The DCRI brought together national leaders to address the promise and challenges facing digital health technologies in the transformation of health care.
A paper published today in the Journal of the American College of Cardiology summarized the proceedings of a multi-faceted think tank meeting organized by the DCRI in December 2016 in Washington DC. A cross-section of stakeholders including academics, industry and regulatory representatives convened at the meeting to address both the potential of and challenges facing digital health technologies in the transformation of health care in the United States.
“The primary aims of this meeting were to really understand the landscape of digital technology and how it’s currently being used in health care,” said former DCRI Fellow Abhinav Sharma, MD, first author of the study. “We wanted to dive in deep to identify issues and barriers with regards to the development of these technologies and their adoption, and to identify solutions using perspectives from providers, industry, regulatory agencies, payers and professional societies, to use this innovation to drive better delivery of health care.”
According to Sharma, modern health care is literally shifting from clinics and hospitals to the palm of a patient’s hand. There are many examples of how a patient can now enter information on their cellphone and through a dynamic decision algorithm, find out exactly how they should be treated and medicated from the comfort of a familiar home setting. Digital technology is being used not only as a diagnostic tool, but also as a decision support tool, to recruit patients for clinical trials and for informed consent.
“Digital technology is completely revolutionizing the way that we think about health care,” said Sharma, “and it is becoming so much more necessary as our health care costs explode on an unprecedented scale, increasingly lessening our ability to take in, treat and manage complicated diseases in a traditional brick and mortar hospital setting.”
But with all these potential upsides, there are also countless challenges that need to be addressed. According to Sharma, one of the biggest concerns is health data privacy. With a lot of money being pushed into cellphone apps and other digital platforms, it becomes even more critical to ensure there is some degree of regulation on how health data is utilized and the way it is stored and the privacy that comes along with it, so issues like the ones that have happened with popular social media platforms recently can be avoided.
“Interoperability of data is another major challenge, where health record platforms in multiple institutions have no way of connecting with one another,” said Sharma. “There is also an inherent ‘productivity paradox’, where there is a visible decrease in productivity because people don’t really know how to use all this new technology such as gadgets and devices, and the data generated from them to improve the delivery of health care without losing valuable time, energy and resources,” he said.
“Ultimately, we need to make sure our enthusiasm for technology doesn’t outpace our need to validate them,” said Sharma. “Both users and developers need to weigh all new inventions and devices against their preexisting counterparts and see whether or not they improve upon or increase the quality, cost and use of care in comparison.”
The paper strongly advocates the rapid development and implementation of innovation networks on a local, regional and national scale, combining brainpower from academics, entrepreneurs, agencies, associations/societies and regulatory bodies such as the Food and Drug Administration, to review novel technology as soon as it hits the market.
“Digital technology like cellphones have completely revolutionized and changed the way we think about health care,” said Sharma. “When you think of the computational power just in the phone alone, it completely outsmarts most of the computers that we have had in the past.”
According to Sharma, leveraging this phone-based and app-based technology is where a lot of the future is going to be headed. But as digital innovations become more readily available, establishing a proper framework for their appropriate use and rigorous standards of regulation become even more essential.
In addition to Sharma, other authors included Robert A. Harrington, Mark B. McClellan, Mintu P. Turakhia, Zubin J. Eapen, Steven Steinhubl, James R. Mault, Maulik D. Majmudar, Lothar Roessig, Karen J. Chandross, Cheryl A. Boyce, Eric M. Green, Bakul Patel, Andrew Hamer, Jeffrey Olgin, John S. Rumsfeld, Matthew T. Roe and Eric D. Peterson.