health technology

Telemedicine and children’s health: what you need to know

Children’s Health defines telemedicine as “the use of technology to exchange medical information among providers.” The innovation allows for doctors to discuss patients and their cases together from any two or more places in the country, using video and other electronic communication. Telemedicine is especially promising given rural access to healthcare in the U.S.—and internationally—is often limited. Where there are healthcare facilities, they may lack specialization in areas like pediatric care or mental health.

Several large hospitals in Dallas, Philadelphia, Boston, and soon northern California have integrated telemedicine into their practices. Early studies show patients consider telehealth visits as equal or better than in-person visits, and there is high potential for improving children’s health in particular. For example, teens who see certain mental health physicians throughout high school can continue receiving care from the same familiar face if they move away for college. Another opportunity for telemedicine involves connecting physicians with school nurses, which can hugely benefit diabetic students.

Of course, with any new health technology, there are challenges. Insurance coverage is an ongoing struggle for health innovations in the U.S. and telemedicine is no different. However, in the past two years, legislatures in Pennsylvania and New Jersey have been working to pass bills requiring insurers to reimburse remote telemedicine care.

Other struggles represent fundamental limitations in telemedicine intervention. Physicians may miss key elements of a patient’s condition when communicating through a screen. For certain diagnoses, patients may have to travel to specialized care centers anyway. Moreover, telemedicine brings up questions of data security and potential privacy breaches with medical data. Finally, telemedicine may bring an incomprehensive quick-fix and/or false sense of resolution to the broader issue of poor rural healthcare access.

For now, telemedicine is offering innovative options for children and teens who need to see their doctors remotely. As more and more hospitals adapt to this new technology, CHIL encourages patients take advantage telemedicine, while continuing to be mindful of its limitations.



Continued discussion: intersection of kids, tech, and well-being

About three months ago, Facebook rolled out a controversial mobile messenger app for kids. The app, which targets children aged 6-13 years, allows users to send texts online after connecting with a parent’s Facebook account. Its key features include sending pictures, edited pictures (think colorful drawings transposed over selfies, etcetera), videos, and emojis, all without the usual clutter of advertisements.

While Facebook argues their new novelty encourages kids to connect rather than spend time on passive mobile applications like games, health experts say the young children Messenger Kids targets are just beginning to grasp written communication and are developmentally unprepared for the app’s interactions. Facebook further claims kids increased involvement with technology in this modern age is inevitable, so parents might as well embrace platforms like Messenger Kids, which requires their consent and doesn’t subject young users to harmful advertisements. On the other hand, health experts ask if Facebook is truly acting in the best interest of children, or just trying to exploit parents’ loyalty to their platform while hooking kids early on.

At the core of this debate is the question of how young is too young for kids to begin using and relying on digital communication. It is reminiscent of the Fitbit for kids case covered in February: are children too young to be wearing health-tracking devices? As new technology like these challenge traditional notions of childhood, it’s no wonder parents and pediatric specialists alike are divided.

Reflecting on our article from two weeks ago, too, regarding the adverse happiness effects of increased screen time on teens, Messenger Kids critics’ can add another layer to their argument. In light of Twenge et. al.’s research, it’s hard to see how Facebook’s new app could improve health.  The app gives young children yet another reason to use a screened device, setting them up for more phone dependency as they enter adolescence. Even if we say that increased social media time reduces  happiness, and not messaging apps or screens themselves, this point only goes so far when considering Messenger Kids as a gateway for younger users until they reach Facebook’s minimum required age for an account. Facebook guidelines state users should be 13, conveniently right at the recommended age cap for Messenger Kids users. If Messenger Kids preps users to join the Facebook community as soon as they are 13, then the introduction of the app would in fact increase social media time (thus reducing happiness, according to Twenge et. al.). As early as age 6, Messenger Kids ropes children into social media.

Another argument could be made for the better health outcomes associated with kids being more communicative with their parents and friends. Yet digital communication can only go so far. This point has no more validity than one that notes greater ease of texting could lead to fewer genuine interactions. More research on the topic is necessary to stake such claims.

Finally, Facebook’s defense that they are offering a connective, active app in contrast to other “passive” options does nothing to actually reduce time spent in front of the screen. Perhaps the answer to passive mobile applications is not an “active” app like Messenger Kids, but rather encouraging non-screen activities. Viewing all technology adoption as “inevitable” is a rather unproductive stance. If a new app for children could lead to decreased happiness down the line, potentially compromising mental health, it is insufficient to stand by idly, saying it’s the lesser of two evils. We encourage parents who do use this app for their kids to explore other options out there, encouraging positive, non-digital interaction. After all, with regard to the collective behavior we noted two weeks ago, the app is only as good as its popularity.

On Screen Time, Health, and Collective Behavior

Continuing in the spirit of exploring the heath-technology intersection we wrote about two weeks ago, researchers at San Diego State University recently found that teenagers who spend more time on screen devices are less happy than their less-screen-time counterparts. Specifically, non-screen activities like sports, reading, and face-to-face interaction were more common among those who spent little time on their phones and TVs. Psychologist Jean M. Twenge and her colleagues further remarked their confidence that screens were causing unhappiness, not the other way around, evidenced by a growing body of literature on the topic.

The next logical question for Twenge et. al.’s “Monitoring the Future” longitudinal study would  look into possible explanations for the screen-time and unhappiness correlation. Perhaps it could be a lack of satisfaction with digital interaction, or the even negative impacts of social media—it doesn’t take a scientist to know the dangers of constant self-comparison to peers’ Instagram images. Maybe it’s something simpler: for example, the more time spent in front of the TV —even if it’s not a happiness-drain—the less time to spend on other activities that are more positively correlated with happiness. Either way, the findings certainly have implications for the mental well-being of teens. Adolescence is already a time of inner turmoil as the body goes through puberty and fluctuating hormones. This new research suggests screens could inflate these effects.

But what’s the deal with differential screen usage? Why do some teens use screens more than others?

A theory arising from observing many platforms is that networks behind screens thrive when more people are using them. For example, having a cell phone with a messenger app is useless unless other people also have a cell phone with the same app. The same goes for nearly all social media and remote gaming platforms. To some degree, the same logic also follows with TV shows or YouTube videos. If other people have watched the newest episode of, say, The Bachelor on a Monday night, it adds to an individual’s value of watching the show; they can now participate in Tuesday-morning conversation.

In other words, an increase in people using screens encourages even more people to join them as the value of doing so increases. Likewise, if fewer people use it, the value of screens decreases. A teenager may be swayed to spend as much time in front screen as her friends, and different friend groups could have different norms of screen time.

Twenge et. al.’s study found that the happiness-optimal level was an hour or less in front of screens. Their work begs the question: how can other teens have incentives to reduce TV time to this peak-happiness amount?

Maybe a change in group mentality can help reach a healthier equilibrium. Teens could find value in non-screen activities and collectively, perhaps without much thought at all, hold themselves accountable to limited digital interaction so as to maximize happiness. These are speculations, but nonetheless, asking what drives teens to use screens is imperative following studies like “Monitoring the Future.”

Fitbit for kids? Reservations amidst potential new health motivations

Health technology is an advancing market as the trend of tracking daily eating and exercise flourishes. Countless mobile apps exist to monitor running mileage, steps, heart rate, calories, and sleep cycle—a list which is by no means exhaustive. Moreover, wearable devices like those created by Fitbit aim to give consumers the health data they want without the inconvenience of carrying a phone everywhere. After seeing success among young adults, Bloomberg reported just last month that the fitness tracking company is looking to develop a wristband for kids. Fitbit guidelines currently suggest users be 13 years or older, so the market for this new device would likely be those 12 and under.

The idea is indeed an exciting prospect for children’s health. Just as the product has incentivized thousands of its young adult consumers to live more active lifestyles, it could do the same for kids. After all, younger generations love tech, but unfortunately most electronics—television, video games, computer time— encourage us to be sedentary. A smartwatch like the Fitbit could change that. For example, since getting Fitbits, my mom and sister have friendly competitions over who can get the most steps in a given day or week. They’re not alone in their game—Fitbit has a built in “challenge” function just for this purpose. Maybe challenges can start at a younger age, getting kids eager for active games rather than competing on couches with headsets via Xbox live. This new tech could potentially appeal to a wider range of children, including those who may not be into traditional sports.

While all of that sounds promising, it’s also important to consider the slippery slope health monitoring can follow. Data can be helpful, but it should not hijack our motivations.. In a society that continues to value health numbers, we’ve seen it get to a point of overvalue, where we face problems like excess stress and even eating disorders. If kids are exercising only for a number, not for fun, the Fitbit could take all the enjoyment out of recess and free time - a counterproductive consequence. Devices like Fitbits might also unintentionally act as indicators for  whose family can or cannot afford such devices, which raises questions of what health means in this era.  Health should not depend on someone’s ability to buy a wearable tracking device.

A Fitbit designed for kids could have the power to keep young people educated about health from an early age. This is a goal everyone can get behind. However, it also demands that we consider our reliance on health data. These points should be kept in mind and kept in check as health technology further modernizes.