I class myself as someone digital. I get technology (to an extent) and have an inherent interest in and how it works. I love it and I live with it pretty much 24/7. I have been part of GP at Hand / Babylon Health and their telemedicine service for almost two years now. It works for me and my lifestyle. By that I mean, I’m pretty busy, and find it hard to find time to queue at 7.30 am for an appointment at the doctors, I don’t have any chronic diseases and know that 9 times out of 10, I have pharyngitis and need antibiotics. Through my app, I can get a video appointment usually with 45 minutes from 6pm to 10pm and get my prescription sent to my local (whether at work or home) pharmacy. Seamless, effortless and effective.
However, this is not the case for those older citizens who firstly are most likely are unaware of the service, secondly often prefer to see a doctor face to face and thirdly more likely to have chronic conditions or health complications. A video call is just not enough a lot of the time – or so we all seemed to think until recently.
COVID-19 has accelerated the world two to three years ahead of where many predicted it would be. Adoption of remote working and all the tools that go with it was almost transformed overnight and arguably for ever. With the rise of the pandemic coupled with the WHO and government advice, telemedicine was the only route allowed. Suddenly, video calling was upon us and we instantly adopted it. Many needed to use online forms and decision algorithms to diagnose and direct patients but with confusion over whether it was COVID-19 related, flu related or totally unrelated wasn’t an easy one to make. A recent study suggested that the “the lack of eye contact and nonverbal cues during phone-based visits are problematic and telephone-based visits can hinder exploration and explanation of complex topics. The lack of face-to-face interaction also made it difficult for providers to gauge how well the patient understood the relayed information. Additionally, without visual assessment evaluation of gait and objective physical function could not be performed.”
However, we have the tools and solutions to resolve this. Albeit not widely prevalent, imagine using sensors such as those in the X-box Kinect or the accelerometer in mobile phones to predict when someone could fall? Roche’s Floodlight work in MS is a great example of using different components of mobile devices to ask patients to draw various shapes to assess speed and accuracy and changes over time in order to monitor any change in the progression of their disease.
Care homes unfortunately have come under huge scrutiny globally due to the susceptibility of the elderly and subsequent infection and death rate during this pandemic. Surely these care homes should become a breeding ground for elderly medical support, health trials, app testing rather than that of a disease.
The remoteness of life in care homes is hard enough without a lockdown and social distancing. I wonder whether each home could have a product similar to a ‘Like-a-hug vest’ to bring some back some of the emotion and face to face interaction.
Even the track and trace apps that are in place to help fight the pandemic that have been employed in some countries seem a little clunky - with call centres at the helm, rather than automated communications. These platforms could be taken further, for example, assessments based on GPS to track those in the vicinity or predictive measures to warn others away from congested or ‘virus active’ locations. This is already in place in countries such as South Korea and surely something that more countries should be adopting.
This article is titled ‘what my mother taught me’ as a follow up to an article I wrote a year or so ago called What My Father Taught Me. I felt I owed it to my mother to write one for her too. She passed away in March from COVID-19 very suddenly, leaving me, my sister and father behind.
Sadly, she was at home for the majority her short illness with undiagnosed symptoms - despite calls and videos with various doctors. Technology should have enabled my family to know how ill she really was. If it had, maybe we could have done something more or sooner. But it didn’t, and we can’t change that for her. Having all the technology and connectivity at our fingertips was, for us, meaningless. So, as much as I still love and very much believe in it - without the right access, without distribution of additional tools and monitors, and without the support of connected data – technology can cost lives. My mother taught me that.
Simon Stebbing is CEO, Wunderman Thompson Health London