As downloadable apps from France, Germany and the UK enter the Luxembourg market, the face of healthcare will change, says Dr Abeywickrama
As the global market for mHealth continues to grow--set to quadruple by 2025--the patient role takes on new responsibilities to which the public must adapt.
A tannoy of slogans--“a doctor at your fingertips”, “consult a specialist within minutes from the comfort of your own home” and “more efficient than your average doctor”--reiterate the promises of mHealth (medical health app) providers as empowering the patient takes on a new meaning.
Luxembourg is dipping one cautious toe into the ocean of digital health with sante.lu's app designed to provide practical information for the general public with easy-to-access medical advice, public health alerts and on-call emergency services. Furthermore, booking medical appointments is now a tap away, thanks to doctena.lu. These examples, however, remain within the confines of safely practised medicine.
The “apptimisation” of medicine
So where exactly is mHealth headed? We need not look far for the answer: echoed in recent talks regarding the transatlantic trade deal, the “NHS is on the table”, which is plain English for privatisation. The beauty of mHealth is that it can be accessed anywhere and is applicable globally. From Googleʼs well-being coach, nudging you into healthy behaviours while tracking your vital signs, to Push-doctorʼs instant sick notes, patient choice is now abundant, additionally as Babylon bids to become the shiny version 2.0 of the NHS.
In the midst of the “apptimisation” of medicine, warning bells ring loud. Increasingly, mHealth is linking with insurance companies in Europe, recruiting low-cost doctors from various countries and specialties in order to provide large-scale healthcare. It sounds seamless and idyllic--yet rather Orwellian.
The first concern is a lack of standardisation - which already exists within medicine itself. Digital medicine is a fast-growing and vast specialty, rendering it a poorly monitored field.
Secondly, the risk of expansion across countries means, on average, a suboptimal service provision, ultimately detrimental to patients. To manage this, the UK has created committees tasked with setting standards to ensure that strict boundaries for digital health are respected.
Onus on the public
As downloadable apps from France, Germany and the UK enter the Luxembourg market, the face of healthcare will change. Patients will swipe and seek advice from doctors abroad, with varied qualifications and often no proof of consultation. This is something inevitable and upon which the CMG (Cercle des médecins généralistes) of Luxembourg will need to act. Establishing a list of safe mHealth providers is paramount as the public take their health into their own hands.
We have to accept that a patient is not an informed consumer in a healthcare market. mHealth provides the patient with a platform for choice as a buyer, but with this power comes free rein--and free rein with a lack of guidance is a worrisome combination.
Take the appealing symptom-checker WebMD, created to mimic the thought process of a clinician and incorrectly labelled a pocket doctor. When entering symptoms in such an algorithm the majority of patients are vague, thus few excellent apps can narrow conditions down aptly enough to provide the public with useful information.
Yes, knowledge is indeed power. However, misdirected knowledge can lead to a false sense of reassurance for some, whilst an influx of vast quantities of information will heighten the anxiety of others.
What’s next? The onus is now on you--the public--as you seek care digitally. Take responsibility and learn to question. Question the company which you choose to entrust your health to, question the legitimacy of their doctors, question their training and experience, question how many patients a day they consult with and how stringently they verify your identity. Speed is not everything, just as a diagnosis within minutes may feel efficient yet be so wrong.
Use mHealth as an adjunct but, as the disclaimer of each of these companies rightly states, seek face-to-face medical care if the problem persists.
Dr Lilani Abeywickrama is a Luxembourgish ophthalmologist currently based in London. Her main interest is advocating healthy living and precision technology within her specialty and is pursuing her interests in the field of healthcare management.