19. Mobile medicine

Jo goes for a run every morning.

She uses Nike+ to measure her running speed, heart rate, steps per minute, distance covered and speed.

She uses an iPod to ‘tune her run’ – to place musical tracks at precise points in her run to spur her on.

When she gets home, Nike+ shares her stats online, to allow her friends to compare and compete to achieve goals.

Nike+ has built a vibrant competitive community out of running.

And it has sold large amounts of sports apparel as it has done so.

Meanwhile

Meanwhile PruHealth partners with Virgin Active health clubs in the UK to offer a corporate health program where employees get benefits in return for hitting quantitative exercise and diet targets and for swiping their cards regularly at the gym.

Meanwhile

Meanwhile, in 2008, Johnson & Johnson developed the first iPhone diabetes app, which evaluates blood sugar levels for type 1 diabetics and helps them manage their diet and insulin.

These are models for a whole new range of services in the 2010s, as health digitizes and mobilizes:

• Doctors are encouraging patients to take responsibility for their own care, and this involves much measurement.
• The world is being flooded by gadgets to check your blood pressure, blood sugar and cholesterol.
• The ageing of rich world populations means that there are many more older people around, many of whom are keen to monitor their health.

Health numbers

In the past, the only numbers most people knew about themselves were their height and their weight.

Today, things have changed.

	Nike+’s events include combined running and private shopping evenings – the ultimate sporty woman fantasy.
	The most popular track by far on Nike+ is Survivor’s 1982 hit ‘Eye of the Tiger’. Runners are such clichés.
	People make irrational trade offs with their health: when the credit crunch hit, large numbers of Americans postponed critical medical procedures.
	Googling your meds has become a national pastime amongst elderly Americans.

Typical rich world fifty year olds may know their blood pressure, pulse, blood sugar level, levels of good and bad cholesterol, and much else.

This trend is likely to accelerate as portable devices drop in price and as insurance companies demand more numbers from their prospects before they agree to insure them.

The trend may also be driving people towards new ‘quantified’ self perception, as identified by Kevin Lane Keller in his blog, The Quantified Self.

But whilst consumer electronics and pharmaceutical companies gear up to flood the world with new, more and better gadgets, problems are arising:

• For many people, numbers are an area of great confusion and fear.
• People struggle to self-report.
• They are also unable to identify an average from a range of readings they have taken.
• Others delude themselves about their numbers, following a long history of denial about their weight.

The solution to all of this is clear: the cellphone needs to become the central, automated collection and transmission device for all of this information.

So:

• Expect mobile digital medicine to become an integral part of the middle class lifestyle in the 2010s.
• Your phone has an accelerometer. So it already knows whether you went for your run this morning or not. And indeed some Docomo phones in Japan already give you a read out of how many steps you took today. It’s not a big leap to a piece of software that wakes you up tomorrow morning and makes you put on your sneakers.
• Similarly, certain Japanese Au phones already talk to bathroom scales via Bluetooth. All phones need to know how much their owners weigh.
• Blood pressure of 160/100 was considered fine in a sociable 35 year old in 1960. Today it would put them in the emergency room. Expect the medical profession to upgrade numerical health targets further as the 2010s progress. And therefore expect the need for gadgets to grow.
• In most countries, there is a huge difference in life expectancy between richer people, who eat better and exercise, and poorer people who don’t. Can the user-friendliness of cellphones break digital health out of its current middle-class ghetto?
• Self-help in medicine has been growing ever since medical authorities allowed people to buy previously prescription meds over the counter in the nineties. Expect a gossip culture infrastructure to grow around this in the 2010s.
• But as always, simplicity rules. You need training to operate most ‘consumer’ healthcare gadgets today.
• How much could all of this be worth? A typical affluent sixty year old is worth $2 to $3 million. How much of that would they pay for a shot at another ten years of active life? The Boomers are getting old. And they don’t want to die.