The ACES Podcast
The ACES Podcast Episode 29: Dr Vipul Gupta
Oct 19 2021
In an article published in the Springer journal Philosophy and Technology, ACES Ethics, Policy and Public Engagement Research Fellow Dr Mark Howard explains why a technocentric approach to healthcare, shaped by technology corporations and an emerging digital health market, risks undermining the real clinical potential of mobile health (mHealth).
The practice of using wireless technologies like smartphones and wearable devices to facilitate healthcare interventions across health categories, such as disease management, monitoring of physical function and disability, and lifestyle mediations (collectively known as mHealth) is experiencing rapid growth. mHealth is already used in clinical settings to monitor people’s physical and mental health and partnerships between hospitals and national health services, including Britain’s NHS and technology corporations, Apple, Amazon, and Google, are becoming more common.
In his article, Dr Howard explains that while the narrative surrounding digital and mobile health is overwhelmingly positive, the development of mHealth interventions needs to be socially aware and grounded in civic obligations such as solidarity and inclusivity. The promise of quick and cost-effective technological solutions to complex healthcare problems is attracting the attention of funders, researchers, and policymakers and during this development care needs to be taken to avoid exacerbating inequalities in health for those who are marginalised or experiencing social disadvantaged.
“This emerging digital health marketplace requires critical oversight,” Dr Howard said.
“mHealth is often framed as a pathway to personalised medicine, improved efficiency and quality of care, the empowering of under-resourced communities, and delivery of health services previously unavailable to the citizens of developing countries. However, critical oversight is often missing from the overly enthusiastic accounts of mHealth and wearable health devices in contemporary medical, industry, and science literature. Consequently, important social, political and ethical implications of these technological innovations can be overlooked.
“Adopting a technocentric approach to problems that are predominantly social, not technical, may be problematic in the long term and improving equality in health outcomes may be better served by targeting the sources of inequality directly. It is often the underlying social factors that maintain disparities in health, and this is manifest in examples where the expected advantage of mHealth was not achieved, and in some instances produced worse outcomes, for patients compared with traditional approaches.”
Dr Howard’s article includes two case studies – diabetes and women’s health in developing countries – to illustrate the influence of socio-economic inequalities on individual and population health and highlight the potential harm that a wearable-led revolution in healthcare might cause, and the benefit that might be lost, if isolated from consideration of complex social environments and civic values.
Read the paper here.
Dr Howard also recently contributed to a Monash LENS article on Covid point-of-care diagnostics. Read more about it here.