Digital health and patient centricity: One and the same?
by Julien Rashid, Intern
Digital health – a term that refers to the confluence of electronic health records, cloud computing, artificial intelligence, big data, and other emerging technologies – will define a new era of more patient-centric health care. On Oct. 24, the Milken Institute’s Lynda and Stewart Resnick Center for Public Health hosted the Future of Health Summit with a breakout panel, “Driving the Digital Health Revolution,” that discussed this topic. The panelists, a group of business leaders, policymakers, and philanthropists, conveyed their visions of a digital health future. Their compatible visions had promising implications for patient-centricity – a topic of focus at FasterCures.
From left: Indu Subaiya, Esther Dyson, and Donald Jones
The digital health wave has been pushed by new currents in health information technology (HIT). Panelists tacitly agreed that HIT would inevitably converge health data into centralized hubs. Karen DeSalvo, the former acting assistant secretary for health and national coordinator for HIT at the Department of Health and Human Services, predicted this convergence would lead to a “digital medical home” – a place for patients to access and archive their medical data and receive input on health-care decisions. Ideally, from a FasterCures perspective, this tool would also give individuals greater control over how their data are shared and further transparency about their use.
Donald Jones, the chief digital officer at the Scripps International Science Institute, believes that digital health will not only help patients answer “what’s next?” but also will multiply their options. Digital health will give patients more autonomy and access to knowledge. This will allow more efficient self-guidance through the health-care system. Cindy Elkins, co-founder and chief operating officer of MyWays, noted that utilizing patient capacity will lighten some of the excessive burdens on health-care providers. Further, by giving patients more freedom to move between institutions and greater control over how their data are shared, digital health will facilitate ambulatory care and create a more patient-centric health-care system.
A benefit of patient-centricity, DeSalvo stated, would be the “generation of health without health care” – a coverage of the “middle-ground” between public health and primary care. Throughout the Future of Health Summit, several speakers emphasized the economic burden of chronic diseases, which is projected to soon be $3.4 trillion annually. Unhealthy behavior, a major cause of chronic disease, is one of many health determinants outside of the health-care system. In fact, as DeSalvo noted, most health determinants are independent of the system. Digital health, by creating new platforms for behavioral change interventions, could have a major impact on how chronic diseases are addressed in this “middle-ground.”
As Esther Dyson, executive founder of Wellville, put it, one way digital health may cover this “middle ground” is through behavioral health precision medicine. Paul Chew, the chief medical officer at Omada Health, discussed Omada’s initiatives in the digital health therapy space at the individual level. Omada provides digital health coaching and an online network for people with diabetes. Digital health may also have benefits at the community level. Dyson noted that digital health could improve the effectiveness of local health leaders by delivering tailored community health curriculums. Both Dyson and Chew commented on how organizations will be able to assess and tinker with digital health approaches and tailor them to individuals. Dyson said this is similar to how startups in Silicon Valley approach product development. For payers to buy into this new digital health model, new metrics will be needed, stated Chew, including patient engagement.
At the end of the panel, DeSalvo discussed her experience in New Orleans after Hurricane Katrina. In the wake of the storm, the health-care silos typically buttressed by regulation and payment structures became irrelevant under martial law. What evolved was an organic patient-centric system. Social workers, doctors, and other professionals joined forces to address patient needs holistically. In DeSalvo’s view, in the past, when society invested in health care it erected barriers that isolated the field from public health, business, and humanity. Digital health might be just the treatment needed to restore a patient-centric system with fewer barriers, with an emphasis on prevention, and in which, to paraphrase Dyson, society will begin investing in health instead of renting it.
Digital health will continue to be a defining feature in a new health-care epoch. On Nov. 13-14, FasterCures held its annual Partnering for Cures conference in San Francisco, the second of 2017. Many of the panels at both conferences discussed topics related to patient centricity and digital health, including data science, patient value frameworks, precision medicine, artificial intelligence, and health citizenship. Read summaries of plenary panels and videos of all the sessions at www.partneringforcures.org.
