Kenya’s healthcare landscape, and the East African region by extension, faces a critical shortage, with only 2.26 doctors per 10,000 people. (WHO, 2021). However, the issue isn’t just in the numbers, there exists a systemic challenge caused by this, where quick treatments are often prioritized over comprehensive care.
What does this look like on the ground?
- Patients are rushed through consultations, to get through as many as possible in a day.
- Symptoms are treated, but the root causes remain unexplored.
- Personal health concerns are frequently overlooked and even dismissed. (Ladies especially, can relate to this).
- Ultimately, the most vulnerable populations, in the most under-resourced populations, remain underserved due to this system.
This is where precision medicine comes in.
As opposed to the one-treatment-fits-all model, precision medicine aims to tailor treatment to the unique needs of each patient. Individual symptoms, experiences and genetic make-up are taken into consideration, root causes explored, and a comprehensive treatment plan developed.
This can be seen in the oncology (cancer) space, where each tumor is investigated for its vulnerabilities, and targeted therapy done. This avoids generalized treatments that may further weaken the body and remain ineffective on the cancer itself.
How do we do this if there’s already a workforce shortage?
This is where continuous monitoring comes in! Leveraging relatively-affordable, high-precision devices, continuous monitoring allows for collection of patient history, over a long period of time, giving the relevant data needed for healthcare personnel to make informed decisions.
It’s less guesswork for the patient – as they have a decent record of their health – and a more comprehensive picture for the hospitals/clinics, allowing them to take all factors into consideration, and hopefully, take your concerns a bit more seriously. Good data doesn’t lie.
But what exactly is Continuous Monitoring?
Previously the traditional routine check-ups and static medical records sitting on your family doctor’s shelf, recent continuous monitoring efforts take a real time approach to tracking essential health parameters using wearables, stick-ables and all kinds of other-ables. It provides reliable data on your well-being over time and proves more reliable than your mother or spouses’ memory of your medical history, as it can track abnormalities that may go unnoticed, or ignored.
It goes further to detect early warning signs of potential health issues, like that persistent ache you’d keep taking painkillers for, that came with a bit of a racing heart and fatigue which was assumed to be work-related stress. Devices, and their in-built algorithms can detect these early signs, and alert potential risks – such as heart failure in this case. This has been seen to be successful with the Apple smart watches, which have been able to detect abnormal heart rhythms with nearly the same accuracy as medical grade tests.
Additionally, with this data, continuous monitoring can then provide personalized insights into your health trajectory. This allows for adjustments in personal practices for better health, as well as enabling preventive healthcare interventions, greatly reducing the burden on the healthcare system.
Finally, continuous monitoring can also track the efficacy of on-going treatments. This allows real-time adjustments based on how well, or how poorly, treatment plans go, allowing for faster, and better decision-making.
So where does this tie into precision medicine?
With enough of a patient’s history, treatment can then be customized to meet their very specific needs. Further, treatment efficacy can then be monitored, and adjusted real-time.
In some parts of the world, the treatment and monitoring can both be done remotely. For example, continuous glucose monitoring devices regularly measure blood glucose levels, allowing individuals to take preventive action: Reduce carbohydrate intake, or immediate reactive action – inject insulin, when at critical levels.
With other diseases, a more targeted approach can be taken using the data collected, where specific symptoms are targeted, avoiding over-medication, adverse drug reactions are detected early enough, allowing for quick intervention, while also ensuring that the root cause is uncovered over time as patterns emerge, improving outcomes in the long term.
The TECH behind it.
As earlier mentioned, traditional monitoring methods rely on handwritten notes, self-reporting and memory, all of which have significant flaws.
Today, continuous monitoring is tech-enabled, allowing for accurate data collection and automated data analysis pattern recognition all from the comfort of one’s home.
Wearable Devices and Sensors are one of the most recognizable forms of continuous monitoring, with a wide range of consumer products in the market for this (smart watches, rings etc.), and a few medical grade options. The difference comes in their regulation. Medical grade devices are well regulated, and data collected can be used for clinical action/medical diagnosis while consumer products are not intended for medical diagnosis, and are considered health/wellness information, and sold over the counter.
Common parameters for medical devices to monitor are heart rate variability, such as the Apple watches’ Heart App, that acts as an ECG monitor, as well as oxygen saturation devices, which also fit into watches and are more commonly seen here in the pulse oximeters that were all the rage during COVID-19.
While the African market may be priced out of the more advanced wearables, such as the insulin pump with integrated continuous glucose monitor, there are options that are more accessible, such as some reliable smartwatches. These, however, need to be used with care as they may lack the necessary context for the African market as seen with the poor performance of pulse oximeters, and contactless thermometers during COVID, as they did not work as well on dark skin and thus provided in-accurate results.
AI and Machine learning are an excellent add-on to wearables as they improve precision, identify subtle patterns, and allow for more accurate predictive analysis with personalized intervention recommendations. However, most Machine Learning algorithms have been trained on Western datasets and may not be well suited for the African populace.
A well-designed device, well-tested on diverse populations, with strong algorithms, can be a powerful tool for personal health management.
Data Privacy and Safety continues to be a huge concern for both users and device manufacturers and should be taken into consideration both when manufacturing for sale, and using these devices, especially as cyber security threats continually emerge. Personal health information needs to be handled ethically, and in-line with existing data protection regulations.
A New Era of Personal Health
Continuous monitoring in precision medicine is not just a technological advancement—it’s a philosophical shift in how we understand and manage health. By enabling personalized, predictive, and proactive healthcare, it empowers patients to take control of their health.
As technology advances and awareness grows, continuous monitoring will play a pivotal role in transforming how we prevent, detect, and treat diseases. It’s a future where healthcare becomes truly personalized and centered on the unique needs of every patient, and its benefits can be well harnessed for the African population, without further stretching the thinly spread healthcare workforce.
What do you think? How do you see continuous monitoring impacting healthcare in Africa? Let us know!
