Time to see the iDoctor: how far have phones moved towards being our doctors?

From calorie apps to heart-rate trackers, the medical tech industry has never been healthier, says Joshi Herrmann
Digital Doctor: medical tech is on the rise (Picture: Adrianna Williams/Iconica/Getty Images)
Adrianna Williams/Iconica/Getty Images
Joshi Herrmann9 July 2015

Who knows more about our health these days – your doctor or your smartphone? That would have been a silly question at the time of the iPhone’s first release but when Apple told its developers’ conference about a series of updates to the health app on its iOS9 operating system recently, medical professionals must have wondered whether they were watching themselves being innovated out of a job.

Users of the app — on iPhone or iPad — can now monitor UV exposure, water intake and sedentary state, and for the first time it has room to store family planning metrics like basal body temperature and cervical mucus quality. Then there are people wearing one of Fitbit’s activity tracking products, which include the Fitbit Tracker, the Charge HR and the Surge, who can look at real-time charts showing their walking distance, sleep and calorie-burning alongside those of family and friends.

And if that level of mobile health scrutiny isn’t enough, subscription apps like Babylon promise to turn a user’s phone into an “end-to-end” health service, allowing them to chat to doctors in real time, have video appointments, organise prescriptions or click a button to order testing kits that arrive the next day.

Which raises the question of how far phones have moved towards being our doctors? Real doctors who have observed the trend towards mobile in recent years are generally hopeful about its potential to give patients more control over their health, while at the same time wondering if apps like Apple’s or the Fitbit will begin to interest the kind of people for whom calorie-counting and exercise-tracking are a matter of urgent necessity rather than faddishness.

Healthy prophet: Apple CEO Tim Cook (Picture: Stephen Lam/Getty Images)
Stephen Lam/Getty Images

“I think they are a great idea as they empower the patients to make decisions about their health,” says Dr Selvaseelan Selvarajah, a GP partner with the Bromley by Bow Health Partnership in Tower Hamlets, whose practice is experimenting with an app that monitors health in patients with chronic illnesses.

Because the medical profession is already packed with mobile technology, from platforms that allow doctors to manage and bill their workload, to systems such as Telestroke that can diagnose a stroke remotely via HD video, many doctors and nurses are comfortable with the idea of smartphones having a role in our wellness.

“You notice that a lot of patients have got wrist devices now,” says Dr Mohammedabbas Khaki, a GP in north London, “and I’ve noticed that patients are very interested in that kind of bio-data.” He adds, though, that watching data from a Fitbit or an Apple Watch may be one thing, but patients “don’t really know how to act on it”.

The Apple Watch has a heart-rate monitor and is described by Apple as one of the most advanced health-tracking devices around. The company says in its promotional material that its HealthKit tool, which allows other fitness and health apps to work together and feed in data together, so that a nutrition app can tell a fitness app what pre-exercise consumption has been like, “might be the beginning of a health revolution”.

Apple Watch accessories - in pictures

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Fitbit, which reportedly has a 68 per cent share of the $3 billion fitness- tracking industry, which also includes competitors such as Jawbone, makes products that are cheaper than the latest iPhone or the Apple Watch, and part of the reason for the company’s soaring stock price is its success in the “corporate wellness” market — where companies buy trackers for employees.

More than 16,500 of BP’s 20,000 employees in the US use Fitbit, and the company allows them to save hundreds of pounds on their work health insurance if they travel a million or two million steps a year. According to the Washington Post “BP, like most big companies, uses an outside vendor to manage the wellness program, so the company does not see any individual data on activity levels”.

“Tackling the motivation behind the activity is often the problem, not tracking activity that is already being done,” cautions Dr Kartik Modha, a London GP and health tech enthusiast. He says he is more likely to recommend that patients download a calorie counting app like MyFitnessPal than an activity tracking equivalent.

Most of the monitoring current phone apps are capable of is relatively unsophisticated, though the analysis software is improving all the time. Hamed Khan, a GP and clinical lecturer at St George’s, University of London, says the blood-pressure readings that many of his younger patients record on their phones (using plug-in devices) “seem to be fairly accurate” when he checks them against readings he does in his practice.

Relatively speaking, though, the technology of blood-pressure monitoring is simple. The San Franscisco company Sano seems to point to the future though, with its biometric sensor, that will “help people understand what’s happening inside their bodies through continuously monitoring important markers in their bodies’ chemistry”, their site says.

Babylon’s founder, a former Goldman Sachs banker called Ali Parsa, whose app is being downloaded once a minute in the UK and Ireland, says he is increasingly relying on artificial intelligence to answer questions from patient subscribers. “We have generated answers so that doctors don’t have to type them out — you just choose the right one,” he says.

Perhaps it’s that kind of claim, rather than other tech announcements, that will give practitioners pause for thought.

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