I have a highly competitive running fixation.
As the races grow longer and my competitive streak larger, I’ve found myself applying a more data driven approach to my body; I log meals into MyFitnessPal, train according to measured heart rate zones, and track pace in a race against my targets.
If you think that sounds like a lot of effort, it isn’t - passive data collection combined with multiple apps working together to consolidate it can deliver the insights I need to make performance analysis easy.
My Dad suffers from heart failure - the left side of his heart doesn’t work, resulting in very high blood pressure. He’s been prescribed a series of lifestyle changes to reduce and sustain a lower blood pressure, with a table to log and measure the impact that these changes have. The table is divided into 4 columns: Blood pressure reading, a self-rating of how ‘good/bad’ his meals have been that day, hours of sleep and the type of exercise completed.
The contrast between how we each monitor our physiology is stark. Whilst Connected Fitness is commonplace, it’s clear that Connected Healthcare still has a way to go with how we collect data, aggregate it and use it to inform treatment. But if fitness can get it so right, then why can’t health? Especially when the outcomes are potentially lifesaving?
1. Framing and preparing the right data
In the world of Fitness, wearables track a user’s daily step count to encourage a more active lifestyle, informing the wearer if their day has been too inactive. But for athletes trying to increase fitness levels, step counts are meaningless – instead, they monitor changes in average resting heart rate, or body fat vs muscle mass percentages. This is logical and doesn’t require professional intervention to understand.
For health, despite the same ability to gather accurate physiological readings, the information requested by Dad’s GP is subjective and high-level. It asks nothing of his sleep ‘quality’ (REM), the nutrient composition of his diet, or the heart rate zones reached from exercise. How can the impact of lifestyle changes on his blood pressure be measured without first understanding those changes at a deeper level?
2. Remove barriers, make collection simple
Approximately 2 million fitness trackers were sold in the UK last year alone. Not all 2 million are ardent athletes, so why bother tracking their performance? Well, because it’s easy; wearers are gathering data and tracking activity unconsciously. If it required a stopwatch, counting pulse rate, and logging numbers into a notepad, would 2 million people still be recording their activity? Probably not.
Instead of the effortless data collection we are familiar with for Fitness, Dad has the task of recalling by hand a ‘self-assessment’ of his day. As the owner of an Apple Watch, a GP may have suggested that he record and share his physical and nutritional data via these means, less arduously and more accurately.
3. Get it together
I use different apps to log my food, exercise and sleep quality. But I rarely open them all – to me, value comes from viewing this data together in Strava. Here, I can see how accumulated factors are affecting my running performance.
For my Dad, without an integrated view of the effect of his diet, sleep quality, and exercise on his blood pressure readings - the value of that data to him and his GP is low. What’s more, without the support of systems which receive, consolidate and communicate patient data in line with their patient’s medical record, the GP is receiving a fragmented picture of the patient’s health.
4. There’s no time like the present
Dad visits his GP every 3 months with his table to report on his progress. This is a common patient/doctor model - data is collected intermittently between GP visits, then stored in an electronic medical record system.
Imagine a new model, where Dad’s smartwatch - monitoring his vitals continuously - can provide actionable, contextual and relevant feedback to him on his behaviours. Visibility of our own data is powerful; it heightens our accountability, educates us and encourages behavioural change in real time.
Thinking one step further
What if Dad’s smart watch – or the APIs powering it - could regularly update his GP on his response to treatment?
With a comprehensive view of their patient’s activity and physiology, a GP could be notified of changes that indicate developing symptoms ahead of diagnosis. This could spark a shift in our approach to health from episodic and reactive, to continuous, proactive and preventative healthcare.
The level of detail available on a patient’s physiology also opens a doorway to more tailored prescriptions; personalisation in healthcare is on the rise. With the concept of precision medicine growing fast and mass market, and inexpensive gene analysis more accessible (such as 23andMe and Living DNA), the ability to tailor treatment to a person’s biochemical makeup is becoming a reality.
So, what’s stopping us from getting started with wearables?
With personal data comes responsibility
A connected approach to healthcare would allow health professionals to prescribe tailored treatments, proactively and more efficiently. But truly Connected Health has barriers. For example, redesigning a support system to integrate and analyse live data with medical records requires digital transformation.
Then there’s the omnipresent question of data privacy, and data doesn’t get more personal than health. Broader and deeper information being shared with healthcare professionals poses a whole host of legal and privacy issues which will require a new approach to legislation and greater scrutiny.
Nevertheless, the connected approach to Fitness is a good rubric for the future of Connected Health. We still have a way to go, but we can take the first steps to creating something better. A starting point would be in providing further support to our GPs in the stellar work that they do. With the enormous pressure they feel from a healthcare system at max-capacity, we could be complimenting their vast, existing knowledge of physiology with an understanding of new systems and data analysis provided by the latest digital technologies. This will help form an understanding of new ‘wearable’ patient data, and in turn how it could be applied in their day to day appointments.
In turn, GPs should feel supported to encourage patients to understand their own physiology and wearable data. Whilst not all wearable owners share the enthusiasm for their average minutes-per-mile, we do all share a responsibility for our own health. Rather than overlook, or even fear our detailed health data, we can empower ourselves with it, and embrace its greater accountability over our wellbeing.
Through familiarisation with our own data, and greater confidence in sharing it with our GPs, we have the opportunity to kickstart real behavioural change, create efficiencies for our health services, and work together with health professionals to create effective treatments, tailored to our individual requirements. Our health doesn’t switch off between our Doctor’s appointments, and with the opportunity for a more joined-up approach to Connected Health, neither should the way we view it.
*Hannah’s Dad is aware of this article and has given express permission for us to share his story.