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30 September 2015

The future of healthcare: Using big data to stay well

The health effects of physical inactivity are estimated to cost Britain £6.5 billion per year, while alcohol costs £20 billion, according to the National Institute for Health and Care Excellence in London.

By New Scientist

If you often find yourself reaching for a chocolate eclair rather than your running shoes, you’re not alone. It seems that human nature makes us prone to taking our well-being for granted. “We often go around leading our daily lives, not worrying about our health until something dreadful happens,” says Robin Ireland, chief executive of Liverpool-based health advocacy Heart of Mersey.

It’s not as if we don’t know what’s good for us: three in four people in the UK believe eating well and staying active are vital to preventing illness, according to healthcare technology company Philips’ 2015 Picture of Health Report. Despite this, a quarter of those surveyed said they don’t have time to exercise, and one in five admitted they lack the will.

Picture of health

It’s also clear that our bad habits are costing us. The UK’s most common health problems –heart disease, lower back pain, stroke, lung cancer and chronic obstructive pulmonary disease – all frequently have roots in unhealthy lifestyles. In fact, in England poor diet and smoking accounts for 40 per cent of disease, according to a major study by Public Health England. Climbing obesity rates, fuelled by unhealthy eating, have been described by NHS chief executive Simon Stevens as a “slow-motion car crash”.

And then there’s the matter of money. The health effects of physical inactivity are estimated to cost Britain £6.5 billion per year, while alcohol costs £20 billion, according to the National Institute for Health and Care Excellence in London.

What to do? Primary preventions, aimed at stopping health problems before they occur, will already be familiar to most people: think of the smoking ban, or the suggestion to tax sugary drinks. Inevitably, though, serious health issues will still occur. This is when secondary preventions step in to manage these conditions more effectively and encourage healthier habits.

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This idea is gaining ground with the wealth of relatively cheap and powerful health-related technologies becoming available. In September, Philips unveiled a set of personal health programmes to help people tackle specific issues such as obesity and heart conditions.

Each programme uses a series of connected devices – blood pressure monitors, scales, a smartwatch and thermometer – to measure everything from heart rate to BMI to sleep patterns. That information is beamed by Bluetooth to a Philips smartphone app, where people can then access personalised lifestyle coaching. The data is also stored on a cloud-based platform called the Philips Digital HealthSuite so that, with permission, it can be viewed by a doctor. Healthcare providers can even add the results of hospital tests to a person’s HealthSuite profile, allowing for a comprehensive view of their condition. The devices are designed to be medically regulated, to ensure that the data they stream to clinicians meets rigorous quality standards.

There is growing evidence that connected devices can have a significant impact on health. Earlier this year, the Philips Picture of Health survey revealed that almost 90 per cent of people who use a connected device say that it has helped them improve their health.

But there is still the challenge of turning data from wearable tech into meaningful action. “The gap between recording information and changing behaviour is substantial,” wrote Mitesh Patel, David Asch and Kevin Volpp in January 2015 in the Journal of the American Medical Association. “While these devices are increasing in popularity, little evidence suggests that they are bridging that gap.”

Philips’ personal health programmes are designed to tackle exactly this problem. Indeed its connected devices are different from the average fitness tracker. The personal health programmes are “not for people who want to run faster around the park,” says Caroline Clarke, CEO of Personal Health Solutions at Philips. “We’re really focusing on people who are at risk.” That means people who are prediabetic or who have high blood pressure, for instance.

The programmes aren’t just about collecting data. They also offer personal coaching – both virtual and human – to help lessen the challenge of making positive behavioural changes, one of the more significant hurdles for many individuals. “We’re not just dispensing devices,” says Mark Aloia, the global lead for behaviour change at Philips HealthTech who also researches behaviour at the National Jewish Health research centre in Denver, Colorado. “We are offering solutions and support.”

Virtual coaching

Aloia says the programmes work in part by tailoring advice to a person’s circumstances, and by offering manageable steps that build confidence. Meanwhile, Philips’ algorithms analyse data to understand what’s working, and what isn’t. One example is weight loss. If a person isn’t shedding the pounds, the software can dig deeper into the data to discover why. “By connecting the data points of what they’re eating but also activity, sleep and stress, we can see that perhaps they’re not sleeping well,” says Clarke. “We know from that data point that what they need is not a nutrition plan, it’s actually a sleep plan.” The app can then offer a personalised sleep programme that promotes better eating habits. “That level of personalisation and relevance is extremely important because you get a sort of light-bulb moment from the consumer,” says Clarke.

The technology is particularly useful for those who have already been admitted to hospital with chronic conditions because it can help them to live healthily at home for as long as possible. Research has shown that this can be achieved by digitally monitoring people discharged from hospital and intervening as needed to avoid a relapse.

A 2014 study by Philips, involving six Dutch hospitals and the Netherlands’ three largest health insurance companies, found that digitally monitoring people with heart failure at home resulted in a 52 per cent decrease in hospital admissions and a 26 per cent cost saving per person.

Cost savings are clearly a bonus, but the real reason to prioritise prevention is to improve people’s lives. “Some preventative activity will obviously save money, but as a whole, the purpose of prevention is to improve health and longevity,” says David Buck, a senior fellow in public health at The King’s Fund, a health-related think tank based in London.

A key part of that, says Aloia, will be understanding why we act as we do. “Philips wants to be at the forefront of shaping the future of healthcare and positively affecting lives,” he says. “I think once you take that on as a challenge, you realise pretty quickly that you have to understand people.”

This article was first published by the New Scientist on 11 November and is re-published here with permission.

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