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Connected health solutions: what’s the future?

This seemed to be a hot topic at Respiratory Drug Delivery in Lisbon last month and one that really got me thinking.

During one of the conference sessions we heard talks on a number of ideas to potentially improve asthma management; these included a range of smart, connected and mobileHealth (mHealth) technologies. The talks also covered broader views based on learnings from injectable drug delivery, a sobering reminder of the challenges of working in an ever-congested intellectual property field. During the talks I scribbled down a few notes that I thought would be worth mentioning:

• Patients are ready for mHealth but views on its use differ.

• There are many asthma apps on the market, but the general opinion was that they’re not very good!

• Real life adherence and techniques are poor and may remain so even with smart inhalers.

What does the future hold for connected health solutions? Two opposing lines of thought seemed to have emerged…

• The standard approach to counselling patients isn’t working but there were discussions on whether electronic monitoring, shared with healthcare providers, could lead to effective interventions and hence reduce exacerbations and hospitalisations.

• Smart algorithms based on acoustic monitoring and signaturing of inhalers may be able to provide healthcare professionals with data on patient competence and adherence, but lots of work on validation – and encouragement of participation in such initiatives – will be required.

• A patent search based on the keywords ‘inhaler’, ‘sensor’ and ‘asthma’ yielded over 2,000 results, each of these patents bestowing a ‘negative right’ on the owner to prevent others from using that invention.

• Last, but certainly not least, three things are required for successful connected health systems: the right technology, well understood business drivers and a solution that serves patients. There are still challenges to be met with each.

During a panel discussion some interesting questions were posed, though not answered:

• Are the connected technologies of today in a position similar to that of devices 20 years ago, when everybody was using syringes and vials for injections and nobody knew who would pay for devices?

• What if regulators enforced the take-up of connected technologies the same way they enforced the take-up of dose counters? Will the patients who benefit most from smart devices the ones most likely to be engaged?

Connected health discussion

Finally, as the discussion came to a conclusion, another question emerged: What does the future hold for connected health solutions? Two opposing lines of thought seemed to have emerged:

Either: Connected health solutions are inevitably going to become more prevalent, driven by the trend towards digitalisation, continuous improvements in technology and the desperate need for better adherence and competence. This is likely to improve outcomes for patients and provide economic benefits which can fund the technology.

Or: Connected health solutions are unlikely to move beyond targeted, specialist applications and could be held back by global trends towards reducing cost, reducing waste and improving sustainability. Connected health solutions could also be unable to provide effective solutions to real issues:

• Our devices and formulations are fundamentally not good enough and their weaknesses are not best addressed by the addition of connectivity.

• The challenges of adherence are rooted in human behaviour change, which is not yet sufficiently well understood and arguably beyond the reach of technology.

A final question was raised at the conference: who in the auditorium thinks that, in ten years, most inhalers will be ‘connected’? Under half of those present raised their hands, and I wasn’t one of them. Now, if the question asked was: who thought all inhalers will be connected in twenty years? I wonder if I would have changed my mind.

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