What is the point of Digital Health?
Updated: Feb 15
A strange question perhaps, for the CEO of a digital health start up. But one worth asking I think.
This article was first published in April, 2017
Image: Digital Health technology promises a new frontier in human health
By Baron Armah-Kwantreng
Let's start by looking at global health trends. Global Health and Aging, a joint report by the World Health Organisation (WHO) and the National Institutes of Health's National Institute on Aging, highlights the theme of Living Longer. The report cites the "dramatic increase in life expectancy" in the 20th century as one of "society's greatest achievements".
Most babies born in 1900 did not live past 50 years, whereas life expectancy in Japan, the global leader, now exceeds 83 years and rising. Thanks to vaccinations, the leading causes of death and illness have shifted in the last century from infectious and parasitic diseases to non-communicable diseases and chronic conditions like heart disease.
In modern societies, most people live past middle age, and deaths are highly concentrated at older ages. With ever increasing longevity a study published in The Lancet suggests women in South Korea will average 90 years by 2030.
Understandably, perhaps, daily headlines in countries like the UK focus on stories of "The NHS in Crisis" faced by challenges of under-funding and staff shortages. However, global health systems are now arguably managing the problems of success. We can see these success trends in the strategy documents of leading non-communicable disease charities.
Cancer Research UK states its strategy is to help increase cancer survival rates from less than a quarter in the 1970s, to half today, and up to three-quarters in the next 20 years. Success with these aims would represent an achievement close to the impact of vaccines on infectious diseases in the 20th century.
Similarly, The British Heart Foundation's 2015-2020 strategy notes, since its founding in 1960, UK death rates from cardiovascular disease have more than halved. Most babies born with congenital heart disease now survive to adulthood.
This success could be leading to a law of unintended consequences. An increasingly common experience for modern middle-aged adults is to care for chronically ill parents living into long old age. Reflecting on both of his parents living into their late 80s/early 90s with debilitating degenerative conditions, a friend said recently: "People are living too long now, its as simple as that."
Challenging questions arise: How long do we want to live - 120, 150, 200 years?! Is the focus on eradicating all diseases, and by extension all causes of death, still appropriate? Should we retune medical intervention to accept current average life spans as "natural" and focus instead on quality of life while we are here?
I asked Dr. Cécile Monteil, a Paris-based paediatric physician and start up entrepreneur: "Is eradicating all disease and exponentially increasing life expectancy the true aim of modern doctors?" Dr Monteil says she does not believe she and her colleagues are focused blindly on increased life for its own sake. The emphasis instead is on helping patients to reach a high quality of life throughout a full natural length of life.
This focus on quality of living is echoed in the British Heart Foundation's forward aims: "... coronary heart disease remains the single largest cause of death in the UK, quality of life is diminished for millions living with cardiovascular disease and each day seemingly healthy young people die suddenly from a heart rhythm disturbance. Only when we fully understand the molecular processes underlying these events will we be able to neutralise their threat."
At RemoteHealth Tech, our aim is to assist digital health to be of useful relevance to society by contributing to increased quality of life and to the understanding of the causes of sudden loss of life of people suffering from abnormal heart rhythm conditions.
Baron Armah-Kwantreng is CEO of RemoteHealth Tech, an ambitious digital health software company focused on improving clinical outcomes of people at risk of heart rhythm conditions via a series of remote monitoring software services.