By Nicola Smith News Is your smartphone your next doctor? 24 Mar 2017 American cardiologist Dr Eric Topol clearly remembers the first time he realised the potential of technology to revolutionise the future of medicine. “Back in ’07 I was at a conference in San Diego and they were talking about the smartphone coming out – the so-called iPhone,” he recalled. “And I was thinking this could really be the centre of the universe for many people and it could become a critical part of future medicine, so that’s when the Eureka moment was,” he said. “Basically we rely on this so much for our daily existence. It wasn’t a big leap of insight to realise that this was going to have equally, if not more important, use in maintaining health.” Smartphone apps have revolutionised the way we bank, shop and communicate. Many predict they will soon transform the medical sector, reducing our dependence on doctors, cutting costs, and improving the efficiency of global healthcare systems. Smartphones – the new doctors? Ten years later after Topol’s San Diego conference, patients are already monitoring glucose levels, blood pressure and can even do cardiograms by clicking on a phone app. “It empowers people to do things they could never do before or see things they could never see before, all while they’re doing their emails and surfing the web, they are taking care of their health,” he said. Topol is excited about the potential of smartphone technology to create a sophisticated “virtual medical coach” that would process your medical data – nutrition, blood pressure, sleep – and use it to guide your health choices. “It is tracking everything about you, learning about you, and then giving you feedback, and you’ll be able to take what you have to an avatar or a voice or a text or however you want to get this information from your coach,” he said. Not only would this benefit an individual’s health, but it could provide a cost-cutting benefit to an overburdened system, he argued. A patient could communicate their own cardiogram results to their doctor instead of going to a hospital. “It can cut costs by giving information that was previously unobtainable.” Apps reducing wait times The evolution of medical apps has already spawned an entire industry of smartphone health providers in the US and the UK, who link up customers with on-call doctors. In the UK, leading companies include Push Doctor, Babylon and the Now Healthcare Group. “We understand how difficult it is for many people to see their GP. Babylon’s mission is to put affordable and accessible healthcare into the hands of every human on earth,” Babylon said in a statement. It ensures that its GPs all have an average of ten years experience. Over 120 UK companies have partnered with Babylon to offer its services to over 220, 000 employees, saving, it claims, thousands of lost working hours and hundreds of thousands of pounds. Push Doctor, Europe’s largest digital health provider, also connects patients to a network of thousands of UK qualified GPs. It can take as little as six minutes on any device, compared to the days or weeks’ wait for a traditional doctor’s appointment. The company operates with a smart network of over 7,000 General Medical Council registered GPs, who speak to patients face-to-face via a secure video platform. All of the GPs work primarily as NHS or private doctors. “Digital doctor services like Push Doctor are enabling more people to access GPs, relieving pressures on GP surgeries and accident and emergency services,” said CEO, Eren Ozagir. “We know that 62% of Britons are already using tech to monitor their health and wellbeing, which is only set to increase as people continue to seek new levels of convenience,” he said. “According to our research, almost one in three claim they would consult a GP via video if it meant they could have an appointment when and where they wanted.” Companies like Push Doctor believe they can be one solution to a looming shortage in GPs in the future. Research into the number of GPs needed to meet patient demand in 2020 shows that a 30% increase may be required to maintain a safe and effective service. Predictive data will revolutionise the industry The “huge amounts of data generation, capture and analysis”are another benefit of the increased use of healthcare apps, said Andrew McKechnie, health partner at PricewaterhouseCoopers LLC. It could be used to “better design services to treat people in the most efficient way,” he said. “Secondly to have predictive analytics for a population or an individual. In the long term, the power of the data will be in preventative, predictive analytics for individuals,” added McKechnie. An example could be an app which tracks an elderly person’s movements around their home, helping a clinician to track whether symptoms of dementia were accelerating and predict whether the patient is more likely to have a fall. “These apps will start to provide a huge amount of information. The challenge that it will give the health sector is how will they respond to it? How do they use that data effectively and then change services appropriately,” said McKechnie. “It can definitely be a tool to improve the efficiency of the system. If you’ve got predictive data analytics and you’ve got ways of interfacing with, and intervening with individuals, where they don’t have to come to a hospital, then you immediately remove the burden from the structural system.” Impact to accountants The rapidly changing technology landscape will also have inevitable consequences for the financial profession. “The most significant evolution to accountants working within the medical world is that of cloud-based accounting systems,” said Alan Coveney, senior healthcare manager at Coveney Nicholls, a firm affiliated with the Association of Independent Specialist Medical Accountants. “Doubtless there will be a more rapid uptake with the looming requirements of Making Tax Digital,” he said. “The ability to quickly dip in and out of a client’s records, without the need for emailed backups or trips out to client sites, allows accountants greater scope to work alongside clients, spending greater time focusing on business management and planning.” Cloud accounting was leading to “savings for clients with smaller businesses who are now able to link their accounting package to eBanking systems,” said Coveney. “This saves data entry time, and improves visibility and access to data for accounting professionals,” he said. “GP partners and managers can review the state of their own practice finances from the comfort of their sofa of an evening, rather than being stuck in the surgery at all hours.” Many self-employed locums and other medical professionals were already making use of systems such as electronic locum organisers to keep day to day control of their personal books, which helped to inform their accountants when preparing tax returns, Coveney added. According to Now Healthcare CTO, Tim Ng: “Medical apps are currently scratching at the surface. The potential is endless.” By the end of this year, there are expected to be 4.7 billion mobile devices worldwide. “The younger generation are all going to be expecting to be able to use and access health services through their devices,” said Ng. But despite recent advances, he sounded a note of caution about putting too much trust too soon in artificial intelligence. “You can’t replace the experience and intuition of a medical practitioner overnight as some of our competitors seem to be suggesting,” he said. Even visionaries like Dr Topol believe improvements must be made before technology can be fully embraced. “The bigger issue is privacy and security of the data, and that is a very chequered story so far,” he said. There’s a lot of hacking and phishing and selling of people’s data and medical identities, and for this to really take hold we’ve got to do far better at preserving one’s privacy,” he argued. “There are a lot of technical solutions for that. There also has to be legislation for that too.” Nicola Smith has spent a decade reporting for The Sunday Times on both the European Union and South Asia.