According to George Bernard Shaw, science never solves a problem without creating ten more. The intersection of improved longevity and information technology is a case in point. Because of basic medical innovation, we are living longer. In 200 years, life expectancy at birth has almost doubled (at least for the wealthiest). The long-term result will be an epidemic of elderly people who need to find ways to continue to live well.
Along with increased longevity, research has given us technologies that help us to monitor health. This should be good news. Whether it’s their resting pulse, blood pressure, weight or glucose levels, people now have access to information about themselves that could significantly transform their health care. Instead of doctors relying on the snapshots that patients give them, trends in personal health could be monitored automatically and the data could be integrated with electronic NHS health records. It’s not hard to imagine algorithms able to flag up signs of the onset of a problem.
But we can’t do this yet. One issue, according to a report in the Health Service Journal, is ascertaining who owns the data. Andrew Chitty, director of Digital Life Sciences, a company that develops health-care technology, has been working with government agencies to resolve this. The problem is that the NHS “often regards itself as the owner of people’s data”, he writes. When you gather your own data and attempt to integrate it with that of the NHS, too many lines are blurred and health-care providers stare, terrified, into a legal abyss.
The information might not be used anyway. In March, a review of how medical professionals use electronic resources – advice, case studies, diagnostic tools, and so on – showed that they could do better. Although electronic health information (EHI) has never before been more accessible or available in such quantities, this has not translated into improved outcomes for patients.
The review of the practices of 535 health professionals, including 352 doctors, found that there was “no evidence that the use of EHI translates into improved clinical practice or patient outcomes”. Even with training and education, which increased the use of the available information, the extra measures were “insufficient to improve patient care or clinical practices”. The next study, the researchers suggest, should investigate why doctors are so reluctant to apply information gained electronically.
This is particularly important, considering our ageing population. The UK has been conducting an investigation into digital techniques that could improve the lives of those over 50 who depend on continual support from the health-care system.
The Delivering Assisted Living Lifestyles at Scale (Dallas) programme aims to bring care for the elderly and long-term ill into the digital age. Researchers led by Alison Devlin of Glasgow University have recently reported on its implementation phase. They foresee challenges in establishing the necessary partnerships between agencies such as the NHS, private care providers and homes that offer assisted living. This is made more difficult by changes to the NHS mandate. As private ventures become influential, there will be hurdles in dealing with branding and marketing claims. Those added years, it seems, will be messy.
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