image courtesy of histalktv.com

Are apps the solution to everything? perhaps not… given my new role, directing a programme of work developing the use of digital tools such as apps in clinical services, you might guess my response would be a big definite resounding yes.

However, a number of conversations I’ve had, and articles I’ve read this week, have caused me to wonder if we are in danger of naivety in we succumb to an uncritical delight in the role apps might play in relation to our health, and indeed many other aspects of our lives.

The first thing which has surprised me when talking to clinical services, is that so many have an idea for an app they’d like to develop. Apps are popular – people like them,  people think they can improve clinical care, and people think they can help save money in an increasingly cash strapped NHS. All of these things are likely to be correct to varying degrees, but I’m also struck by a sense that we must think critically about how much they can solve.

In his recent talk to the Digital Life Design (DLD) conference, Evgeny Morozov questions what he sees as our desire to expect too much from technology at the expense of collective solutions to social problems. In the NHS we talk about empowering people to take control of their health, whereas he talks about the state delegating responsibility to the citizen and blaming them when they fail to do the ‘right thing’. To illuminate this point with a simple example – an app that supports healthy eating may be one part of the solution but lack of money to buy fresh food may be a more substantial structural barrier to good health  . By focusing our time and energy on the app we might be failing to focus on more fundamental barriers to health and wellbeing – individualising the problem rather than taking a collective view.

I recommend his talk which you can see here:

I also came across a New Scientist article critiquing the role of apps, which increasingly enable us to track every aspect of our existence – from the quality of our sleep to the calories we ingest and the amount of steps we take each day.  Whilst acknowledging the positive potential of ‘lifelogging’ as they describe it, the article quotes Evan Selinger, a philosopher at the Rochester Institute of Technology in New York, who says:

When markets form around logging activities, the question that consumers should always ask is: Is the value of what I’m revealing worth the services I’m receiving in return?

The article argues that when this trade in data is unequal, corporations can end up with undue levels of control over people’s personal decisions. In his DLD talk Morozov goes further to argue that our privacy, which was once free, is being increasingly commodified. He encourages us to question this fact.

I’m a big fan of digital, and I think there are amazing things we can do in the NHS (and beyond) which will enable us to better manage our health and wellbeing. At the same time I’m reflecting on the importance of thinking critically about technological solutions and recognising that there are both tensions and pay-offs that we need to evaluate when thinking an app might be the answer. And whilst apps might be new currency, the issue of technology in heathdefinitely isn’t – any one remember that Monty Python Sketch – the machine that goes PING! ?