The Evolution of Healthcare: Integrating Lifestyle and Technology
The Reality of Aging and Chronic Conditions
The Reality of Aging and Chronic Conditions
Age does not come alone is a commonly held belief. By mid-sixties many people are already on up to four medications, usually four chronic conditions such as hypertension, diabetes, cardiovascular disease and high cholesterol. Treatments for these conditions are available and take up a significant portion of clinical time in terms of monitoring and adjustment of medicines.
They are also conditions where medical compliance is variable, as they are pretty much symptomless until a significant event occurs eg heart attack or stroke. More bizarrely perhaps is that people attend different appointments for different follow ups, meaning any one individual may go to their GP four times a year, just to make sure everything is in order. In parts this is perpetuated by a system that measures the frequency of these check ups to remunerate the surgeries.
While this is seen as a preventative measure, it is also getting well people in to a system that is already overloaded.
The Interconnectivity of Chronic Diseases
Another issue here is that these conditions do not occur alone, but interact with each other in ways that are not always shared fully with the person who has them. High cholesterol and diabetes can make hypertension worse. Hypertension can make heart failure worse. Diabetes can lead to heart attack and stroke. All of these conditions improve with exercise and the correct diet.
So why not have one appointment to discuss all these things in their totality and then use technology for the person to self regulate their own health - only then needing a clinical review if things change significantly.
Yearly reports can still be generated to meet government targets, but the education and self awareness that collecting personal data can bring is truly preventative and hopefully helps build habits that improve health, not maintain it.
The current system changes abnormal measures to agreed norms, using medication. It does not often change the behaviour that led to the problem in the first place. Many chronic conditions are related to inactivity and poor diet. It is hard to address these in the surgery, but easier to give daily reminders in a smartphone app.
The Role of Technology in Holistic Healthcare
But can this all be linked together in to something that can truly impact on the health of an individual while supporting primary care?
This was once thought to be attempting to boil the ocean, so many apps were niched in to parts of the overall equation. But like an orchestra, the individual components never equal the sum of the parts.
At OptiChroniX we decided to look at the lifestyle factors that contribute to chronic illness, identify an individual’s profile and suggest ways to mitigate detrimental behaviour, while encouraging good habits.
At the same time the usual measures for the common diseases of ageing are taken at regular intervals, including cognition, as this is known also to be impacted by all of these conditions, probably through shared pathways around inflammation and metabolic dysfunction.
In this way the whole person is connected through their physical, mental and behavioural self in a way they can see those interactions and react accordingly.
The Need for a Unified Approach to Healthcare
Nobody wants an app for each condition. It is time consuming and has the same issues of not demonstrating the interwoven nature of chronic disease.
It is stated that 70% of symptoms in chronic disease and 40% of symptoms in dementia can be ameliorated through lifestyle management. They are significant figures, which have two important messages. Firstly there is a lot you can do for yourself. Secondly, healthcare wastes time trying to do that for you. Holistic personal approaches, where the individual owns their health and takes responsibility to maintain it has to be the way forward.
This is a process that potentially takes up a lot of time and is best done for a few minutes daily at home; not at regular GP visits. A holistic app can meet the needs of everybody and transform current healthcare. No need for routine visits when you are well, but data driven requests when things are not as they should be, making best use of stretched clinical resources.
A Sustainable Future for Healthcare through Technology
This is building a sustainable future for healthcare, as resources are already in short supply and that situation is not improving. But it is also sustainable in terms of new technologies. Sensors are improving daily and can be linked to this system. New blood tests can be matched to better personal data to help treat the person, not just the results. Plus, improving or maintaining health could be rewarded through in-app incentives eg gym memberships, insurance reductions etc. This is far from the passive system of the moment, where the individual has far less knowledge than they should.
Embracing Self-Directed Holistic Care
Self directed holistic care is the way forward. People need to understand that their health is the consequence of their actions and not entirely down to their genes and luck. Technology can help people understand and live better, while informing clinical services about their progress. We all do better when we have knowledge and feel in control.
That time is now.
Credits: Meet Roger Bullock , a highly accomplished geriatric psychiatrist with over 30 years of experience in the field of psychiatry. Roger completed his medical training at Keble College, Oxford University, and clinical medical training at St Bartholomew’s Hospital in London. He specialized in psychiatry, specifically geriatric psychiatry, and established the Kingshill Research Centre. With an extensive career, Roger has published over 100 peer-reviewed papers, several books, and chapters. He also served as Clinical Tutor and Academic Secretary of the Royal College of Psychiatrists Faculty of Old Age Psychiatry for 8 years. Roger is a member of the Royal College of Psychiatrists and has received awards and recognition for his contributions to the field of mental health.
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