Often when you go to your doctor you have your blood pressure taken. Your blood pressure is one of those vague things where your doctor gives you a series of numbers and is either happy or concerned. Sometimes your doctor is so concerned he will give you medication for it. I commonly ask patients if they understand blood pressure and why they are on medication for it, however many people do not really understand the concept. So allow me to give you an explanation. Imagine you have a series of pipes in the body along which blood is pumped by the heart. When the heart squeezes the pressure reaches a maximum number (the top number on your blood pressure reading) and when the heart relaxes the pressure drops to a minimum number (the bottom number on your blood pressure reading). This maximum and minimum number change with time and activity, so things like exercise and stress can increase your blood pressure (both maximum and minimum numbers).
The key point is if the pressure is too high for too long, the pipes burst. If this happens in the brain, you have a stroke, if in the kidneys, you can have kidney damage or if in the eyes can it lead to eye problems. By monitoring your blood pressure we can prevent a problem from happening by reducing your blood pressure before it gets into the danger zone. The problem for us as doctors is that it is stressful when you as a patient come to see us and so your blood pressure is artificially high. As a result we do not make any decisions on blood pressure unless it is taken on 3 separate occasions and abnormal. From the patients point of view you have to keep on coming back to see us time and again. I often tell my patients to purchase a blood pressure machine - this is not new technology but is certainly useful. Measure your blood pressure when you are at home and relaxed over a period of time and bring those readings in to show me. This is often a truer reflection of your current blood pressure and makes an efficient assessment possible by your doctor. Current products on the market offer a sleek appearance, portability and connection to your phone. As long as it is clinical grade and calibrated, it is good enough for me, (decisions on design etc, I will leave to you!) These products if used on a regular basis can identify issues before they become a problem. The real game changer however will be the device that is small, wearable, accurate and most importantly continuous. If we can track you blood pressure on a continuous basis then we will truly have an accurate insight into your health. We are not there yet but when this happens, I do believe those who embrace this type of monitoring will be able to offset a really common cause of ill health. Blog post written by Dr Khurram Akhter. Khurram is an experienced primary care physician and a thought leader in the field of digital health. Disclaimer: This text does not serve as medical advice and if you have any questions, seek advice from your doctor.
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A few years ago, I worked as a family physician in the UK. We had a system where due to there being no appointments available we would ring a patient on the phone to determine how unwell they were and prioritise an appointment accordingly. It was an awful system but the NHS did not have the capacity to meet the needs of the community. People would ring and say they had a cough for a few days, a fever, and they were coughing up mucus that was yellow in colour. They also felt a bit short of breath. So, I ask you budding doctors, is this patient sick? The answer is I don’t know. In this situation you would use all of your skill to work out how unwell they are. Did they sound wheezy? Could they complete a full sentence on the phone? With as much information you would try and make a safe decision as to when you should see this patient. What we really needed however was some objective information. With the right tools available to the patient, it would enable a much safer consultation. If the patient said he had a temperature of 38.9 degrees Celsius that he measured on his thermometer, oxygen levels of 93% on room air and a pulse rate of 120 measured on his pulse oximeter, I would be seriously worried. If his blood pressure was 90/60 and if I could listen to his chest with his digital stethoscope and hear that he had noises indicative of a pneumonia, then I would be sending this man to hospital. All this equipment is freely available and relatively cheap to purchase. But I hear you say, I don’t live in the UK so I don’t need this equipment! The point is with the right tools, healthcare can become safe and accessible. You can access a doctor where and when you want to online (Telehealth) and they can do a safe and thorough assessment of your health remotely. The doctor needs certain information and if you can give it to them, they can make a safe decision. Don’t get me wrong, Telehealth will never replace seeing a doctor but I strongly believe it will become part of the journey when you are feeling unwell. So when you have that cough and are worried about it being something serious, you get online and obtain an opinion from a doctor who then has the information to reassure you or investigate things further. So looking at your current first aid kit, it would probably contain some plasters, antiseptics and pain relief. Now it should contain:
Having tools like the above can be vital in determining how unwell you are. I would argue these 6 things would be your basic first aid kit but I also have a colleague who is in his late 60’s and has a defibrillator at home. This is a machine that can shock your heart if your heart stops working. (They are found in most public spaces such as shops or airports and are very easy to use but are rarely found at home). He doesn’t have a heart problem but has it at home just in case. It is expensive but it could save his life. I am not suggesting we all do this but we should now be thinking outside the box about how to look after our health with the technology that is now available to us. Blog post written by Dr Khurram Akhter. Khurram is an experienced primary care physician and a thought leader in the field of digital health. Disclaimer: This text does not serve as medical advice and if you have any questions, seek advice from your doctor. Today we have so many products available to use that can track our health: the Apple watch, Fit Bits etc, but are they of any use? 30 years ago, as a young child, I remember my parents returning from the local hospital having just visited one of my father’s close friends who had just had a heart attack. When I asked how old he was, the response was 36 years old. At the time, I felt that he was really old, but now I now realise that that is very young to have a heart attack. However in the 1980’s this was quite common. In 2018, how many 30 year olds are having a heart attack? Evidence shows not as many as the 1980’s. So what has changed? People have become more health conscious following better quality lifestyles: smoking less, doing more exercise. In addition to this doctors have been more proactive in monitoring certain parameters in your blood, such as cholesterol levels. If problems have been identified, lifestyle changes have been reinforced and treatment has been started to prevent heart attacks. The effect of this has been to reduce the number of individuals suffering from heart problems. Now you are more likely to hear about the 70 year old with a heart problem rather than a 30 year old. The point of me talking about this is that if you track your health you can identify a problem before it becomes a problem. Up until now your doctor may track your health on a 6-12 monthly basis. Now developments in technology mean we can track health parameters on a second by second basis. This now provides us with vast quantities of data which can be analysed and used to identify problems that may develop well into the future. As a result, changes can be made to your lifestyle to prevent or delay those problems from happening. So which parameters should we be tracking? As doctors we can make decisions on your health with information on your blood pressure, pulse rate, blood sugar levels, temperature and blood parameters such as how your kidneys are functioning or your cholesterol levels. The list is endless as to what we can monitor. The key question is what can you, as the health focussed individual or patient, monitor accurately to assist your health professional make decisions on your health. The answer depends on what your health needs are and what your health professional can suggest that is available in the market to meet your needs. This knowledge of the market is not widespread at the moment. Digital health is a disorganised mess of AI driven products, wearable devices and accessible services. What we hope to do at HealthAide.co is to bring some structure to the chaos of digital health so you and your health professional can identify which product is clinical grade (ie accurate) and most suitable for your health needs, based on scientific research and opinions that really matter. Blog post written by Dr Khurram Akhter. Khurram is an experienced primary care physician and a thought leader in the field of digital health. Disclaimer: This text does not serve as medical advice and if you have any questions, seek advice from your doctor. How we access healthcare varies from country to country but rarely do you find patients content with the service they receive. In the UK the service is free yet you may have to wait 2-4 weeks to see your primary care physician for a non urgent consultation. In the USA, costs are excessive. These issues lead to poor standards of health within the population. Advances in technology (digital health), however mean that this no longer needs to be the case. But how can we use digital health to our advantage? In an age where we like to be in control of most things in our lives, we need to start taking control of our health. Doctors are given ownership of our health but rarely have the time to focus on in depth holistic care. In an age where information is everywhere, we can educate ourselves on healthier living but care must be taken in choosing where that information comes from. We can track many health parameters using our watches etc but which parameters are really of use: the number of steps you have walked or your heart rate? Also is this information accurate? Having learnt about your health and recorded relevant information, it is important to have a professional interpret it, but how can you obtain an appointment quickly and cost effectively? Now that you have found a professional to talk to, do they have the expertise and understanding of the developments in medicine, to analyse your data and then tailor your care to your own personal biology? The benefits of digital health are reliant on 4 pillars:
We at HealthAide.co are creating an environment where motivated individuals can improve their health using the 4 pillars of digital health.
Healthcare is a heavily regulated industry that is not meeting the needs of the population irrespective of whether the patient is paying for their care or not. We need to alter our mindset as doctors and patients and only then will standards improve. We both need to embrace the pillars of digital health and in time this will ultimately improve standards of our health wherever we are. Blog post written by Dr Khurram Akhter. Khurram is an experienced primary care physician and a thought leader in the field of digital health. |
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