19 October 2017
Are new technologies for monitoring the health and development of newborns milking parental anxiety, or can they be a viable part of the solution to increasing gaps in health visitor provision?
Figures out this week record a 9.5% decrease in the number of health visitors in England since 2013, with numbers are set to fall below 8000 by February 2018. According to figures quoted by Shadow Health Secretary, John Ashworth, provision of visits to newborns is as much a postcode lottery as many other services with home visits within the first 14 days varying between 99% in Enfield, North London, to just 25% in North West Somerset.
Despite the discontinuation of public sector pay caps and promises from Labour should they come to power, with the Brexit effect on recruitment and the scrapping of bursaries for student nurses it’s hard to see the NHS recruitment crisis reversed any time soon. Are novel technologies poised to fill the gap? Should we be welcoming the virtual health visitor into our homes?
With My Healthy Future, PHG Foundation is leading a conversation with experts and enthusiasts – and the sceptical – about new technologies in health, particularly their role in preventing the onset of disease and maintaining wellbeing.
For new parents there are a burgeoning array of smart technologies to monitor their newborn’s health and wellbeing at home and provide early warning of illness or below expected development.
Among some of the ‘award winning’ early development apps and monitors - note that few if any of these currently require approval by health regulatory bodies – are sensors that attach to various bits of clothing, to a cot mattress, even to a nappy to monitor heart rate, breathing, movement, temperature, excess sweating, nourishment and hydration levels. Changes in any of these could be an indication of a potentially life-threatening event.
The baby book is, inevitably, taken to the next level with smart monitors that include video streaming, baby events log, and access to WHO stats to easily benchmark how the baby’s measurements correspond with regional averages.
Wearables may even be able to let parents know not only that their baby is crying, but also to understand why. After measuring and recording an infant’s movements or behaviours and processing resulting data, the computer can assess the data to interpret the purpose of the child’s behaviour and inform parents or clinicians through wireless communication.
And should the pressure to measure contribute to parental anxiety, even pushing the mum with baby blues into postnatal depression - well, there are apps for that too.
It’s a paradox - at the heart of much person-centred medicine lies a machine, an algorithm, a bot. In the future, could the human factor become obsolete, human error become a thing of the past? A good thing, surely?
With ‘My Healthy Future’, PHG Foundation is leading a conversation with experts and enthusiasts – and the sceptical – about new technologies in health, particularly their role in preventing the onset of disease and maintaining wellbeing. Embracing four life stages, the project kicks off with a look at the role of technology and our relationship to it during reproduction, pregnancy and the neonatal period.
Myriad questions arise: how might technology affect parent-child bonding; if the app can tell you more clearly what the baby needs, why look to the baby? And what about the impact on infant development, essential to which are touch, human connection and exposure to nature? And of course, many of these technologies are not cheap. Should any, some or all of these be available on the NHS?
Machines aren’t infallible either. Paediatricians in the US have noted an increase in neonatal admissions following false-positive alarms from smart appliances. Apps can overreact too, they say, setting off true positive alarms for events that whilst being common in healthy infants may, ultimately, not be clinically significant.
Of course, if these technologies were to be widely adopted, overall emergency admissions for newborns might well decline as early detection of warning signals could mean a problem is addressed before it looks life-threatening. Parents, armed with evidence may feel empowered to seek help early on to address developmental problems. It’s too soon to tell.