Digital health is a big business. But it also raises many doubts.
It consists of using technology to help provide health care. It includes, among other things, sanitary applications and implanted microchips.
The digital health market is expected in 2024 have a value of US $379,000 million around the world, a jump more than considerable compared to its value in 2017: 71,000 million dollars, according to the consulting firm Global Market Insights.
But this notable expansion has also raised concerns: technology that promises to improve the lives of users could be used against them?
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It is estimated that in Google Play and Apple Store there are More than 200,000 healthcare applications available.
"Through sensors, tracking devices and other data collection tools, we can identify trends, anomalies or other environmental or physical factors that could affect the way we treat and manage diseases, and ultimately, improve people's lives"says John Bardi, vice president of digital medicine business development at the pharmaceutical company Otsuka.
"But that promise carries a huge one responsibility".
Doubts range from ethics to data security. But how could these applications hurt you?
1. You could end up paying more for your life insurance
Last September, John Hancock, one of the largest and oldest insurance companies in North America, caused a sensation.
The company announced that from now on it would only work with "interactive" policies, which control physical conditions and health data through devices wearable (those who join clothes, for example) and smartphones.
They explained rewardlaugh to customers who they had healthier lifestyles with discounts and gifts. They were based on statistics showing that holders of interactive policies live between 13 and 21 years longer than other insured persons.
But some insurance experts have warned that this decision could induce insurers to use the data obtained punish customers that did not meet the goals, and even charge more to those who opt for interactive policies.
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However, the company claimed that what pushed mandatory interactive policies was customer demand: The use of health data monitoring has increased by over 700% in the last three years, according to them.
"For centuries, the insurance model has provided financial protection to families after death, without improving the quality of life," said Marianne Harrison, president and CEO of John Hancock, in a statement.
"We believe that insurers should be concerned about the time and quality of life of their customers, and with this decision, we are proud to become the only US life insurance company that relies solely on health according to habits of life and leave behind the old way of doing business ".
2. Your device could spy on you
Millions of people with respiratory problems such as sleep apnea use expensive machines and public health systems do not necessarily provide.
In November, an investigation conducted by the US radio station NPR found that some health insurance companies provided the patients with these interactive machines to send them data on the use they made of them. So, in the end they could deny coverage to users who do not meet the requirements.
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But the German data specialist Christian Bennefeld warns that companies do not need to go to these extremes to monitor people.
A study conducted by his company, eBlocker, found that health sector websites already they spy on customer browsing activity thanks to Internet monitoring programs.
"The problem is that many users do not know that this information is being monitored, even when they consult a medical website for advice and research for terms such as cancer, for example," Bennefeld told the BBC.
3. You may be tempted to self-diagnose
Many years ago, there is much information on symptoms and diseases available online.
However, with a increasingly sophisticated technology Patients have a number of tools that allow them to scan and even perform genetic tests.
Public bodies such as the UK National Health Service also have applications with virtual assistants to help filter queries.
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However, a study conducted in 2016 by the Royal Pharmaceutical Society showed that over half of UK adults they use the internet instead of going to the doctor.
In addition, a survey by research firm Mintel concluded that it was likely that more and more young people would trust the health information they found online rather than doctors or pharmacists.
And this despite the warnings of the health authorities: the British Medical Journal analyzed 23 health websites and concluded that its diagnosis was correct only in 34% of cases.
4. They could hack you
One of the biggest concerns in terms of digital health is the large amount of data obtained from patients.
Are they vulnerable to losses that have been repeated in the last decade?
So far, the list of the biggest data losses of all time does not include any company related to the health sector.
But at the beginning of this year, some hackers entered the Singapore government's health database have collected personal data of 1.5 million people, about a quarter of the population of the country.
5. You can be a victim (or not) of a part algorithm
Digital medicine enthusiasts claim that technology will lead to increasingly personalized medical care.
But many believe it can also lead to uncomfortable situations for patients.
And this because prejudice of the algorithm, which occurs when an information system reflects the implicit values of human beings participating in its construction.
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A series of studies on the use of artificial intelligence highlight the need for a larger representation in the developer teams, as well as in the data.
The independent British organization Nuffield Council on Bioethics said: "Artificial intelligence could work worse when data are scarce or difficult to collect digitally, which could affect people with rare diseases or other people who are underrepresented in the clinical trials and research data, such as blacks, Asians and ethnic minority populations. "
6. They can not give you any benefits after all
Studies on the success of digital health have produced contrasting results.
An example is an article by Virginia Commonwealth University that relates technology that helps to count calories and play sports with eating disorders.
On the other hand, some studies in the United Kingdom have been shown to have reduced income and home visits among patients with chronic obstructive pulmonary disease.
At the beginning of this year, a study by the University of Bond, Australia, revealed that only 23 health and wellness applications had been analyzed according to the highest academic standards, and that only one works: GetHappy.
There is a curious case in this sense. It is an application developed by the Swedish government to curb the consumption of alcohol among university students (Promillekoll), which eventually made the male students drink more, according to a study published by the journal Addiction science and clinical practice.
7. You could get the opposite of what you wanted
With over 700,000 users from 200 different countries, Natural Cycles is a recognized application like the first "digital contraceptive" certified in the world. It uses a hormone-free method based on reproductive cycles and has even been approved by the US Food and Drug Administration.
However, the application and the company are the focus of attention since July, when the cases of unwanted pregnancies.
The Swedish health authorities reported in January that 37 of the 668 abortions performed at a Stockholm hospital were women who had used the application.
In August, the UK Advertising Standards Authority banned Natural Cycles advertising on Facebook, ensuring that exaggerated the effectiveness dell & # 39; application.
"No contraceptive method is 100% effective, and unwanted pregnancies are a risk with any contraception," the company said in a statement in August.
Natural Cycles ensures that clinical trials prove this its effectiveness rate is 93%. It was independently supported by the Swedish medical products agency, which authorized the use of the application.
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But the agency also asked Natural Cycles "to make explicit the risk of unwanted pregnancy in the instructions for use and in the application, so that users can take it into account. "
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He also said that "unwanted pregnancies will continue and we will check that there is no deviation from the amount predicted on the basis of the clinical evaluation".
"We identify with all women who have had unwanted pregnancies and we understand that it is a difficult situation, however, the number (of pregnancies registered in the hospital) corresponds roughly to the number of users we have in Stockholm, which is 5% in line with what we expect from the application, "Natural Cycles technical director Elina Berglund told BBC Radio 5.
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