Advances in the accessibility of online-based healthcare services has the potential to change how we use and access medical help.

A Service called ‘Thriva’ offers online and postal health monitoring services. Pay somewhere between £24 and £69 per package and you can have your blood tested for cholesterol, liver function, vitamin D and more.

The idea is that individuals can monitor their own health, but is this actually anything new?

A qualified GP still has to interpret the results; the only difference is they don’t know anything about you and the test has usually been requested because of anxiety or curiosity, and not for a medical reason.

Samples are collected by fingerpick blood collection which Thriva states is accurate and supported by research, but when contacted they declined to give further details. A literature search of Medline was unable to yield any papers on the sensitivity and specificity of this method of testing.

Thriva is not alone, but part of a wider network of tech companies trying to get in on the medical business. Last year the Apple Watch Series 4 came with a single lead ECG function. This is more than the usual heart rate function on a fitbit, and it claimed to be able to detect atrial fibrillation (AF) and provide data to take to your GP for diagnosis.

Apple did provide very impressive data on sensitivity (98.3 percent) and specificity (99.6 percent), however their unpublished study only included 600 patients, a very small sample when dealing with AF which has an estimate population prevalence of 2.5 percent.

23andMe has also jumped on the e-health bandwagon. For £149 it claims to be able to provide genetic risk analysis using a spit sample. It claims it can then use your genome to predict your risk of developing certain diseases, despite no evidence that genetic risk calculators are ready for use in the general public.

In conclusion, this kind of testing has the potential to see healthy patients presenting to their GP with ‘abnormal results’ or ‘genetic illnesses’, despite the tests they have taken being backed up with limited scientific evidence. What are GPs meant to do with this information? There is no precedent set.

It’s likely to cause anxiety for patients, overtreatment from doctors and a whole new level of legal backlash. As a wise doctor once said ‘all patients are people but not all people are patients.’


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