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How can the NHS use wearable data to create benefits for patients?


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Anyone with newly qualified young drivers in the family will know that up until recently their insurance policy cost resembled the national debt. But assenting to ride around with new 'black box' technology in the back, monitoring driving habits with a view to promote - and reward - low risk behaviour, is seeing significant drops in premium. Which got me wondering, would my health insurer consent to lower my premiums if I shared my Fitbit data with them (over 1000 days of granular records), evidencing as it does that I do try and make an effort where health and exercise are concerned? And from there it didn't take much of a leap to consider a completely new social health paradigm, where we monitor and record a whole host of well-being indicators - blood pressure, glucose, cholesterol, heart rate, ECGs etc - and rather than just using them rather passively to guide our lifestyle we actively share them with our GP and the NHS. There are micro and macro pictures here - the micro is the individual patient and the patient/GP relationship, where this data flow could underpin a whole new line of preventative monitoring and screening, preemptive action or early diagnosis; the macro is the biggest of Big Data exercises, where so much data gathered so quickly and accurately from so many different sources across so many geographies could be a game-changer for medical research, healthcare strategy and hospital management (though I recognise the data handling and security challenges could be momentous ones in this context).

For once, technology is not the problem (however I'll caveat this by saying that we do need the right standards in play). We already have medical-grade consumer devices in the home, wearables and smartphones have hugely amplified the whole fitness and health-checking movement, and we're now also seeing clever AI-led solutions such as Skin Vision, which can scan and appraise moles for skin cancer via an app. Who says that in time we won't have swallow-able little cameras that can film our gut and pronounce on the condition of our bowel? I suspect that the tech will be able to do anything we want it to do, the only problem is the 'we'. What do we want? Or rather, what will we allow?

The trouble with medical data is that it's rather the Crown Jewels of personally identifiable information. We already sniffy, quite rightly, about keeping private stuff private, and medical info has long been seen as absolutely sacrosanct. And here we are, with the very real potential to get in front of health problems (and solve some of the debilitating operational issues within our health service), but we need to get the Crown Jewels out and share them around: we need to socialise our own health data.

It's a big ask. You can't blame people for being wary of anything that has a touch of the Big Brothers, even if it is for the individual and collective good. While the fitness freaks may be waving their Apple Watches around showing a perfect health profile and confirmation of their health insurance discount, there will be many leading normal, moderate lives wondering if their predilection for a bacon sarnie and that extra notch on their belt will send them to the bottom of the waiting list come hip replacement time. It's not difficult to see the tabloid headlines around this sort of initiative and indeed it is a big argument-filled melting pot of the cultural, ethical and attitudinal. But the prize could be amazing - a way to take personal responsibility for your health, to unlock a new means for GPs to supervise that health, and to right-time and right-size professional interventions, with all the knock-on benefits to both patient outcomes and the NHS's long-term viability.



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