Would you trust your Uber driver to give you first aid?
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Version 0 of 1. One of the winning ideas at this year’s Future Lions student ad contest in Cannes suggested that Uber may be your best bet for first-response medical care in the future. The team from the Fondazione Accademia di Comunicazione in Milan wrote: “In large cities the average response time for emergency services is more than seven minutes, which can be the difference between life and death.” Uber cars, by contrast, can arrive at a location in about three minutes. The students suggest a programme to provide Uber drivers with certified first aid training and lifesaving first aid kits. When an ambulance is called, the closest Uber car is notified and the driver can provide first aid until the ambulance arrives. This may be a pragmatic solution to a serious issue, but it still prompts a shudder. Jason Levy, a senior vice president at Saatchi & Saatchi Wellness, says: “There might be this lack of trust of healthcare outside of traditional healthcare environments. We’re just not there yet.” But we are getting closer. Apps and services to help consumers track and maintain their health have proliferated in recent years, leading to questions over their quality. Des Spence, a Glasgow-based GP, has warned in the BMJ of the rise of apps that monitor heart rate, blood pressure and so on. These are untested and unscientific, he writes, and can “ignite extreme anxiety” and “medical harm” through over-diagnosis. Then there is the question of legal implications for the companies involved. A European Commission consultation on mobile health (mHealth) published this year noted: “Manufacturers need to have a clear understanding of their liability when designing mHealth solutions.” It recommends developing a clear legal framework with adequate guidelines. According to Karen Taylor, research director of the UK Centre for Health Solutions at Deloitte, the standards are not in place yet. She says there are still plenty of barriers to overcome before health technology becomes mainstream “around regulation, data security and privacy, [and] trust in the technology”. However, some tech companies are creating well-researched, doctor-supported healthcare apps and services. Sleepio Sleepio is a digital programme that helps people overcome insomnia, with a course of cognitive behavioural therapy (CBT) delivered via an app. Patients that sign up are asked to record their sleep patterns and then guided through techniques to address their insomnia by an animated professor with a gentle Scottish accent. It is developed by Big Health, a UK-company that moved to San Francisco last year. Taylor says the use of apps in mental health is one area where there is growing evidence of success. “Mental health has been an under-resourced area of spend across many developed countries, as demand for support – access to services like CBT – have increased. This technology provides that support in a way that for many is seen as more beneficial because it reduces the stigma associated with having to go to a mental health clinic.” There are concerns around the quality of health apps when they are effectively delivering treatment. Sleepio is in the NHS Choices health apps library, meaning it has been reviewed by clinicians to ensure it is clinically safe. The company also conducted its own randomised controlled trial to test the effectiveness of its product. It says results show that the Sleepio course helped around 75% of people with persistent sleep problems to improve their sleep to healthy levels, compared with the placebo and no treatment conditions, which had relatively little impact. HealthCab There are apps that support the health service, such as HealthCab, which allows renal patients to book NHS-funded transport to and from hospital through their smartphone, check the credentials of their taxi, ambulance or volunteer driver and track the vehicle’s movements by GPS. At the moment many of these patients, who might have three dialysis appointments a week that can take up to four hours each, are told to be ready for their transport two hours before it arrives and often arrive at the hospital late. Sarah Fatchett, managing director of 365 Response, the company behind the app, says: “The patient group becomes extremely agitated, because there is no way of checking when the transport provider will pick them up. People are coming off dialysis early because they’re stressed.” The app has been built and is due to be tested this month at Leeds Teaching Hospitals NHS Trust. Fatchett has big plans for HealthCab, which could also be used to deliver medicines to patients after they are discharged. This would solve the problem of patients who are ready to go home but trapped in hospital waiting for their medication. 365 Response, which has received funding from the Department of Health, is also creating the first national standard for the suitability of the cars and drivers used to transport patients. Fatchett says: “We are specifying the standard of care, the skills required [of the drivers]. You don’t need to do a lot but you need to do enough to safely convey patients around the system.” |