Tuesday, 26 January 2016

The lifecourse and digital health

I've just been away for the weekend with a group of people of varying ages. Over breakfast, I was chatting with Diane (names have been changed), who surmised that she was the oldest person there. I looked quizzical: surely she's in her 70s and Edna is in her late 80s? But no: apparently, Diane is 88, and thinks that Edna is only 86. Appearances can be deceptive. Diane has a few health niggles (eyesight not as good as it once was, hip occasionally twinges) but she remains fit and active, physically and mentally. I hope I will age as well.

Meanwhile, last week I was at an Alan Turing Institute workshop on "Opportunities and Challenges for Data Intensive Healthcare". The starting point was that data sciences have always played a key role in healthcare provision and deployment of preventative interventions, and that we need novel mathematical and computational techniques to exploit the vast quantities of health and lifestyle data that are now being generated. Better computation is needed to deliver better health management and healthcare at lower cost. And of course people also need to be much more engaged in their own care for care provision to be sustainable.

There was widespread agreement at the meeting that healthcare delivery is in crisis, with rising costs and rising demands, and that there is a need for radical restructuring and rethinking. For me, one of the more telling points made (by a clinician) is that significant resources are expended to little good effect in the interests of keeping people alive, when perhaps they should be left to die peacefully. The phrase used was "torturing people to death". I don't imagine many of us want to die in intensive care or in an operating theatre. Health professionals could use better data analytics to make more informed decisions about when "caring" means intervening and when it means stepping back and letting nature take its course.

In principle, better data, better data analysis, and better personalised health information should help us all to be better manage our own health and wellbeing – not taking over our lives, but enabling us to live our lives to the full. My father-in-law's favorite phrase was "I'd like a bucket full of health please". But there's no suggestion that any of us will (or wants to) live forever. At the meeting, someone suggested that we should be aiming for the "Duracell bunny" approach to live: live well, live long, die quickly. Of course, that won't be possible for everyone (and different people have different conceptions of what it means to "live well").

This presents a real challenge for digital health and for society: to re-think how each and every one of us lives the best life we can, supported by appropriate technology. There's a widespread view that "data saves lives"; let's also try to ensure that the saved lives are worth living!