From a thread on the handihealth discussion group.

@medicine20 tweeted ‘The reason Silicon Valley hasn’t built a good health app

The general thrust of the article is that current crop of popular mHealth reflect the needs and desires of particular socio-economic groups: white, suburban, materially secure, educated technologists creating apps that compliment the gym going, lifestyle jogging hipsters. Apps become the technological expressions of the ‘quantified self’ of the developers - “Homogenous teams of innovators make products for people just like them. And that’s a problem.”

Perhaps this ‘quantified self’ analysis misses for the point, for not just the old and cynical but for the vast majority of the population : “After all, we build what we know.”

Yet there is a grain of truth here. It is probably easier to build an app that helps a specific group of people from within that group. If you are a COPD patient you are probably in a strong position to help other COPD patients than other outside that cohort, or if you have never been to a doctor with a problem…. Similarly it is easier to build a GP system if you are a GP. True, but perhaps this inside/outside logic is diminished by contemporary software development tools and techniques.

So what is the problem with the some of the current rash of ‘health’ apps, particularly from the US? These apps are not really for patients at all but for the ‘curious well’ or already well-motivated. They also give the false impression that we can somehow engineer ourselves into life-long good health.

More here on the Future of Self-Tracking including this comment.

“This is a case of “not everything that can be counted counts, and not everything that counts can be counted.” The self-monitoring movement is jut another manifestation of our profound self-absorption. When you measure something, presumably you have to react to it. Is the hope that this constant self-monitoring will change our behavior? My guess is that it will simply generate revenue and speaking opportunities for its aficionados and compost, but have little impact on public health. Just look at how decades of focus on diets and weight have fared. In fact, it feels to me that this fixation on blow-by-blow narrative of our “health” is quite the opposite of what real health looks like. Oh, well, call me a luddite! "

Of course this is only a small segment of what might be covered by HANDI but it is currently very fashionable in the US and may distract govt and other funding sources from more useful approaches. “Innovate for a population who needs it … . This will require non-traditional business approaches, and willingness on the part of entrepreneurs and innovators to work directly with incumbents, be those pharmaceutical companies, health insurance companies, hospitals, or government agencies to inject productivity into the system through technology.”

This much was agreed by those in the discussion group. Which is why one thought it was important to actually understand the needs of specific patients, more than patients in general, especially those with chronic illnesses or long term contions. Not only do they need the greatest care, it is perhaps them that seeks to benefit most.

With thanks to Tim Benson, Wai Keong Wong, Ian McNicoll.