Digital Health - An Introduction

Primary Category

Digital Neurology

P-Category

Secondary Category

S-Category

Authors:

Filzah Faheem MD
Junaid Kalia MD

Defining Digital Health

Conceptually,

Intersection between technology and healthcare
Digital transformation of healthcare
includes: software (apps), hardware and services

Digital Health Characteristics

Digitized - Digitization of all care touchpoints and backend process in healthcare
Demonetized - Decreasing cost by automation
Dematerialized - Materials are getting cheaper and faster including digital
Decentralized - Digital first allows to be global first
Democratized - Stakeholder economy with voting by wallet
Deregulated - Regulation is slow to catch with digital innovation
Deceptive - Suddenly becomes the norm (e.g digital camera)
Disruptive - Completely replaces older model (e.g. LED lights)
Exponential Growth - Algorithmic growth affects billions simultaneously

Defining Digital Health Technologies

💡

Definition of digital health technologies (DHT)

A system that uses computing platforms, connectivity, software, and sensors for healthcare and related uses. These technologies span a wide range of uses, from applications to support general wellness to medical device applications such as apps that provide a reminder to stay out of the sun to limit UV exposure. They include technologies intended for use as a medical product such as digital therapeutic that provides cognitive behavior therapy, a medical product that uses consumer technology in fitting a hearing aid, or as an adjunct to other medical products (i.e., devices, drugs, and biologics) such as an app to boost adherence to therapy. They may also be used to develop or study medical products.

Benefits of Digital Health Technologies

Quadruple Aim

↑ Outcomes
↓ Cost
↑ Patient Engagement
↑ Provider Satisfaction

4Ps of Digital Health

Predictive
Preventive
Participatory
Personalized

Other

↓ inefficiencies
↓ inequality
↓ fraud
↓ abuse
↓ inequality
↑ access
↑ Value (quality at cost)

Understanding digital transformation

Digitization: The transition from Analog to Digital. Use old workflow

Digitalization: Improve the business process by leveraging data, New Workflow

Digital Transformation: End-to-end transformation with enhanced core competencies, New Use cases & Experiences

Term	Explanation	Workflow	Core Competencies	Mapping
Digitization	Analog to Digital	Old Workflows	None	PDF of paper Maps
Digitalization	Analog-Digital to Digital	New Workflows	Limited	MapQuest
Digital Transformation	End-to-end transformation	New workflow New Use Cases	Enhanced	Google maps DoorDash Uber/Lyft

Understanding digital Shift

Cultural Shift in the making

eCommerce
Remote work
Remote learning
Online Entertainment
Decentralized Finance (DeFi)

Impact of Pandemic accelerated the digital shift

It is estimated that the pandemic moved digitization at least 7 years forward

Digital Health Funding Landscape

$57.2 billion in funding in 2021

79% jump from the $32 billion raised globally in 2020

Figure 1: Global Digital health funding

Convergence of digital technologies

Digital technologies are converging at a record pace

Each of the below will be discussed in individual chapters

Artificial Intelligence (AI)

Computer Vision
Predictive Analytics
Clinical Decision Support (CDS)
Natural Language Processing (NLP)

Mobile Technologies

5G
Cloud Computing
Mobile Health (mHealth)
Healthcare Internet of things (hIoT)

Virtual Technology

Virtual Care Continuum (VCCs)
Virtual Clinical Trials (VCTs)
Virtual Hospital at Home (VHH)

Intelligent Reality

Augmented Reality (AR)
Virtual Reality (VR)
Mixed Reality (MR)

Digital Therapeutics

Digital Twins
Digital Devices
Remote Patient Monitoring

Tokenization

Non Fungible Tokens (NFT)
Blockchain

Genomics

Sequencing
Editing

Manufacturing

3D
Adaptive

Importance of Artificial Intelligence in digital Health

With the increased amount of data being produced

AI is not only an important but necessary part of digital transformation

Continuum of applied knowledge

Information > Data > Knowledge > Wisdom

Figure 2: Artificial Intelligence at the heart of Disruptive converging technologies

Artificial Intelligence as a Service (AIaaS)

AI in healthcare will develop as a service model

Exactly as Sofware-as-a-service (SaaS) model

Cloudbase
API Based
Solve individual pain points
Produce value in niche areas

Figure 3: Artificial Intelligence as a Service (AIaaS) - Plug-n-play modular services to enhance and enable new competencies

Figure 4. “Ecosystem as a service” for cAI.

Overview of the EaaS approach for cAI with its three main components: 1. Global coalition of AI clinicians, 2. Training opportunities, and 3. Networking opportunities, integrated with an individual hospital system.

Source: Ishii-Rousseau, J. E., Seino, S., Ebner, D. K., Vareth, M., Po, M. J., & Celi, L. A. (2022). The “Ecosystem as a Service (EaaS)” approach to advance clinical artificial intelligence (cAI). PLOS Digital Health, 1(2), e0000011. https://doi.org/10.1371/journal.pdig.0000011

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International Public Health and Governmental Response

World Health Organization (WHO)

WHO has been supportive and progressively releasing digital health strengthening and implementation guidelines

Digital Implementation Investment Guide (DIIG): Integrating Digital Interventions into Health Programmes15 September 2020
WHO Guideline: recommendations on digital interventions for health system strengthening17 April 2019
Classification of digital health interventions v1.0A shared language to describe the uses of digital technology for health14 March 2018
Monitoring and evaluating digital health interventionsA practical guide to conducting research and assessment13 December 2016

Food and Drug Administration (FDA)

FDA created Digital Health Center of Excellence and have create multiple guides to help companies to accelerate digital health transformation

National Health Service (NHS)

NHS long term plan states that Digitally-enabled care will go mainstream across the NHS

Opportunities

Decreasing Costs

Computation

Storage

Bandwidth

Capitol

Gene Sequencing

Open-Source/Open-access

There are increasing sources that available with open-access

Increasing paper are published with code

Project InnerEye Open-Source Software for Medical Imaging AI

CardinalKit - An Open Source Platform & Codebase for Digital Health Research and Applications

Figure 5: Curse of Dimensionality in Healthcare Data & Convergence of Digital Technologies - Enabled by Artificial Intelligence

Challenges & Limitations

Information Inequality

Information gap has led to asymmetric access to data leading to further inequality

Data Related

Big Data (5 Vs)
Curse of Dimensionality
Data governance
Data Ownership
Data Standardization
Cybersecurity
Bias in Data
Interoperability
Data Shift

Algorithm

Interpretability
Explainability
Transparency
Bias in Modeling
Model Shift

Ethical Challenges

Equity
Access
Empathy
Trust
Consent
Privacy

Regulatory Related

Liability
Accountability
US RoadMap

Software-as-a-device (SaMD)

UK RoadMap

NHS pathway

EU Roadmap

Education Related

Medical education
Health education

Communities

Network!

Digital Medicine Society (DiMe) - Advancing digital medicine to optimize human health.

Founded in 2019, the Digital Medicine Society (DiMe) is the first professional organization for experts from all disciplines comprising the diverse field of digital medicine. Together, we drive scientific progress and broad acceptance of digital medicine to enhance public health.

https://www.dimesociety.org/

Health Tech Nerds - Home

Stay ahead of the news and trends in the industry via our newsletter & join in the conversation via our community

https://www.healthtechnerds.com/

Want to Create my own Digital Health Product!

Use Open Access Tools

CardinalKit ·

CardinalKit is an iOS framework for digital health innovators and institutions designed to accelerate rapid prototyping of digital health applications by reducing costs by as much as 75% (~$150,000) and timelines by 12 months. + Simple configuration and setup for accelerated development. + Informed consent process and survey generation using ResearchKit .

https://cardinalkit.org/

Bibliography

Ravi V. CardinalKit Workshop - October 28, 2021 [Internet]. YouTube. 2021 [cited 2022 Feb 8]. Available from: https://www.youtube.com/watch?v=mlAEeWsVotw‌

The Impact of a Shifting Care Environment on Healthcare Facility Operators. (2019, October 2). Ecgmc.com. https://www.ecgmc.com/thought-leadership/blog/the-impact-of-a-shifting-care-environment-on-healthcare-facility-operators

Amazon.com: The Fourth Industrial Revolution eBook : Schwab, Professor Dr.-Ing. Klaus: Kindle Store. (2022). Amazon.com. https://www.amazon.com/dp/B01JEMROIU/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1

Big Ideas: The Tech Breakthroughs Investors Shouldn’t Miss in 2019. (2019, January 14). ARK Invest. https://ark-invest.com/articles/analyst-research/big-ideas-2019/

Amazon.com: The Future Is Faster Than You Think: How Converging Technologies Are Transforming Business, Industries, and Our Lives (Exponential Technology Series): 9781982109660: Diamandis, Peter H., Kotler, Steven: Books. (2022). Amazon.com. https://www.amazon.com/Future-Faster-Than-You-Think/dp/1982109661

The Exponential Age: How Accelerating Technology is Transforming Business, Politics and Society: Azhar, Azeem: 9781635769098: Amazon.com: Books. (2022). Amazon.com. https://www.amazon.com/Exponential-Age-Digital-Revolution-Rewire/dp/1635769094?tag=smarturl-20

Global digital health funding skyrockets to $57.2B with record cash for mental health, telehealth. FierceHealthcare. Published January 21, 2022. Accessed January 31, 2022. https://www.fiercehealthcare.com/digital-health/digital-health-startups-around-world-raked-57-2b-2021-up-79-from-2020#:~:text=The record-breaking funding marks,to 2%2C518 deals in 2020.

CB Insights. State Of Digital Health 2021 Report. CB Insights Research. Published January 20, 2022. Accessed January 31, 2022. https://www.cbinsights.com/research/report/digital-health-trends-2021/ ‌

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Digital Health - An Introduction ( A Neurology Perspective)

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