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Smartphones to aid in forecasting illness

A recent report highlights how smartphones and wearable devices can provide a comprehensive picture of one’s health and how they can alert a person when it begins to deteriorate.

With almost everyone carrying a smartphone everywhere they go, the device may probably have already tracked a lot of the person’s data and behaviour.

Wearable devices, similarly, would also be generating a multitude of fitness data about the individual.

Putting all these information together would form a person’s “digital phenotype”. It is the comprehensive picture of one’s health and well-being.

When collated with data obtained from clinical assessment such as blood tests and diagnostic imaging, it could generate valuable insights for health professionals to inform care planning.

The extent of information that digital devices know about a person include the usual waking time and, possibly, the amount and quality of sleep.

It can also capture the journey or commute to work through GPS and geographical data. It will include the amount of time spent sitting or standing during that travel period.

Moreover, it can also track physical activity done during the course of the day such as distance walked or climbed, and standing time.

Even the estimate of the exercise undertaken and energy expended can be tracked with the help of accelerometers.

In addition, information like medical history, diet and weight data may have been logged through an app or a smart scale. Heart rate and rhythm could have been recorded via a smart watch.

Data collected by these devices can help track a person’s health.

Take chronic heart failure, for instance. An estimated 480,000 Australians are living with chronic heart failure, which is increasingly prevalent among older adults.

While heart failure is a progressive and terminal condition, there are often signs and symptoms that precede the periods of deterioration.

These include oedema or the swelling of the ankle or leg, dyspnoea or the shortness of breath, fatigue, and reduced capacity for exercise.

If someone living with heart failure was being monitored by a smartphone, the data could highlight increasingly disrupted sleep patterns, reduced physical activity, changes in weight, and irregularity in vital signs like heart rate.

These changes in the daily functioning of a person would clearly indicate a deteriorating condition that should, ideally, trigger a visit to their nurse, GP or emergency department.

Furthermore, the changes could prompt an alert to a health professional, allowing timely clinical assessment and intervention.

This would not only save significant health costs, but improve symptom management and unwanted deterioration.

Globally, the population is living longer and with multiple chronic health conditions. But few health care professionals are currently tapping into the digital phenotype to inform clinical decisions.

There is not a lot of education about how to access these data, or how to routinely apply it within a practice, at the bedside or in the clinic.

Protocols, procedures and platforms for collecting, analysing and integrating these data into medical record systems are not common either.

There are some forms of remote health monitoring that already exist. Telehealth and telemonitoring systems allow clinicians to remotely deliver health care through telephone and web-based platforms.

But their uptake in routine clinical care has been relatively slow. This is possibly because it requires both patients and clinicians to manually log data.

This is in contrast to the kind of passive data collection that occurs with smartphones and wearable devices.

There is urgent need for innovative models of health care that support patient monitoring in those with chronic conditions, and the early detection of symptoms.

That means establishing data feedback loops between patients and clinicians.

Passive data collection done by smartphones and wearable devices may provide monitoring technology as a low cost, accessible solution that does not put a huge burden on the provider and patient for data input.

But first, patients must consent to health professionals accessing and using their personal digital data to inform their healthcare.

There must be data security all along the chain. Plus, value of a direct and personal relationship between the patient and clinician must not be overlooked.

Monitoring data alone cannot improve outcomes, but it may be used to identify deterioration in the patient’s condition and thereby enable timely clinical assessment and intervention.

More details can be found here.

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