Advances in digital technology in healthcare
Digital technology has rapidly advanced in recent years, making our lives more convenient. For example, mobile phones have become indispensable tools for our daily lives. In healthcare, digital technology has potential to improve care quality while reducing human error and saving healthcare resources. Non-communicable diseases (NCDs), such as cancer, cardiovascular diseases, diabetes, and mental health disorders, are major global problems [1]. Key modifiable risk factors for NCDs are intricately linked to our lifestyles and encompass dietary choices, smoking, physical activity, and sleep [1]. Therefore, effective lifestyle management requires a proactive approach involving willingness to modify lifestyle, correcting unhealthy habits, and cultivating self-efficacy and motivation. This emphasis on lifestyle changes empowers individuals to take control of their health. Mobile applications equipped with education, feedback, interactive communication, and counseling offer promising tools for managing modifiable risk factors. These applications are expected to enable close monitoring with minimal time, labor, and cost, and could be particularly valuable in Japan given the inevitable decline in the working-age population [2]. Before launching mobile applications in healthcare, it is crucial to conduct a thorough technology assessment, including validating the tool and gathering evidence of its effectiveness. Presenting this information to stakeholders (e.g., developers, vendors, consumers, insurers, and policymakers) will ensure the reliability and effectiveness of digital tools in healthcare and provide guidance on what the digital tool should be.
Abe et al. conducted a comprehensive systematic review that clarified whether mobile applications were more effective at lowering blood pressure (BP) compared with conventional healthcare [3]. That review included 76 studies with 46,459 participants. The primary finding from the meta-analysis was that use of mobile applications was significantly related to systolic and diastolic BP reduction compared with routine healthcare. In addition, a significant reduction in office systolic BP at the 3-month follow-up was found among normotensives, and those with hypertension (HT) exhibited a significant reduction in office systolic BP at both the 3- and 6-month follow-ups. The BP reduction tended to be more prominent in those with HT than normotensives. The review noted that in terms of application function, wireless transmission of BP measurements was critical to the success of the mobile application. The authors also noted a limitation in that evidence regarding the long-term effectiveness of mobile applications was unclear.
These findings suggested that mobile applications have a significantly preferable effect on BP control compared with routine healthcare. Nomura et al. conducted a health economics analysis and reported that a digital device was cost-effective [4]; therefore, there are high expectations of mobile applications in several settings. One assumed application is adjunctive use for healthcare. The CureApp HT® is already covered by medical insurance and prescribed in healthcare settings. Real-world data showed that there was a statistically significant reduction of systolic and diastolic BP of ~8/5 mmHg with the use of CureApp [5]. Another potential application is adjunctive use for health guidance. A specific health check-up launched in 2008 aimed to reduce metabolic syndrome and consequently contain healthcare costs [6]. Mobile applications could become strong adjunctive tools for health guidance in healthcare settings; insurers may enthusiastically welcome such innovations to contain healthcare costs.
The authors of the systematic review discussed above [3] could not demonstrate the long-term effects of apps on BP improvement and further studies examining the long-term impact of mobile applications are warranted. In addition, studies addressing artificial intelligence (AI) are indispensable as AI-powered mobile applications are already beginning to be implemented. For example, Lark Technologies, Inc. has provided a “Hypertension Care Program” using a coaching application powered by AI [7]. AI-powered applications may enable effective management through personalized and precision medicine [8]. Branch et al. reported a significant reduction in BP following use of a personalized AI-powered application [7]. The effectiveness of AI for BP control compared with usual HT care has not yet been shown in a systematic review because of a limited number of studies [9]. However, I believe that such application of AI will become mainstream in the near future.
Finally, I would like to offer some suggestions for the regulatory authorities. It is taken for granted that tools that do not meet minimal requirements, such as privacy, security, and ethics, should be removed from the market. However, excessive requirements on developers before launching a tool may burden them, delay or spoil technology innovation, and lead to loss of competition. Syed reported in his book “Black Box Thinking: Why Most People Never Learn from Their Mistakes – But Some Do” that the lean startup method was effective in helping entrepreneurs quickly test and validate their business ideas by emphasizing early customer feedback and iterative experimentation [10]. I hope the relevant authorities support and encourage lean startups and uninterrupted improvement, which will subsequently stimulate the market and promote free competition and technological innovation. I sincerely hope that digital technology innovation will brighten our future and that Japan will take a leading role in digital technology in healthcare.
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