Digital Health - An Introduction

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

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

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.

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
• Wireless Medical Devices
• Software as a Medical Device (SaMD)
• Guidances with Digital Health Content
• Software Precertification Pilot Program
• Device Software Functions Including Mobile Medical Applications
• Artificial Intelligence and Machine Learning in Software as a Medical Device
• Clinical Outcome Assessments (COAs) in Medical Device Decision Making

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!

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/

Further Reading

• Center. Digital Health Center of Excellence. U.S. Food and Drug Administration. Published 2022. Accessed January 31, 2022. https://www.fda.gov/medical-devices/digital-health-center-excellence

• WHO Guideline: recommendations on digital interventions for health system strengthening. World Health Organization. Published online June 6, 2019. doi:/entity/reproductivehealth/publications/digital-interventions-health-system-strengthening/en/index.html

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/ ‌