Can digital technology really save healthcare?
After a slow start the health and wellness sectors finally seem to have noticed the digital revolution Eager start-ups are in abundance and the health industry leviathans are falling over themselves to embrace them.
History tells us that as each revolution in technology solves the problems of the day but often creates the problems of tomorrow. People of the 19th century marvelled at the internal combustion engine, people of the 20th century choked on the fumes.
In our mission to prevent and manage chronic conditions we ask how can we best use digital technology and how do we avoid just creating new problems?
Health for the healthy
The first big thing was wearable wellness, Fit Bit et al. We worry greatly that wearables just help the healthy wealthy to be healthier. It would be folly to map the data from those across a wider demographic assuming a scaling effect.
A prescription for profits
The current fad are diet/exercise, AI, smart lifestyle management coach apps for the obese and those with diabetes. The problem with these, as with wearables, is financial.
NCD costs the NHS billions, right? A person with a single NCD costs nearly £2,000/year, those with multiple NCDs cost £20,000+/year. So a £300 app based programme which supports people to lose weight and be more active is a no brainer – look at the billions we would save.
Not quite. There are around 14m obese adults in the UK, if we put them on one of these apps then that’s £4.2bn plus NHS admin, call it £6 billion. The truth is that the long term success rate for weight loss programmes is a depressingly low 16%. So £6 billion later we still have 11.7 million obese people, with each success costing us £4,615 per person… more than bariatric surgery.
A prescription for politics
More than anything the challenge here is politics, what politician spends £6bn today, on something that not many people will support, in full knowledge of the headlines 12 months later that 84% are back to their old weight? The benefit, such as they are, won’t really be known to long after the current election cycle. Lose, lose, and lose.
Health is for life
The core problem is that obesity, diabetes and many other long term chronic conditions can’t be permanently fixed in 12 weeks. In 12 weeks you can lose weight, you can reduce your blood glucose, you can create a great illusion of success but changing your relationship with food, exercise and a healthy lifestyle typically requires support for life. It’s hard to find a business model to support that.
Above all we worry that greatly that a wave of digitech will just increase health inequality, the have and have nots of healthcare.
The hard truth is digital entrepreneurs and society have a very different definition of success. If a company supplies a £300 solution to just 10% of the 4 million people in the UK with type 2 diabetes and 20% succeed in reversing their diabetes then the founder would be rich, loved by investors and lauded by peers. Meanwhile, the increase in the annual rate of growth of people with type 2 diabetes has dipped a little.
Entrepreneurs need investors, and investors look for confidence in good returns. If you can make a fortune picking low hanging fruit why even bother with the “too hard”.
To really address the public health challenges of our society we need to look for digital solutions which can scale to the size of the problem, connect with a wide and diverse population and overcome or bypass the institutional resistance of slow moving leviathans and short term thinking.
At Living Loud that is exactly our challenge. We think we have the answer. As a charity we will make it available for free to everybody, everywhere and for as long as it takes. Watch this space.