4iP Blog

Just to clarify Dan - This is for software only.  Nothing towards any sensors that the iphonic ubisensor will talk to.

The 3.0 SDK is AWESOME! You’re right about the oversights but put simply Joe Public isn’t interested in developments in the SDK, just what they can start to use such as Copy/Paste.

The big one for me is Push notifications. They are a great way to enhance the contact experiences of customers (assuming you have a business specfic app) and provide a great interface to keep in touch…

Great competition, I look forward to seeing what you get out of this as a result

Timely indeed - I’m sittin at the launch of the European Connected Health Campus - and the slidepack already had an iPhone on-screen. Folks have noticed and last week we also created a Connected Health and Wealth Initiative in Northern Ireland.

Excellent news!

Good question Toby. I’ve been thinking about this for a while and 4iP is certainly interested in hardware although we recognise the problems and costs associated with scaling. In this case we’d probably favour software only but if the proposal was for both hardware and software I’d certainly consider it. Understand that there are a limited number of sensors available in the market that are ready to talk to the iPhone so it would be foolish not to.

Is there a potential danger that has to be negotiated in using iphones (or any smart phones) in healthcare - the danger being that you are saying to people potentially in need of care “First, go and buy an iphone.”?

Diabetes, one example quoted, is mostly a disease of poverty. Will the NHS be giving out iphones to diabetes sufferers (that might not be a bad idea, and might well be cost effective, but will the Daily Mail see it like that?)

If the NHS isn’t providing the tools, free at the point of delivery, are iphone health care apps simply another, albeit small, way of privatising health care? Better phone, better care?

It is true that “everyware” will eventually be everywhere, with everyone, so there won’t be a distinction between people who can and can’t afford, but that is not yet, and the “not yet” is important, especially if we use what might happen sometime in the future to define what we do now.

These distinctions have certainly already been debated and decided by people who know far more about it than me, and I do think we should get excited and experiment, but they are questions worth asking in this context, if only to inform our experiments - what are the values we want to support?

Hi Andrew,
The problem with technology is that bleeding edge is always going to cost someone money. The point about this is to lead the way - it’s not about a brand or a manufacturer.

Connected Health is about interoperability - there’s heaps of EXPENSIVE equipment out there that people can already buy which has poor design, low interoperability and entrenched support. People have these issues right now. The difference is that by taking the lead and creating a path for interoperability with “a” brand of smartphones, we will see this extending to other smartphones as they play catchup.

It’s fair to say that the iPhone has been a trailblazer here and has left the operators and device manufacturers wondering how they are going to beat it.

And if they do, everyone wins.

Diabetes affects a wide demographic, not just the poor. It is a disease of ignorance, not poverty. The wealthy and the poor are equalised by health issues these days - even as their relative incomes become even more disparate, they are joined by their chronic diseases.

We have 100% saturation of mobile phones in the UK. Elders have them, children have them. It’s now we can endeavour to use them for more than just calls and texts.

So, if we don’t do this, suggest a better way because otherwise we’ll do nothing. That’s not an inspiring position.

Can you provide more details of the ‘iphonic ubisensor’  I have not come across it before and it sounds very exciting.

Matt, I think you are mostly absolutely right, and a search for diabetes and poverty supports that.

(this is from Metro, so best to be wary, but it will do as an example)

“Using various sources it reveals shocking figures which show Britain’s poorest communities are 2.5 times more likely to develop Type 2 diabetes and 3.5 times more likely to develop serious complications, including heart disease, stroke and kidney damage, compared to people from higher socio-economic groups.

The report also found that those in deprived areas are less likely to have access to the appropriate care and are not getting the vital health checks they need to prevent complications.

For example, they are less likely to have their blood glucose levels or blood pressure monitored.

Entitled “Diabetes and the disadvantaged: reducing health inequalities in the UK”, the report has been published by Diabetes UK and the All-Party Parliamentary Group for Diabetes for World Diabetes Day. “

My question, and it is purely a question, is how does “iphone health care” fit into that context?

I’m sure you are right that it does fit, especially in leading to standardisation on a wide range of personal mobile devices - devices which will necessarily become more widespread and cheaper than existing specialised hardware and to a point where we all have access in preventative contexts, or doctors can provide “phones” or plug-in hardware as specialist medical devices (though at the moment the mobile phone market in the UK is diverging rather than converging, between smart and dumb phones with the middle ground disappearing).

But I think there is a small but very real danger of it being another step in transferring responsibility for healthcare from a society that takes responsibility for its least successful members to one in which the individual looks after themselves: “Buy your cure on the app store”.

It’s a perfectly reasonable argument to say that’s a good thing, but it needs saying, one way or the other.

That sounds political and to an extent it is and no apologies. It doesn’t mean that mobile health apps are a bad thing, just that everything is in a wider context than the iphone or the internet. Private companies (or hackers, interaction designers etc) don’t have any responsibility to consider those contexts (other than their personal sense of responsibility) but public services do. This is a danger to be negotiated, a reason for proceeding with eyes open.

I can also understand where the 100% penetration rate of mobile phones with voice and text in the UK may be helpful in the above context, and certainly wouldn’t suggest doing nothing - the most interesting innovations in mobile health care are probably in Africa, after all.

Diabetes is a poor example by me, and actually very real innovation will come from looking at specific problems faced by healthcare specialists which I know nothing about, but “The wealthy and the poor are equalised by health issues these days - even as their relative incomes become even more disparate, they are joined by their chronic diseases. ” is a massively contentious statement, with which you could start a fight among any group of health sociologists you ever meet.
Andrew

The transfer of responsibility to the end user (with cloud-based health informatics) is something that is being viewed with interest from the Health Trusts over here. The stats that monitoring a patient for a day can cost between £500 and £3000 is incredibly sobering (at least to me as a taxpayer) as is the knowledge that the largest health trust in the province (Belfast) is cutting it’s budget by £150 million next year.

It’s terrifying to believe that 50% of Northern Ireland’s tax burden is spent on healthcare - that’s over £4 billion every year!

The development of technology to reduce the care burden is something that has a lot of attention (and correspondingly dozens of pilots and a heap of cash). The thought that through their mobile phone a person with Diabetes might not end up in hospital due to self-monitoring and cloud-based reporting is an incredible motivator to work on solutions like these.

Yes, it’s headline chasing to consider the iPhone and no other platform and that’s entirely why we do have a burgeoning iPhone Initiative here in Northern Ireland and with our colleagues in the Republic. It has to start somewhere and for the price of a Nintendo DS you can get a device that will provide entertainment, communication and maybe healthcare - seems like a bargain. And if not this platform, then we’d have to pick another (with likely a less mature market and developer base).

I’m not concerned that Britain’s poorest communities are more likely to develop these conditions because it just proves to me that it’s a disease of ignorance more than anything else - a result of a higher incidence of obesity for example. We might argue that poverty is the root of ignorance but I don’t think we can solve all ills today. One thing I do know - you’ll find more than low end dumbphones in the estates that represent these statistics.

There are bigger players here. The apps themselves are a conduit to services that can be offered to Health Trusts as a value-added service. This is all about increasing public service value - and healthcare is a major spend in that area.

I’m wrong. Mostly.

???

“It’s terrifying to believe that 50% of Northern Ireland’s tax burden is spent on healthcare - that’s over £4 billion every year!”

So governments try and reduce spending by privatising parts of the service and allowing people to buy better care - and those who can pay have got iphones, and those who can’t, aint (though that is much too much of a generalisation, and not really relevant.)

But then

“The stats that monitoring a patient for a day can cost between £500 and £3000 is incredibly sobering”

why not give away iphones as medical devices?

But then why give a massive american multi national all our tax pounds?

Why not get some Taiwanese handset manufacturer to build an nhsPhone, and buy a job lot of 5 million of them with an open source OS?

But then they’d be like Soviet-built cars and look rubbish and no one would want them and they’d just loose them and not do their diabetes monitoring.

I don’t know! My head hurts!

But when I say “responsibility” I don’t mean remembering to take pills, I mean a privatised health care system like the US, which Obama will be spending all his waking hours trying to work out how to not have.

For those interested, we have set up a Smart Phone Forum meet-up in London. Meet 6-10pm every 2 months. First is on 2nd April. http://www.smartphoneforum.co.uk

All welcome to join and contribute.
Thanks
Martine
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I think we’re 100% in agreement.

I guess it’s a pipe dream to expect that in a few years, personal data devices with ubiquitous networking will be relatively commonplace. With the recent possible caps to data roaming charges (dropping to €0.50 per megabyte over next two years), networks are going to be very very important.

And watch the Operators fight to get a slice of the pie.

When you consider this is state of the art in medical devices…

https://www.healthhero.com/index.html

...there’s a lot of potential to develop something really cool.

Talking of smart phones, has anyone ever seen or used one of those iPhone clones? They’re made by some company called CECT, I think, and just wondered if they’re any substitute for the real thing?

I can see that you are putting a lot of time and effort into your blog and detailed articles! I am deeply in love with every single piece of information you post here. Will be back often to read more updates!
Personal massager

Another interesting debate around a great idea.

I particularly like “£300-£5000 a day to monitor a patient? Give him an iPhone and start to save, NOW!”

...and this is EXACTLY the kind of thinking that would get you fired from the civil service that runs the NHS (tongue in cheek)

Suffice to say that the NHS patient records experiment, sorry, project, is late, massively overbudget, and further investment has been curtailed by our Darling.

Boooo.

We have 100% saturation of mobile phones in the UK. Elders have them, children have them. It’s now we can endeavour to use them for more than just calls and texts.

First of all thanks a lot for the great and informative article. I am really interested in iPhones and their applications so I always search some new information about this amazing device. It my job indeed. I have to find out what other people think about this device and what applications they require. Thanks a lot for sharing this great information and for the great discussion and I will be waiting for other great posts from you in the nearest future.
Regards, Steve Tenner.

But dig a little deeper and you’ll notice some enhancements aimed squarely at the gaming industry. Significantly, the iPhone 3.0 update enables iPhone and iPod touch owners to wirelessly play games together and and use micro-payments to purchase extra levels, weapons or add-ons within the applications themselves.

I think that this new iPhone firmware will make gaming much better for me.

It has to start somewhere and for the price of a Nintendo DS you can get a device that will provide entertainment, communication and maybe health care seems like a bargain. And if not this platform, then we’d have to pick another.Bridges To Recovery