I have a chest infection. I am sure of this without tests because I get one pretty much every year. I’m asthmatic, which makes me more susceptible to infections, and means that they tend to take hold. One year I was taken to hospital in an ambulance when the oxygen reaching my blood got very low. Not a situation I want to repeat.
This morning I called my GP for an emergency appointment to be told they were trialling a new system: triage by phone before handing out appointments. Ten minutes after I called, my GP called me back. This is pretty much our conversation, constructed from memory and edited only for brevity.
Doctor: “What seems to be the problem?”
Me: “I think I have a chest infection again. I’m coughing up some unpleasant day-glo stuff, and wheezing a lot at night and in the morning. It’s been going on for about two weeks and I’ve been doubling up my preventer and taking six to eight blasts of Ventolin each day. My peak flow isn’t down too far but I think that’s only a matter of time.”
Doctor: “Are you allergic to penicillin?”
Doctor: “OK. I’ll prescribe you five days of antibiotics. The script will be ready at the front desk.”
Me: “When can I pick it up?”
Doctor: “It’s there now.”
I’ve cut out a brief conversation about whether I needed an appointment and me requesting an extra inhaler but you get the idea. My (always excellent) GP dealt with my problem quickly, and kept me out of the surgery saving time and money.
This process is made easier by the fact that I present my GP with evidence when I say there’s something wrong. I keep a decent record of my inhaler usage and my peak flow. I’m also recording my physical activity at the moment and sometimes (when trying to lose weight) record my calorie intake and daily weight. If everyone could present their GP with this sort of data, we could probably save a lot of time. And money. And lives.
Imagine if there were a cut down version of the device on my wrist (an Oregon Scientific Dynamo) in each of my inhalers. Instead of supplying a new body with each inhaler as they currently do, you get one with your first prescription that contained a tiny low power Bluetooth chip. Every time you took a blast it would sync up to your phone and store the data locally or, if you were happy to share it, in the cloud where it could be accessed by your GP.
You could set flags on this data to take action even before a patient has called in. Much cheaper to intervene when a situation can be controlled than to see that patient land in A&E. For example, if it’s winter and my inhaler usage goes up by a certain percentage, it may be worth giving me a call or even dropping me an email or text, prompting me to call in if I feel unwell.
Whether you like the privacy implications of this or not, the chances are something like it will soon be a reality. The reasons are the simple economics that we hear about every day: we have a large, ageing population who are likely to live a long time and be very expensive to support. We need to do what we can to a) improve their quality of life and b) reduce the burden they place on the health and care services. Monitoring people’s health and intervening early when the outcomes will be best and the costs at their lowest will play a large part achieving this aim.