A Primer for Digital Healthcare
Posted on: April 23, 2024
This opinion piece was contributed by the author of the book "Digital Health", Nilmini Wickramasinghe, professor and Optus Chair of Digital Health at La Trobe University.
What inspired you to write "Digital Health: A Primer," and what key insights do you hope readers will gain from your book?
Today, and especially in a post COVID-19 world, digital health has become critical to address and ameliorate many of the challenges facing healthcare delivery. These challenges include; escalating costs, rapid rise in chronic conditions, an aging population and longer life expectancy, workforce shortages and the need to provide equitable high quality care to all irrespective of location. Further, volumes of data are being generated in healthcare and it is simply not possible for any one person to process all these data correctly, accurately and in a timely fashion; and so are witnessing a rise in the adoption and diffusion of technology to assist us in the form of digital health solutions.
Thus, the adoption and diffusion of these digital health solutions leads to the need to understand the digital transformation this enables. Since, it is by having a thorough understanding of the digital transformation for healthcare delivery that we can then try to leverage the opportunities to provide superior, high quality, high value care to all and thereby realise the healthcare value proposition of better quality, better access and high value for everyone, every time, everywhere.
Taking all this into consideration and recognizing the opportunities for digital health as well as the challenges to ensure its full potential is realized is primarily what motivated me to write this book “Digital Health: A Primer”. After 25 plus years of researching and teaching in digital health in US, Europe and Australasia, I felt it was important to provide a critical perspective of the topic and highlight the key issues and important considerations when designing, developing and ultimately deploying digital health solutions. The book is designed to be of assistance to all healthcare stakeholders; clinicians, hospital administrators and C-Suite, payers, regulators, health tech vendors, patients, their families, researchers and consultants.
I hope on reading this book, readers will have a better appreciation for the opportunities that digital health provides. I hope the book assists them to understand the importance of taking a responsible approach to digital health which includes incorporating strategies of co-design which takes into account multiple healthcare stakeholder perspectives, most especially patient and provider perspectives. And that such a better appreciation will enable them to navigate the road from idea to realisation for any/all digital health solutions. Further, I trust the book will leave readers curious and comfortable with digital health and that its mystique is dispelled.
How do you see digital health technologies transforming patient care and healthcare delivery in the coming years?
My vision is that through the appropriate design, development and deployment of digital health technologies we can provide superior healthcare delivery and wellness management to everyone, every time and everywhere. The provided care will be precise and personalised. Further, the care will be with them throughout their life i.e.; from the womb to the tomb. People will thus be able to stay stronger for longer and enjoy a high quality of life and a long life. Moreover, with digital health technologies we can remove the fear and uncertainty around care delivery so patients and their families can have confidence that the care they will receive at the point of need is the best possible care for their specific healthcare problem.
To realise this vision, digital health technologies must also provide, support for healthcare providers so they can deliver high quality care. This includes helping healthcare providers work smarter not harder, releasing capacity as well as uplifting and upskilling them. In so doing, healthcare providers will be best placed to make accurate and critical decisions around the care to be administered which in turn will lead to better clinical outcomes. In addition, high fidelity diagnostic technologies will enable earlier detection and thus more timely administration of treatment protocols, while technologies that support prehabilitation will ensure less likelihood of developing complex healthcare problems. On the other hand, technologies focused on supporting rehabilitation will ensure a return to a better health status for patients sooner.
Digital health technologies can also assist with supporting the provision of superior aged care, palliative and hospice care, care for people with physical and mental disabilities and the provision of various forms of allied healthcare. In short, digital health technologies can provide tremendous assistance in all areas of care delivery, its on going management and planning. At a public health level too , digital health technologies can support important aspects around awareness building, health literacy improvement and adherence. The recent COVID 19 pandemic is an excellent case in point where globally healthcare delivery was initially taken unaware and quite confused about how to address the COVID 19 virus but within a very short time we saw various vaccinations developed and deployed, telemedicine became a standard approach for consulting with ones healthcare provider, QR codes were essential and the analysis of multiple spectral data to understand changes and spread of the virus was paramount. Thus, our digital health technologies are strategic necessities for the provision of superior patient care and wellness management.
How do you envision healthcare professionals incorporating digital health tools and strategies into their everyday practice?
Today, at some level, most healthcare professionals are relying on at least a form of digital health tools. As we move forward, the key is to have the right suite of tools available to them at the right time so they can provide the best possible care at the point of care every time, everywhere to everyone. These tools thus need to be incorporated and diffused through out our healthcare systems in an easy to use fashion and they should not create islands of automation but rather support the seamless sharing of data and information. Healthcare professionals are dedicated to providing the best care to their patients, but it is difficult for them to do so if the digital health tools they must use create more challenges for them or perhaps have incomplete or inaccurate data.
To ensure uptake and use of digital health tools, it is essential that such tools are co-designed with healthcare professionals and patient or consumer groups so that the solutions are easy to use, have a high fidelity and beneficial. Moreover, structures and infrastructure need to be in place to support the integration of these tools into specific healthcare settings. This includes a focus on maintenance and sustainability of digital health tools once they are implemented. Further, a high standard of data security and privacy must be ensured. When these essential elements are in place, it is more likely that healthcare professionals will adopt and embrace digital health tools and strategies.
Another critical aspect for supporting healthcare professionals in the adoption of digital health tools and strategies is education and training. Healthcare professionals should now be trained not just in clinical and medical issues but also with respect to responsible use of digital health technologies and how to incorporate the use of these technologies into their respective roles so that they can maximise the potential of these technologies in practice. In this way , any fear or concern about digital health technologies will be quickly dispelled and these technologies can be used as key enablers and support in the delivery of essential care. Digital Health: A Primer, discusses this important aspect too.
Are there any emerging trends or developments in digital health that you find particularly exciting or promising?
I do believe it is a very exciting time in digital health as we are witnessing a plethora of new and emerging technologies. These have been enabled by faster computer processing time, 5G and beyond, Internet of Things, advances in mobile technology and analytic techniques as well as artificial intelligence and machine learning.
One area I am particularly excited about is that of digital twins to support superior clinical decision making. Digital twins, succinctly described as the digital representation of a physical object, is a concept that has emerged relatively recently with increasing application in the manufacturing industry. By taking this concept into the healthcare domain it becomes possible to provide enhanced clinical decision support and enable more patient-centric, and simultaneously more precise and individualised care to ensue. Digital twins combined with advances in Artificial Intelligence (AI) have the potential to facilitate the integration and processing of vast amounts of heterogeneous data stemming from diversified sources. Hence, in healthcare this can provide enhanced diagnosis and treatment decision support. In applying digital twins in combination with AI to complex healthcare contexts to assist clinical decision making, it is also likely that a key current challenge in healthcare; namely, providing better quality care which is of high value and can lead to better clinical outcomes and a higher level of patient satisfaction, can ensue.
Digital twins in healthcare are especially well suited for patients experiencing chronic conditions; e.g diabetes or cancer. Previous work has identified digital twins as mathematical models. Digital twins have been classified as grey box, surrogate, and black box models. Based on this classification, the black box models can handle data intensive and sophisticated problems. This makes black box models a candidate for constructing digital twins of patients. Such digital twins can then assist clinicians in clinical decision making. This has the potential to reduce the cognitive burden on clinicians, to increase precision, and personalization of care through enhanced use of data, and to improve patient outcomes and cost implications. However, introducing such digital twins to healthcare represents a significant intervention that would alter traditional clinical workflows. Moreover, to design and develop digital twins it is also important to incorporate various other digital technologies and solutions such as block chain to ensure greater privacy and security, federated learning and data designs to ensure the ability to combine large amounts of multispectral data and latest techniques in AI , ML and analytics to ensure the digital twin is as accurate a replication as possible. Hence there are still many aspects that need to be researched further. To me, digital twins represent quintessentially one of the best digital health technologies. It is an exciting area in which we are currently researching and are confident it will lead to strong clinical results.
Lastly, what message or key takeaway do you hope readers will remember after reading "Digital Health: A Primer," and how do you see it contributing to the broader conversation about digital transformation in healthcare?
We are still in the early days of digital health. For me, if my book Digital Health: A Primer, leaves the reader curious, captivated and inspired to immerse himself/herself in digital health that is excellent. Further, I would hope the reader on finishing the book and has more questions; as I hope the book will be thought provoking. The goal of the book was to ignite and inspire. It discusses how digital health has come to be as it is today and that this is only a point in time not the end of the journey. Thus, we must continue but with a solid understanding which this book provides around the possibilities as well as the areas to be careful and thus have a responsible approach to digital health in all its shapes and forms.
The book therefore should contribute to conversations at multiple levels with respect to policy and regulation, technology development and advancement, even legal safeguards and guidelines. It should equally contribute to research as it outlines key questions which need further analysis and in depth assessment; such as the best ways to ensure seamless data transfer, or optimal strategies to combine multispectral data. Of equal importance, the book discusses how to go from idea to realization; and thus, is very relevant to practice and the opportunity to realise a digital health landscape enabled by digital health technologies in order to deliver a healthcare value proposition of better quality of care, better access of care and high value of care to everyone, every time and everywhere.
Digital health technologies touch all aspects of healthcare and wellness delivery from patient-doctor consults, to drug and pharma development and self-management support. The technologies support and enable early and more precise diagnostic capabilities as well as distance agnostic care delivery through virtual care and telemedicine. These technologies also provide assistance at a public health level whether managing pandemics like COVID 19 or chronic conditions such as diabetes. The technologies also support a more sustainable healthcare environment by assisting with waste containment. Digital health technologies also enable new models of care to be embarked upon such as hospital in the home or aging in place. However, to successfully realise these opportunities and ensure that the full potential of digital health technologies can ensue it is important to have a solid foundation and strong understanding of the topic of digital health as well as healthcare delivery. Digital Health: A Primer, provides such a foundation and enables a more in depth understanding of this field for the reader and thus not only will the book contribute to all conversations around digital health but it will assist in enriching these conversations and elevating them so that we can delve further into critical issues from point of understanding and knowledge which in turn will ensure such conversations are more robust and scrutinize essential considerations so that we can design, develop and deploy superior digital health solutions and thereby stay stronger for longer.