From sick-care to health-care
How digital tools can help us to live longer and happier
What’s the problem?
2021 medical challenges look very different to the challenges a century ago. We’re living up to 30 years longer, eating differently, working differently, and our healthcare achilles heels now look very different. Whereas the biggest killer of the 1920s was infections, in 2021 it’s chronic conditions (diseases which develop over the long term, mainly as a result of lifestyle factors).
Almost half the US population has a diagnosed chronic condition, rising to over 80% of over 60s. The challenge with chronic conditions is that they often don’t warrant ‘urgent’ care, and there’s usually no medical ‘cure’. Many people will go years or decades while developing a condition (such as type 2 diabetes, arthritis, or IBD) before medical attention is sought.
The only real solution to treat and prevent chronic conditions, and to extend our disease free years, is with lifestyle behaviour change. Good nutrition (vegetables and whole foods), sufficient activity, stress reduction, enough sleep and avoidance of harmful substances, all contribute to our overall health and ability to stay well. But our healthcare systems were never designed to be a behaviour change service. Until our symptoms are bad enough that we need medical care (e.g. in the form of drugs/surgery/psychological counselling), our health is left almost entirely in our own hands.
“Our healthcare systems were never designed to be a behaviour change service”
There are lots of things which affect our lifestyle behaviours. Upbringing, education, community, motivation, ability and stress are just a few. And even when we’re ready for change, we often try to do too much at once, or focus on the wrong things first. A clear example of this is yo-yo dieting, where we switch or restrict our nutrition for a period, but don’t change the inherent way we live, meaning we usually end up back where we started. We also oversimplify. A commonly used health phrase, ‘eat less and exercise more’, misses some of the most influential factors — sleep and mental wellbeing, and can even encourage a problematic relationship with food (e.g. where we label foods and consequently ourselves as ‘good’ or ‘bad’).
The route to health optimisation
In an ideal world, we would each have a personal health coach, proactively supporting us 24/7, who was able to navigate us through complex challenges and ultimately help us to achieve great psychological and physical wellbeing. Unfortunately, even if there were enough trained coaches in the world, it would be far too expensive to cover entire populations.
With 1 to 1 human support off the cards, there are some exciting alternatives. Whereas 30 years ago, we’d rely on our immediate community, friends, colleagues etc for information and advice sharing (around health or anything else), now we spend a huge amount of our time online. We’re influenced by what we see and hear on; Instagram, Reddit, Netflix, Podcasts etc. We’re also sometimes negatively impacted by digital….the endless scroll on Facebook, or the mindless auto play of the next episode on Amazon Play. Rightly or wrongly, our attention is on our digital devices, and some of the best health optimisers of the future will live there too.
Not only do digital health products live where our attention is, but they also pack some amazing abilities, not previously possible. Through contextual awareness (e.g. sleep /exercise/mood data), digital health tools can be personalised to your specific needs. Where it may take a doctor 15 minutes to talk with you your recent activities, health markers and challenges (or what you can remember of them!), an app can develop an ongoing and live understanding, in order to provide recommendations and support at relevant times. Additionally, a well designed digital service can make looking after your health much more fun and interesting.
Singapore is leading the way, with a national digital initiative for preventive health. A mobile app offers citizens the chance to claim cash back for doing healthy behaviours like walking.
It’s also becoming more common to prescribe a digital health services alongside a drug, for example Sidekick Health and Pfizer have partnered for IBD and arthritis treatment. The medical drugs, in most cases, are used to control symptoms, whereas the digital service can give someone a chance at reducing or even preventing the symptoms over the longer term.
Germany is the first country to formalise digital health app prescriptions by doctors. And the UK NHS is currently making steps in the same direction. Even where it hasn’t been formalised, rising numbers of doctors around the world are informally recommending digital apps to their patients. With most GP appointments capped at 10 minutes (in the UK), recommending a helpful service to use outside the surgery could lead to better outcomes for everyone. Dr Durant, a rural GP from the US, is enthusiastic about the potential of Holly Health and feels it could be introduced to patients in this way:
I expect that within 5 years, digital app prescriptions (with or without medical drugs alongside) will be commonplace in the UK and US. We are at the very beginnings of this shift.
Exciting digital health tools that you may or may not know about…
Myself and the Holly team try out lots of digital health services, to better understand what’s possible, what’s helpful, and what’s fun! So, to give some context on the kinds of digital apps available, here are a few that I’ve picked out…
Sleep tracking: Pillow or Sleep Cycle
I think that if as a population we were only able to work on one area of our health forever more, we should all focus on our sleep. Not enough, or poor quality sleep, has a knock on effect on absolutely everything else (nutritional choices, digestion, brain health, activity etc.). Of course sleep itself is impacted by stress, nutrition, and exercise, so it still needs a holistic approach.
Period trackers: Flo and Clue
Being able to accurately track cycles, fertility and mood can help women to understand their body better and be better prepared to optimise health and wellbeing at any time.
Nutritional tracking: MyFitnessPal or Lifesum
Food has become tricker to understand and quantify in the modern world. Whether out of a packet or cooked from fresh, it can be helpful to learn what exactly our daily nutrition contains and to seek inspiration for new dishes and shopping ingredients. These apps do the job for that!
Fasting tracking: Fastic or Zero
Intermittent fasting has been making waves around the world, as a method for giving our stomachs a break from digestion between meals. A tracker may help if you’re trying fasting for the first time, or to optimise fasting windows.
Depression or anxiety support: Youper or Iona Mind
Sometimes, a little bit of reflection goes a long way. These apps can help you to reflect on how you feel and what is blocking your way. They will suggest quick therapy exercises to help with stress reduction, improving mood and beating anxiety.
Meditation: Calm or Headspace
Meditation, helpfully, has become much more mainstream in recent years. Both Calm and Headspace are great first introductions to mindfulness, as well as helpful ongoing tools, with huge amounts of variety in their available exercises and practices.
Workouts/fitness: Nike Training Club or Couch to 5k
No gym? No problem! There are plenty of apps to support your fitness journey. The Nike app is great for circuits and bodyweight workouts. Couch to 5k is excellent for getting started with running.
Disease prevention/sustainable weight loss: Holly Health
Holly Health* is designed to be your supportive digital coach for identifying the best behaviours for you to focus on, and providing motivation and tracking to improve your brain and body health in a holistic way. You can think of Holly as a little health coach in your pocket. *not yet in the app store, but you can access the free beta service at www.hollyhealth.io.
Distraction removal: Opal
Opal launched recently, it’s a friendly tool for deactivating access to distracting apps. From 10pm in the evening opal activates on my phone and stops me from being able to use email, instagram, news app etc. It really helps me switch my attention to something preferable before bed, like reading a book.
If you work in healthcare and would like to learn more about the evolution of digital health innovations, or how Holly Health may be able to help, you can reach me at grace@hollyhealth.io.