Digital Health Is Always More Important Than Ever

We will be discussing why digital health is now more important than ever, and how it is poised to accelerate in response to the coronavirus global pandemic. My name is Tim Mackey and I’m the Director of Healthcare Research and Policy at UCSD Extension. I’m also an associate professor at the UC San Diego School of Medicine. My background is primarily in global public health and technology, and I will be giving a brief overview of digital health, how it is being leveraged against the coronavirus outbreak, and I’ll also be discussing some of our own research using big data and machine learning to address specific challenges associated with this pandemic.

Business Environment:

Joining me on this webinar Dr. Daniel Haders, Managing Director of HealthcareTechnology at Nex Cubed. Dr. Haders is a successful entrepreneur, advisor, and investor, and oversees a portfolio of digital health companies. And he will be discussing the overall impact of COVID-19 on the business environment for digital health, and also provide a few use cases from startup companies working on specificCOVID-19-related solutions. I also note that this webinar was supported by the UC San Diego Extension Digital Health certificate, which both myself and Dr.Haders are instructors. So first, what is digital health? Importantly, the wide scope and scale of digital health modalities and technology types actually make it really difficult to define. But one definition comes from an organization called HIMSS, which is a large data and healthcare informatics association that recently stated that the healthcare industry is on the verge of a new age of what we call digital health.

World Health Organization:

Another definition comes from the World Health Organization, which states that digital health is the use and scale of digital health solutions that can revolutionize how people worldwide achieve higher standards of health, access services to promote and protect their health and well being. Most importantly, theWHO ties digital health into broader social goals, some of those outlined in the UN Sustainable Development Goals, which focus on improving the health of all people and also improving equity, including universal health coverage. So importantly, in digital health, there are many modalities, and some of these may be more familiar to people because you’re using them every day.

But some of the main forms of digital health come in the form of m-health, which is the use of mobile phones for delivering health services and information. Digital medicine, which is the intersection between mobile, computational, and connectivity, including genomics. Precision medicine, the process of tailoring the medical experience to an individual patient. The quantified self, which are people who always track data about themselves, their healthcare, their health behavior, and wanna understand better how their health is impacted by their own individual actions. And telemedicine, which we’ll be talking about later on in this webinar, is really the delivery of healthcare remotely, using technology.

Different Technology Typologies:

In order to better understand digital health, it’s also good to look at the different technology typologies that are used. So we talked about mobile, there’s a lot of gamification, so the use of games and things that encourage people’s behavior in different ways. A lot of discussion about communication, sensors, 5G, a lot of internet of things, devices that connect and impact healthcare. Robotics is another space within digital health. A lot of the work that I do is in social media so the impact of social media on health behavior and how we can communicate to people, lots of data visualizations that are really exciting that we’ll talk about in the context of the coronavirus outbreak. Some frontier technologies, so 3-D printing and blockchain that are kind of new technologies that we really haven’t proven yet but are on the horizon.

Virtual reality augmented reality and AI and big data are another big area in all types of data fields but are specifically emerging in healthcare. But the difference between these technology types used in other industries is the health core goals we have of utilizing these technologies for good health outcomes. And so some of the main ones are improving disease diagnosis, improving prevention and management of healthcare issues, and also enhancing patient safety. Another big issue is making medicine more participatory, and having a shared decision process where patients get more access to data and that informs their healthcare and they can make shared decisions with clinicians. And increasing health equity and access.

However there are some challenges in this gray box here which talks about the cost considerations, of data privacy and ethics, a big space within digital health that is slowly emerging, and where there’s a lot of scholarship, but there’s still no framework of how we deal with ethics when it comes to digital health innovation. The evidence base, so we have to show that, these digital health solutions actually work, and sometimes that’s very difficult because we don’t have robust studies to test if the technology is good for your health or potentially not good for your health. Reimbursement and financing, getting these technologies actually paid for, which is a big challenge fora lot of startup companies and other companies getting in the space. Like some of the biggest areas, we can improve healthcare are things like home care, improving population health, not just individual health.

Again really making medicine more precise for the individual. So a lot of people understand digital health within the context of technology that has been mainstreamed. So things like an Apple Watch, which I’m wearing right now. FitBits, a lot of different apps that people can buy and use which are many. And that’s how people interface with digital health on a daily basis. Also interesting is that so many companies are now in the digital health space, and calling themselves digital health companies. A local company here inSan Diego called ResMed is a medical device company but now calls itself a digital health company. 23andMe, a genomics company, also a digital health company that talks about how you can identify things that may be related to your health risks. Examples of big companies like Microsoft and HealthVault who weren’t successful.

Who tried to get into digital health and electronic health records but weren’t able to. And then big companies like Amazon that are now pivoting into the healthcare space, particularly in pharmacy. There’s also a lot more scholarship, which is very interesting from an academic perspective. So before 10 years ago, it was hard to place digital health content in a journal because a lot of journals didn’t really care about it too much. Now we have major journals like the JMIR series, “Digital Health”, the lancet “Digital Health”, that are launching this digital medicine and digital health journals, recognizing the fact that this is an emerging area of scholarship. And of course one of the biggest developments from a policy perspective has been the World HealthOrganization issuing a WHA, which is the World Health Assembly, where they make decisions, a resolution saying that digital health is now super important to global health.

The working previously at the WHO, I can tell you getting a resolution passed by all its member states is a very difficult and long process. So this is recognition by the UN specialized agency in charge of all public health, saying that digital health is now a core area that they have to look at. And they’re concerned about things like making sure people are trained on digital health applications, having the infrastructure to run them, and also making sure that they improve equity and are deployed across all countries, not just the US.