In Denmark, telemedicine, predictive diagnostics, wearable sensors and a host of new apps are transforming healthcare and moving the point of care into the home.
But even for the tech-savvy Danes, world leaders in digital care, this wave of innovation is causing some anxiety.
US tech giants including Google, Apple and Amazon are coming up with countless new fitness tools and devices, some of which are said to be able to diagnose, treat or prevent a medical condition.
Their growing clout in the healthcare sector does not sit well with everyone. “There are these new apps and devices popping up by the minute, but they remain the wild west,” said Thomas Senderovitz, director general of the Danish Medicines Agency, speaking at a digital health event in Brussels last week.
Senderovitz sounded the alarm on the proliferation of untested tools, saying that applications and devices claiming to diagnose or treat medical conditions may not work and in some cases could even endanger people. “They have no requirements to demonstrate efficacy and safety, but we are being forced into the direction of taking them seriously,” he said.
It is not that health experts cannot see the potential benefits of new tools for patients. An app or a wearable device, such as a Fitbit, that persuades people to walk a certain distance every day could contribute more to health – and cost less - than years of prescription drugs and visits to the doctor.
The new forms of patient data created by these tools could also help improve diagnoses and provide better insight into which treatments work.
“From a completeness point of view, we need to be able to get and analyse these new data points,” said Alison Cave, principal scientific administrator at the European Medicines Agency in London. “But we’re a long way off that point – it is the noisiest, most unstructured and challenging data out there.”
It also remains under the guard of companies that are not best known for open data access. Patients signing up to an Apple or Google health service may be giving more than they are getting, cautioned Lars Frelle-Petersen, director of the agency for digitisation at the Danish Ministry of Finance.
“We need to make our citizens aware that there is no free lunch with these big companies. [People] should make some more demands when they give their data away,” he said. “These companies want to know what you want before you know it yourselves.”
In Denmark, people are able to access their health records online through a national website. Any time a doctor, pharmacist or nurse views this information, the patient is alerted by email.
“We have a very sustainable health model, mandated by law and with a lot of public money behind it,” said Lisbeth Nielsen, director general of the Danish Health Data Authority.
Denmark has built an efficient computerised system in which patient data can be transferred from hospital to hospital across different databases. By contrast, if a patient uses the services of the big tech companies they are forced to remain in those systems or face losing their data.
If a patient’s health records are on an Apple system it is difficult to swap to a smartphone running Google’s Android and its health-tracking software Google Fit.
The fine print does little to dissuade consumers. “We all gloss over the 35-page agreements on data rights,” said Andrzej Rys, director of health systems, medical products and innovation in the European Commission’s health directorate, DG SANTE.
With the interest of patients in mind, scrutiny of the health tech insurgents is building in Denmark, as it is in other countries in Europe. Rights to data is one of the many issues putting US technology companies in the cross hairs of European officials.
Lawmakers need more details on the data being collected on patients by these giants, and how it might be used in the future, said Frelle-Petersen. “We need to look into regulation. These private companies will have this patient data for eternity. Can we be sure they’ll always do good things with it?” he said.