When Apple
announced two major new healthcare features this week, it billed them both as
terrific innovations that may well keep us alive.
Later this
year, its Watch will be able to automatically call emergency services if it
detects you have suffered a fall and are no longer moving. And it will also let
you know if you have heart problems and should perhaps visit your doctor as
soon as possible.
Other
devices have offered similar functions in the past, albeit in less elegantly
presented gadgets. But with an estimated 50 million Apple Watches out there
already, there are concerns about the pressures it may bring to already-strained
healthcare systems.
The result
may be even more calls to emergency services and, according to one of Britain’s
leading surgeons, a new wave of technology-driven hypochondria.
"Medical
professionals will also need to be vigilant to the risk of misdiagnosis and
overtreatment that this proliferation of personalised health information could
bring,” said Richard Kerr, chairman of the Royal College of Surgeons’
commission on the future of surgery.
Brian
Fontes, chief executive of the US National Emergency Number Association (Nena),
represents an often overlooked and underpaid part of our communities -
emergency call handlers. He is well-versed in the history of new technologies
designed to make access to emergency calls easier, some proving better than
others.
He recalled
one example of a home security firm seeing a spike in false alarms each year on
Valentine’s Day, with first responders showing up to discover that big, red “I
love you” balloons had set off the system’s movement sensors.
I asked Mr
Fontes if he was worried about the potential for false positives from the Apple
Watch’s fall detection, which combines data on wrist trajectory and impact
acceleration in attempt to work out if the wearer could be in trouble. The
device only makes an automatic call if you don’t move for longer than a minute
- up until that point the wearer has to initiate the call with a tap on the
Watch’s screen.
Mr Fontes
said he had confidence in Apple's approach.
“These are the real beginnings of exciting
innovation. I don’t see, at least initially, an overwhelming number of false
positives coming in. But only time will tell.”
This isn’t
the first time a new technology has raised concerns about over-burdening the
911 emergency services system. Mr Fontes remembered when trials to allow people
to send text messages to 911 began in 2010, a move some said would lead to
handlers being inundated.
"There
was a lot of fear, and a lot of opposition,” he recalled, saying those concerns
proved unfounded. Around 30% of centres across the country now accept text
messages, he said.
That doesn’t
mean he’s welcoming the technology in with completely open arms, however. What
made text messages so effective was the comprehensive training scheme put in
place to prepare call handlers for the changes.
"This
is one of things that I want to follow up with Apple,” he said.
"Are
they working on an education campaign with 911 centres? How will that 911
professional who answers that call understand what’s happening?
"It
should be a high priority. If you live long enough you’re able to tell what
succeeds and what doesn’t. Where there’s an education programme associated with
innovation, it’s a much easier thing to enable when it comes to 911.”
Owojela’s
Blog understands Apple plans to discuss the technology with 911 call handlers
and will be posting a support article explaining the technology in more depth
on 21 September.
The Apple
Watch’s electrocardiogram feature, coming later this year, will monitor the
rhythm of the heart. Like the fall detection, it too was touted as a
game-changing moment in health tech by Apple on Wednesday.
It would
allow the wearer to get, at the tap of a screen, a basic diagnosis of their
heart health that can then be passed on to a doctor.
The
technology has as yet only been cleared by the US health regulator. But if it
does make it to the UK, it could mean more appointments, warns Aiden Doherty, a
leading expert in health devices from Oxford University’s Nuffield Department
of Population Health.
“Staff in
the National Health Service are already time-poor,” he told the Media.
“It is
possible that many new patients might seek earlier, and potentially unnecessary
treatment. This could of course lead to anxiety for patients, and increased
healthcare costs for the NHS.”
Furthermore,
Mr Doherty said we shouldn’t expect the medical community to take Apple’s word
for it on accuracy of the device’s readings.
“Clinicians
will likely seek independent validation studies for this device before using it
to support diagnosis and management of disease.”
The internet
has given everyone the chance to research their symptoms, often with inaccurate
fear-inducing results.
Now, the
Royal College of Surgeons, a leading authority on health matters in the UK, has
warned about the impact of this “immense amount” of new information -
information that, unlike a haphazard search online, offers advice that is
personalised.
"The
'worried well' will be sent into hyperdrive,” neurosurgeon Richard Kerr said.
"GP practices
and Accident and Emergency will undoubtedly see more patients who are concerned
about what this information means for them."
"There
is unfortunately the danger that the unscrupulous of our profession could prey
on the fears of patients, convincing them that treatment is necessary, where it
is not.”
But Nena's
Mr Fontes thinks the reverse might also be true. The device could be right in
telling us help is needed, even if the wearer thinks they’re fine.
"If you
had a device that told you you had a significant fall, maybe that would
reaffirm your decision to reach out for medical help.”
He said he’d
much rather call handlers dealt with a false positive than “read an obituary”.
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