The mobile conundrum

What’s in a word? I was looking at the entries for the DH’s Maps and Apps project which invited people to submit ideas for improving health with mobile technology – it had a great with response with nearly 500 entries. A showcase event is soon to be held where a distinguished panel will choose their favourites.

Among the apps put forward are ones that help people find and access local NHS services, give advice on self-checking for breast cancer, support families with a member suffering from psychosis and allow patients to share information on their experiences. Impressive stuff.

I’ve also been filled with admiration for how mobiles are helping to beat malaria in the developing world. For example texts to rural Kenyan healthcare workers brought a 25% improvement in adherence to national treatment guidelines. Getting that level of improvement in anything is a big achievement, and even more so if it just takes a bit of organising and the use of something as cheap as SMS.

Oh dear! As soon as I wrote ‘a bit of organising’ my heart sank – which takes me back to my opening question. If I was asked whether mobile technology can make a real difference to UK health I’d give a confident ‘yes’. Asked if it will make a difference I’d mutter ‘perhaps’ or ‘maybe’.

There are some positive examples, like the use of texting to tell sexual health patients about test results – not just a convenience but a way to sidestep stigma. But then again, here we are, one of the richest countries on the planet, with the best technology in history and a healthcare IT industry full of talent, yet we can’t find an effective way for medical data to follow patients round the NHS. In fact it was oddly disheartening to read how Julie Moore, CEO of University Hospitals Birmingham FT, was trumpeting a 17% cut in mortality rates now that her organisation has started sharing data with primary care organisations. Good news, but the whole country should have reached this point years ago. Instead we have an information patchwork.

It’s the age old issue about how things should be organised and at what level. My worry about the Maps and Apps type of initiative is that we’ll get lots of back patting but the mechanisms will not be created to ensure that everyone who can benefit will do so. For that to happen this needs organisation and co-ordination between government, industry and the NHS. If not we end up with initiatives that either stop at particular postcode boundaries or are only adopted by certain social groups. One of the biggest potentials for mobile technology is to help hard-to-reach groups. Again, this needs high level organisation or the chances are that those who can gain most will get least.

I know, how about a National Programme for Mobile IT? OK, maybe not. But as a nation we wobble, at irregular intervals, between decentralisation and grand plans. Neither seems fully satisfactory for delivering healthcare. But surely it can be different with mobile technology which is becoming a truly ubiquitous force? Sadly I don’t know what the solution is. Suggestions gratefully received.