Measure for Measure: Self-Diagnosis Comes of Age
1.1. Key Findings
- The Importance of Prevention. 72% of people think that it is important to take action now to protect their health in the future.
- Self-monitoring. This is perhaps one of the most exciting developments in medicine. The benefit of technology is hugely apparent here; it can make and it will make a tremendous contribution to preventative care. The consumer trend towards self-monitoring adds velocity to this trend, offering the prospect of cheaper, better and more convenient treatment.
1.2. Better Than Cure: The Importance of Prevention
Our research shows that an overwhelming majority of people, 72% think it is important to take preventative measures now to improve their health in the future. This desire is reflected in two new phenomenon; self-diagnosis and self measurement.
1.3. Patient Heal Thyself: The Role of Self-Diagnosis
The benefits
Much of the internet’s strength lies in its ability to empower. Our research shows that the majority of Britons have used the web to diagnose themselves. Some 62% of us have visited a site such as NHS Direct to check symptoms – a number that is likely to increase given the increasing frequency with which we use the internet.
The main reason that people self-diagnose is that they feel informed enough to make their own judgement on their condition (or lack of a condition). Unsurprisingly convenience also rates highly (21% of citizens quote this reason) while one in eight of us do not want to ‘burden’ the health service. This respect for the finite resources of the NHS is borne out elsewhere in our research and may indicate a degree of civic responsibility.
This seems consistent with reported behaviour. Among our sample, 14% claim to be visiting a health professional such as a GP less often now with only 5% going more often. Some GPs welcome self-diagnosis.
“I think patients make very good decisions for themselves. They are experts on themselves so they know what they are actually feeling and they do need good counselling on where to get good information and how to make the right decision. I encourage patients to have a look at the internet before they come and see me because then we can have a good debate and a good discussion.” Dr Amit Bhargava, GP, NHS Alliance
Proponents of self-diagnosis argue that it encourages citizens to take more responsibility for their own health and at the same time it reduces the strain on the NHS.
Our research shows that 41% of people feel confident in self-diagnosing their own symptoms. However, this confidence is not shared by all medical practitioners.
The problems with self-diagnosis
“Self-Diagnosis. Well, it’s chaotic at the moment because people are all just diagnosing themselves with the wrong things.” Dr Patricia Macnair, medical practitioner, journalist and broadcaster.
We might expect self-diagnosis from unproven websites to lead to a virulent outbreak of hypochondria. The majority of experts on our Delphi Panel anticipate that self-diagnosis will put additional pressures on the health service.
The experts we spoke to in the writing of this report were consistently concerned with the downside of self-diagnosis, fearing that it could lead to an increase in health anxiety and misdiagnosis. In looking ahead to 2020, our experts believe that the real advance in health will come not from self-diagnosis but from self-monitoring.
1.4. Measure for Measure
Technology is already making a positive contribution to our health through intelligent self-monitoring. An ever-increasing range of innovative devices and ‘apps’ allow consumers to track their own behaviour and health, translating the data that surrounds us into understandable chunks of information.
The iBP app invites users to monitor blood-pressure and pulse rates over time with the option of sending cumulative, long-term data to the doctor for analysis. Glucose Buddy is an all-round health record for diabetes sufferers; blood-glucose levels, food intake and exercise regimes are all logged via a touch-screen interface and presented in colourful graphical displays for the user to analyse. Meal Calc is one of a number of applications designed to log the number of calories consumed each day. The NHS has introduced a free app, the Drinks Tracker which calculates alcohol consumption over ‘weeks and months’.
The research conducted for this project illustrates that significant numbers of people are interested in monitoring their own health – particularly cholesterol, blood pressure, BMI and calorie intake. People in higher social grades are more interested in monitoring calories and weight related issues. We believe that self-monitoring will become an important trend and one that will grow as long as measurement is easy to do. Healthcare professionals welcome this development.
“ [self-monitoring] ...it’s fantastic because it’s empowering for patients in terms of self-management, but it also makes the intervention more efficient if it does need to happen. So I can see this right across a range of chronic and fluctuating conditions, both mental and physical. I think it will be a big area for growth”. Andrew McCulloch, Chief Executive, Mental Health Foundation
“...we are somewhat limited by imagination at the moment [but] the possibilities are huge.” Dr Amit Bhargava, GP, NHS Alliance
Support for self-monitoring even extends to the concept of clothing which could measure body temperature to aid the early diagnosis of illness – one in eight of the people we surveyed felt that people should be encouraged to wear clothing with this capability.
All of the experts on our Delphi Panel believe that, by 2020, people will commonly be using technology to monitor their own health.
Self-monitoring has the potential to contribute hugely to preventative medicine.
1.5. The impact of self-monitoring for General Practitioners
“There’s a lot of technology that can go into people’s homes that can allow them to monitor things like their blood pressure, their respiration, their pulse rate and then have direct contact over the telephone with a support service so that when they get anxious, rather than going into a hospital we can do some basic investigations. They can even do them within their own home and we can reassure them because a lot of people with chronic diseases get very anxious. Self-monitoring can help reduce anxiety and reduce access to health services – this is something that is already happening.” Dr Jonty Heaversedge, GP and Broadcaster
In an increasing networked society the ease with which people can self-monitor becomes much greater. The data they collect is easily downloaded and sent to health professionals. This makes consultations with GPs more efficient, backed by a rich and accurate data resource. There is no doubt that self-monitoring will grow substantially between now and 2020. Patients show a great deal of enthusiasm for non-intrusive devices, while the practitioners we spoke to are excited about developments in this field.
1.6. Conclusions
Over the next ten years we can expect an increased focus on preventative medicine. More resource will be committed to this area in the desire to save money, reduce hospital admissions and improve the health of the nation. Technology has a tremendously positive role to play in this – a role that will be considerably greater in 2020 than it is now. As a consequence of better information, doctors will be able to make better diagnoses and make timely interventions. What is encouraging is that we have identified a trend among the population towards self-monitoring. If this trend can be encouraged and nurtured, there is an enormous gain to be made in preventative care.
