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Will Healthcare Apps effect Musculoskeletal services?

Published by cathalmalone@hotmail.com on

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Will Healthcare Apps effect Musculoskeletal services?

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I’ve been a Physiotherapist for over thirteen years now and I have seen many changes occur in our profession from both a clinical (how best to treat) and from a practical standpoint. There are enough points of view out there on ‘how best to treat’, so I won’t bore you with my views.

My topic today is a personal reflection on how our Musculoskeletal services are evolving in this digital era and whether we are keeping up to speed with this digital revolution. Digital healthcare has certainly become a hot topic in the past year and the advent of ‘wearables’ and the growing number of healthcare apps are fuelling this fire.

Having listened to Jeremy Hunt (current health secretary) at last years NHS England conference in Manchester it became apparent that much hope is being placed on the use of digital devices to help ease some of the burden on NHS services. Through allowing patients to record their own health data it is hoped that patients will take a greater ownership of their health, utilise less healthcare services and even become more proactive in preventing the occurrence of further health problems.

So is this likely to effect our musculoskeletal services? Will smart devices replace some physiotherapy services who just provide advice and exercises? Are we soon to be left twiddling our thumbs as our patient’s take on the ‘self-help’ buzz by engaging with the information, animations and videos provided by their mobile devices!?

I’m afraid, if patients were excited about ‘self-management’ then our physiotherapy services would be much more underutilised than they currently are. Self management has been the mantra chanted by many NHS physiotherapy services for well over a decade and the generalised feeling for this approach by patients is usually one of a negative tone. Patients want to be ‘Fixed’ with treatments or at least reassured that they have nothing seriously wrong with them and the general feeling is that both need to be delivered with a ‘human touch’. Digital devices can provide an abundance of useful health related advice but I’m not sure that an App could instill the important feelings of having been listened to, reassurance and care that are a necessary part of a positive patient experience.

Furthermore, in regards to patients being reassured by the information on digital devices: It is common place that a trawl of a well known search engine for a diagnosis of the latest painful niggle can commonly lead to the creation of many unhelpful concerns, beliefs and expectations for said problem. Humans are complex and health related information (especially when related to seeking a diagnosis) needs to be organised into a context with the events, symptoms and psychosocial experiences of that individual’s problem. Most clinicians will state that it is vital to consider these factors in order to achieve an accurate working diagnosis and more importantly for creating an effective management plan.

The use of digital devices certainly have there use in musculoskeletal healthcare but like so many things in healthcare, the benefits are only fully realised when it is recognised that there use is only part of a patients management plan and not just simply the ‘only thing’. My view is that digital systems have their place in aiding the management of musculoskeletal patients. Exercise prescription and activity tracking software have certainly improved over the years and with there ability to improve adherence through text reminders, video descriptions and ability to record activity levels in real time are tools that can improve the outcomes of ‘self help’ based treatments. This ability to easily record information is believed to become a powerful tool to help improve the delivery of care in the future, however I think that we are still a way off using digital devices routinely within musculoskeletal services (other than providing a set of exercises).

In all, I think that at present it will take more time for not only clinicians but also patients to consider digital devices as being a useful tool in the management of healthcare and specifically musculoskeletal problems.

As a clinician I feel that clinical software (e.g. practice management systems) needs to improve to give clinicians the tools they require in a more user friendly format and in order to achieve this, a greater consideration must be given to utilising clinician input at the development stage.

The abundance of healthcare apps available for ‘patients’ may indicate that a solution to improving healthcare has been found but other than having a smug look at how many steps an individual has taken during their day, I feel that many digital users will ignore the wealth of useful health advice that their smart devices can give them. Ultimately, the primary problem that will remain is the issue with user/patient motivation in improving their health with self-help strategies and I’m unsure how digital devices are going to win this battle that so many clinicians have struggled with throughout their careers.

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