Maintaining good health

Living Money, My resources

Using an online doctor is the way forward for dealing with your health problems.
Advances in AI and communications now make it easier to obtain
a fast and accurate health assessment and
maintain the fitness of your mind and your body

Start by watching my introductory video below (click on the bar under the video to read the full text).
Then spend some time on self reflection and further reading.

Maintaining good health

HELLO. ITS JEREMY here to welcome you to this months topic which is part of a series on your health. Specifically this month I am going to be looking at how you can deal with health problems, the obstacles to getting a good and timely diagnosis and advances in technology that will help you.

Your mind and body are your most valuable resource, and it makes sense to care for and maintain them. If you dont, you deny others the full benefit of your company and wisdom and you may become a burden. Furthermore, you are prevented from doing your best work and making the world a better place.

Here is a story

MY FRIEND ALICE was walking through the fields last April. She tripped over a rabbit hole and badly damaged her right leg. She managed to limp home to rest. Not wanting to put more strain on the NHS and assuming it was simply a bad strain, she delayed seeing a doctor for a few days. It took three more visits to the surgery and a scan at the hospital before, six weeks later, the injury was diagnosed as a torn Achilles tendon.

After so long the NHS would not treat it as an emergency. Alice elected for surgery, which took place at the end of July. She remained in a surgical boot and on crutches until November, unable to do much, let alone work, and only recovered full use of her leg this spring. Accidents do happen, but this could have been sorted out a little bit quicker and we will look at why it wasn’t shortly.

THERE ARE FIVE stages to sorting out a health problem: ACCEPTANCE, DIAGNOSIS, TREATMENT, FOLLOW THROUGH and RECURRENCE PREVENTION.

IN THIS POST we will consider some of the difficulties in the first two stages. Alice’s story perfectly illustrates what we are up against when treating any illness or injury.

Then we will look at how to overcome these obstacles and show how new technologies are helping. Finally, we will look at three new services that can help.

THE FIRST STAGE is accepting something is wrong.

You have to accept or acknowledge something is wrong before anything happens. This may seem obvious. However, you may deny an illness or injury for a number of reasons including.

FEAR OF BEING A BURDEN. My friend Alice consciously mis-diagnosed in favour of a lesser injury as she did not want to be a burden on an overstretched NHS

FEAR OF THE CONSEQUENCES. It is often more comfortable to deny a medical condition than face the possibility of something serious or even life threatening

TIME. Health takes time, which you may not have much of in a busy family and work world. It becomes easier to deny a condition rather than accept the consequences of disrupted plans and schedules

EGO. For some, admitting illness is simply unacceptable, a sign of weakness

SHAME. Some parts of the body and some conditions give rise to shame. You simply don’t want to talk about them. It is easier to ignore them and hope they go away rather than accept them and deal with them

UNCERTAINTY. When you just don’t feel quite right or when you cant quite put a finger on it you may simply decide to ignore it in the hope it will go away

IGNORANCE. Sadly, you might not even know there is something wrong. Some conditions do not exhibit any symptoms in the early stages, which it is why it is worth taking advantage of any screening programme offered through public health services, or opting for a full health check from time to time.

Any or all of these may lead to you denying something is wrong. When this happens you immediately place a BRICK WALL in the way of maintaining your good health. The consequences may be significant and include permanent damage to your health, a longer time in treatment or a serious deterioration in a condition that could have been nipped in the bud if caught early.

THE SECOND STAGE in treating a condition is obtaining a diagnosis

Once you have accepted something needs to happen your next step is to get the condition diagnosed quickly and correctly. Once again, the obstacles to this are plentiful.

TIME. Finding the time to get to your surgery is not always easy. If it is not an emergency you may have to wait some while before getting an appointment, one that fits in with your own busy schedule

MONEY. You could go private. However, you may not be able to afford this. Whether you go private or NHS, a visit to the doctor or hospital could have financial consequences in terms of lost earnings, travel costs and other expenses

EXPERTISE. Medical diagnosis is part art, part science and extremely difficult. Some doctors are natural diagnosticians, others are not. In addition, doctors are under time, financial and target pressures which may, subconsciously, influence the diagnostic process and lead to an under-diagnosis. We were fortunate to have a wonderful doctor in the family who lived in South Africa. He was a brilliant diagnostician and we often used to ring him for an opinion rather than go to our local doctor

LANGUAGE. Although dialects and foreign languages can prevent correct diagnosis, the real obstacle often comes from your own inability to succinctly describe what is wrong. It is, of course, easy if it is something like a flesh wound that is visible and probably has a definite genesis. However, when it comes to describing an indeterminate pain in your body you may end up at a loss for words – literally.

Can I quickly circle back for a moment and look at why we need to overcome these obstacles to a healthy lifestyle. Then, Ill look at how you can you overcome all these obstacles. The goal here is to getting the correct and timely treatment for a potentially damaging health condition.

It is worth repeating that of all your resources, whether they be physical, financial, connections or anything else, your mind and body are the most valuable. Without them in good working order you will be hard pushed to achieve your goals and aspirations. You will be less able to use your wisdom and skills for the benefit of others or to make the world a better place.

How do you do this?

Well, its a combination of INTERNAL AND EXTERNAL solutions

In the first instance, go back to those fundamental questions about yourself. Remind yourself of who you are and your purpose and aspirations for your life. We have talked a lot in other posts about the importance of self-awareness and self-understanding.

When you have this it provides perspective about your body that should banish shame and help you understand that your mind and body are the essential ‘implements’ for leading a meaningful a wholehearted life.

This positive mindset will give you the power to overcome the psychological obstacles to obtaining professional help. In the longer term, such a mindset should also help with any cure required for a condition.

THE EXTERNAL ROUTE comes through technology and developments in life sciences

Life sciences are undergoing SIGNIFICANT TRANSFORMATION. These will affect you and your family. One driver of this transformation is your own changing demand. You have experienced and benefited from the digital disruption of the retail, banking and transport sectors. Unsurprisingly, you now want it in the health sector.

Two words summarise these disruptions: on demand and tailor made. ON DEMAND reflects the difficulties in getting a diagnosis so vividly portrayed in Alice’s story. TAILOR MADE mainly applies further down the treatment process and I’ll cover this in a later post. However, in the healthcare sector it means personalising products to individuals based on their genomes in particular, although tailor-made is also impacting the diagnostic process.

BIG DATA is the key to both. Medical research, diagnosis and treatment today is about unlocking and analysing the mass of high quality data now available. This resource can be used to power AI applications and platforms in the home, surgery and hospital.

AI appears to be one of the most powerful forces shaping the frontline delivery of healthcare. Medicine speaks one language, the language of science and the doctor. Patients speak another often idiosyncratic language when trying to explain their symptoms. AI is already doing much to break down this language barrier through chatbots, enabling a speedier and more accurate diagnosis and the opportunity to prescribe immediate treatments where appropriate, or to take the process to the next stage.

These new techs have already taken hold. At least THREE COMPANIES have launched medical apps for your smartphone. All three use AI and chatbots to carry out an initial on the spot assessment and provide some guidance. This will substantially cut hanging around waiting for your appointment with the doctor. On the other side of the coin, it should reduce the amount of time highly qualified health professionals waste on diagnosing and treating minor ailments.

The potential here is enormous. When you wake in the middle of the night feeling awful you don’t have to wait until morning. You get on your smartphone. No more rushing back to work for an appointment, just use your medical app on your phone. If you are a student and fall between your home doctor and university surgery it does not matter; you simply get a diagnosis through your digital doctor. And gone, too, will be all that hassle of trying to find a doctor when you are travelling.

In the boxes below I highlight Ada, Babylon and Your.md. You can read about these and explore them at your leisure. I’ve also mentioned Google and generic search engines as these could be an alternative to a personalised app if they don’t appeal

A common criticism of the whole online assessment model is that it always ends in this default assessment.

IF THE SYMPTOMS PERSIST we suggest you visit your doctor, or similar.

There are reasons for this, of course:

LIKE FINANCIAL AVICE, there are strict prohibitions on who can provide a formal diagnosis and these apps cant.

A FACE TO FACE consultation with your GP may actually be what is needed

WE LIVE IN A LITIGIOUS society; online health assessment providers minimise their risk of liability by recommending a visit to your GP

However, this does not mean that online HEALTH ASSESSMENT APPS do not have their uses. They are valuable for a number of reasons:

They can provide some PEACE OF MIND. These apps speak well to the old proverb that a problem shared is a problem halved

This can be ACHIEVED WITH SPEED and a high degree of accessibility and removes some of the strain from an overstretched public health service

You may FIND IT EASIER to talk to your phone about sensitive conditions, rather than a doctor

AI diagnosis is MORE OBJECTIVE, and has access to a much larger volume of health data to rely on for an assessment. As the technology improves AI diagnosis has the potential to produce MORE ACCURATE and faster results than a human being can provide

There is NO REASON WHY you should not share the results of your AI diagnosis with your doctor which in turn can lead to faster and more appropriate treatment.

So where does this all leave you? For many reasons its often difficult to deal with the first two steps in treating a condition – acknowledgement and diagnosis. Many of those obstacles are in your mind and will always remain. However, technology is certainly easing the way to faster and more accurate diagnosis.

The technology is new and not without its weaknesses. However it is a start and there seems to be little downside to joining one of the three apps described below, or some other similar service.

What is clear is that life sciences and the provision of healthcare is on the verge of significant disruption. Anything that helps relieve the strain on a hard pressed public health service, leaves professionals to focus on where they are most needed and makes it easier for families to take control of their own healthcare has to be welcomed.

So take advantage of what’s out there already and keep an eye out for future developments.

And in future articles we will look more closely at health maintenance, illness prevention and advances in medical cures.

Thank you.

Personal Health Assessment Apps

Here are a few more details of the personal health apps mentioned in the introductory video. Please remember these are not recommendations at this stage. As we explore the apps further we will add to this page with more details and reviews.

Ada

Ada is a Berlin and London based app that asks the user questions about their health, then provides an assessment which individuals can act on or share with their doctor or other health professional.

In fact, Ada was originally developed to help overstretched doctors research complex cases. It has now extended from speciality cases to general practice and is building a medical database  to match symptoms and ailments.

Ada was selected the winner of Wired UK’s recent ad-hoc test of smartphone symptom checkers. It scored for clear, relevant questions and accuracy in its assessments of four common ailments (asthma, shingles, liver disease and urinary tract infections).

Users can share the results of their initial assessment with a doctor on the other side of the platform. Indeed, founder Clair Novorol sees Ada’s main role as connecting patients and doctors.

I joined Ada only recently (and as a result of my own research) so unfortunately I cannot yet provide a personal experience of the app.

Babylon

Babylon’s mission is ‘to put an accessible and affordable health service in the hands of every person on earth’, so ten out of ten for ambition. It aims to do this by ‘combining the ever-growing power of AI with the best medical expertise of humans (…) to deliver unparalleled access to healthcare, including personalised health assessments, treatment advice and face-to-face appointments with a doctor 24/7.

Babylon describes itself as a team recruited from over 60 different countries (…) working on making healthcare delivery affordable and accessible.

It already has existing operations in the UK and Rwanda and has plans in progress with major providers in China, the USA and Middle East.

Given all this, it is surprising that Babylon fared worst in the Wired UK test. It was ‘the least accurate of the three apps’. However, the survey also points out ‘the symptom checker is an add-on to its larger business model.’ Babylon itself also points out that the version tested has since been updated. Indeed, ongoing improvements and updates to all these services is to be expected in such a fast developing technology.

I joined Babylon a year ago for a £50 fee. Fortunately, I have had little opportunity to use it. However, my son is also a member and had a minor health issue whilst at University. He was impressed with the AI driven chatbot and the ease and speed with which he was subsequently able to hold a video consultation with a very enthusiastic doctor.

Your.md

Your.MD describes itself as ‘a free service that helps you find safe health information so you can make the best choices for your health’.

In the same Wired UK test it came out with mixed results, although there has been a significant upgrade to the app since then. It appears to be more of a specialised search engine than a personal health checker. The site does have a comprehensive Health A-Z and works with NHS Choices. It won  the Unesco/Netexplo Award in 2017 for innovations that can improve society. (Past winners include Twitter, Airbnb and Spotify).

I was concerned about the lack of information about the company itself. Its website gives little information on the company, its location or its top team. Given the nature of the service it is providing, I would have expected a lot more.

Google etc

Of course, you still have the option of keying your symptoms into Google or any other search engine, and obtaining a wealth of information and suggestions for medicines and where to buy them.

As a mater of interest, I searched on ‘earache’ and obtained a lot of quality information from the NHS and Boots websites.

This route falls down because it only provides information and has no capacity for personalised assessments which would take into account your age, gender, fitness, previous conditions, family history etc.

And a search engine does not really meet the growing demand for the personalised health service referred to above.

The shift in healthcare from cure to prevention

In his November 17 TED talk Matthias Müllenbeck, Biopharma Director at Merk in Germany, explains the long-overdue shift in healthcare emphasis from cure to prevention, a course that should cost us less, avoid risky and unnecessary procedures and give us a longer, quality life.