Digital health: promises & challenges

Authors

  • Abdifatah Mohamud University College London Hospitals NHS Foundation Trust

Keywords:

digital health, medicine

Abstract

Introduction

Over the past decades, technology has become a mainstay in every aspect of our lives. The coupling of rapid-paced innovation and open adoption has accelerated the central positioning of technology in how we live and work. The convergence of healthcare, information technology, and mobile technologies has consequently culminated in the birth of digital health.

Digital health as a term is quite broad, can mean different things, and is often used interchangeably. Despite its recent spotlight, as a concept, digital health can be traced back to its roots, as early as the 1940s. From rudimentary beginnings, digital health has accelerated at breakneck speeds, with further nuances and contours added to its initial simplistic definition, with research showing that there are as many as 95 different definitions that exist. For the sake of this article, we will consider digital health as the use of technology in the delivery of care to patients. This leaves plenty to interpretation, which is also recognised by the FDA, which includes mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalised medicine in its definition of digital health.

Uses

The landscape of digital health technologies is continually shifting. With over 300,000 health-related mobile apps in existence today, the breadth and diversity of these technologies are striking. These digital health solutions encompass a wide range of applications, from telemedicine, enabling virtual consultations with healthcare providers, to sophisticated smart workforce rostering systems, and even the utilisation of digital health platforms for delivering cognitive-behavioural therapy to patients dealing with anxiety and depression. However, it's crucial to maintain a sense of perspective. Amidst the excitement, we must remain vigilant, understanding that while these technologies offer significant promise and potential, there may be limitations and challenges that require careful and thoughtful consideration.

Challenges

In the midst of optimism surrounding digital health, it is imperative that we remain cognisant of the potential challenges that lie ahead. Beyond the conventional concern for patient safety, a pressing issue arises regarding digital clinical safety. We must assess the robustness of digital health products and devise strategies to mitigate the risks associated with their use and potential abuse. One significant challenge stems from the pace of innovation, which often outpaces development of regulatory policies and practices. The ever-evolving nature of digital health technology makes it difficult to establish comprehensive regulations. How do we regulate something that is not yet fully defined or is rapidly changing, and how do we ensure that the advancements in digital health adhere to the highest standards of safety and efficacy?

The matter of data ownership, privacy, and accountability adds another layer of complexity to the digital health landscape. Questions linger regarding who truly owns the data and who holds the authority to decide its permissible uses. In addition, the burgeoning involvement of consumer tech giants like Apple and Amazon in the collection and storage of personal health data further complicates the scenario. Aligning their vested interests and motivations with those of patients is essential, as is the need to address the risks associated with potential data misuse. Moreover, the blurring of lines between healthcare and lifestyle, exemplified by the use of wearable devices for tracking health metrics like glucose levels and sleep, underscores the evolving nature of health-related technologies. The COVID-19 pandemic unveiled the existence of a digital divide, highlighting the disparities in access to healthcare technology. As we move further into the digital era, it becomes crucial to ensure not only equitable access where necessary but also to equip patients with the digital literacy skills required to navigate the increasingly intricate landscape of technology in healthcare. In the absence of a standardised governmental body or a repository of evidence-based research, there is a pressing need for collaborative efforts to address these multifaceted challenges and ensure that the promises of digital health are realised safely and inclusively.

Potential solutions

Addressing the multifaceted challenges posed by digital health technologies requires a comprehensive approach. Firstly, there should be a heightened recognition of the potential challenges and pitfalls that come with the integration of these technologies into healthcare. Secondly, to ensure inclusivity and better outcomes, stakeholders, healthcare professionals and patients, should have a more prominent role in the research, development, and deployment of health tech products, thereby contributing their insights and concerns. A key aspect of this approach involves training and educating healthcare staff in digital clinical safety, as this will bolster the safe and effective use of digital health technologies. Recognising the emergence of this new field, it is vital to integrate education on digital health technologies into both undergraduate and postgraduate training programs. Moreover, robust pathways must be established to ensure the safety and effectiveness of digital products, based on well-grounded research evidence, as exemplified by the efforts of organisations like NICE with their digital health assessment guidance and scientific advice guidance services. Lastly, the development of a centralised not-for-profit repository for recommended apps, such as Orcha's recommended apps portal, will assist patients in identifying evidence-based and genuinely beneficial apps, thereby enhancing their overall healthcare experience.

Conclusion

The importance of understanding and actively engaging with digital health cannot be overstated. This field is poised to permeate every facet of medicine, and its integration into healthcare is inevitable. While the potential of digital health is promising, it would be shortsighted not to acknowledge the associated risks and complexities that come with it. By taking a central role in the research, development, and deployment of digital health solutions, we, as paediatricians, need to position ourselves in such a manner to safeguard our patients' best interests. This proactive involvement is critical because only when we possess an understanding of the vulnerabilities and risks can we mitigate them, ultimately ensuring that the benefits of digital health are harnessed while minimising potential harm. In an era where healthcare and technology continue to merge, our awareness and active participation in digital health discussions and processes are indispensable for the well-being of our patients.

 

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Published

17-11-2023

How to Cite

Mohamud, A. . (2023). Digital health: promises & challenges. London Paediatrics, 4. Retrieved from https://journal.londonpaediatrics.co.uk/index.php/1/article/view/85

Issue

Section

Insight