Digitization is leading to changes in products and services. Health apps show how healthy this development is. They are not only changing, innovative products, but also have the potential for medical technology companies to put service-oriented models in the healthcare market.
Digitization deeply affects healthcare. Patients inform themselves on the Internet and use wearable and apps to collect and evaluate health data. Doctors offer advice and assistance via the Internet, and patients are increasingly making use of these services. Service providers are taking up digitization and driving it forward.
Digital technologies can help us better solve the challenges facing almost all health systems in the western world – more and more elderly and chronically ill people are to be treated, expensive medical innovations to be paid for, and rural areas with medical problems provided.
Cloud-based data collection
If you think digitization in medicine to the end and want to use all the advantages (especially big data analysis and AI), you cannot avoid central digital data storage. Nobody seriously doubts that sensible treatment of patients with rtCGM (real-time Continuous Glucose Monitoring), iscCGM, and insulin pumps is only possible with access to the stored data. Time-consuming reading of the devices in practice, sending the data as a PDF document by the patient, or bringing printouts can only be a temporary solution, especially since such processes and measures consume considerable practical resources.
The first approach to this is cloud-based programs for data management of glucose monitoring systems and insulin pumps. “Cloud-based” means that the data is not stored on the practice or clinic server but that an IT infrastructure (server, storage space, software, computing power, etc.) of the software provider. There are currently diabetes software solutions installed directly on the practice or clinic computer and stored the data there. However, cloud solutions are being used more and more.
A year ago, the use of cloud-based programs and their data protection conformity was discussed; in practices with technologically interested employees, they have long since found their way into the daily work routine. After the patient has released the data, the practice data is available at all times. In particular, during a telephone or telemedical consultation (e.g., video consultation, encrypted chat program), advice can be given based on the current data.
Other providers will probably also switch to cloud-based software because of the easier program maintenance and the independence of different operating systems and computer platforms.
The universal apps in the diabetic field only record a limited type and number of data (glucose values, data from insulin pumps) and generally only allow one-sided communication (storage in the cloud, maximum access among others to doctors). Doctors laboriously collect all other relevant data on patients’ treatment from various sources (laboratory, doctor’s letter, etc.). There is no well-founded access to many pertinent data, such as diet and exercise or stress in diabetic foot syndrome.
There are applications in development that offer apps on smartphones, tablets, and computers as a frontend on the patient side, and access to cloud-based portals on the doctor side. These applications manage the data and medical history. The therapy plans and integrates data from other smartphone apps such as fitness tracker, pedometer, nutrition database, scales, blood pressure monitor, and many other applications. This enables more extensive data collection. Secure chats and video contacts are integrated into these systems. At the same time, there is the possibility of direct doctor-patient communication.
There is an unmanageable number of apps that should support patients and practitioners in everyday life. In the diabetes sector, however, there are individual solutions, e.g., B. in the form of blood sugar diaries, nutrition tables and diaries or exercise guides, pedometers, and trackers. Some apps use the resources or other apps of the respective smartphone (pedometer, tracker, Apple Health) or are compatible with other diabetological devices (insulin pumps, glucose monitoring systems).
The next developments are apps with analysis of photos of meals to better assess the composition of the food (especially carbohydrates).
With the apps for calculating the insulin dose, the function goes far beyond the mere calculation aid of a bolus calculator. They integrate a large amount of data into a calculation model that is controlled by self-learning algorithms. These apps are all classified as medical devices and therefore need a CE mark. It remains to be seen whether this will result in increased patient safety.
The future undoubtedly belongs to the integrative apps, which all of the above. Record items, analyze them, and make structured data and examines available to the patient and the practitioner, at any time. Context-related and personalized information and advice (“support systems”) can be derived from this. These apps will change the workflow of the practitioners. They will become an integral part of the work, as are the PVS and hospital information systems (HIS) and the readout programs for the glucose monitoring systems. Here the boundaries between app, telemonitoring, and telecoaching are blurred.
It is essential to provide educational work and to create an understanding of telemedicine app development solutions in healthcare. Acceptance and trust are fundamental prerequisites to advance digital health care. This applies not only on the part of doctors, psychotherapists, and other service providers – it is also essential to develop and strengthen the (digital) health literacy of patients. Because increasing the health literacy of the population can contribute to more sustainability in healthcare.