices during patients’ consultations. A UK app called UptoDate is aimed at clinicians and works as a peer-reviewed catalogue, providing updates of new information in medical literature. It also delivers materials to facilitate clinician-patient communication, including providing educational resources that can be discussed in person or received via email to continue a doctor’s support to their patient. Simultaneously, a drug database allows clinicians to track and communicate drug use and drug interactions, working to minimise patient risk. By speeding up communication and collaboration between specialists, telehealth can enhance existing health services in addition to low resourced areas.

While health professionals can make their daily tasks increasingly streamlined, patients are also turning to tech to guide their own health. 4 out of 5 adults in the UK have a smartphone, and using our favourite apps is often a daily habit. Fitbit usage is one example of wearable tech that people have incorporated into their lives, but telehealth development has progressed far beyond monitoring steps, heart rate, and sleep activity. Another UK app, Babylon, aims to increase patient convenience. It allows patients to video chat a private GP, has the option for booking specialist sessions, including therapists, in addition to the typical activity levels and calorie tracker. But this app is more than a long distance appointment creator — it can also let you chat with, and be diagnosed by, their artificially intelligent medical adviser. Having been exposed to billions of data points from thousands of test consultations, the AI health service is claimed by the company to diagnose with 92% accuracy, and they believe it to be more reliable than a human doctor for many diagnoses. As Babylon GPs can also issue sick notes and can arrange for same-day delivery of prescriptions to your home or office, it is no surprise that patients are turning to their phones as opposed to their GP surgery.

While patient and clinician use of health tech can influence health system structure, health researchers are utilising smartphones to help public health on a broader scale. One such project is in collaboration with the BBC: Pandemic. Having already received over 10,000 downloads, this is citizen science in your pocket. The app will record the owner’s location and how many interactions they have in a day in order to see how a highly infectious flu pandemic may spread. By collecting such data, researchers aim to create a new gold standard for epidemiologists in the UK. This can help with decision making when time is vital, such as closing schools or airports. So much information from real people across the nation can directly influence policy making and emergency decisions that impact public health.

The NHS also sees the benefits of such technology, and has a digital health library of apps. These apps offer everything from GP video chats, to support for mental health, dementia and cancer sufferers. They even have a dental DJ that plays music for the right amount of teeth brushing time! However, all these telehealth opportunities must be used carefully. Whether it is patients, clinicians, or public health services using this technology, it is vital that these apps have vigorous security checks to ensure patient confidentiality. Earlier in 2017, the NHS suffered a severe cyber-attack, with patient information being held to ransom. Unless all health apps can be guaranteed as secure, with the patients’ interests at heart, personal details such as location, medical records, and prescription information could be vulnerable. We must also consider who would be responsible for any misdiagnoses if an AI is your digital doctor.

Poppy-Jayne Morgan is studying for an MSc in Science Communication at Imperial College London

Banner image: Instagram and other Social Media Apps, Flickr /Jason Howie