One of the most exciting forefronts of healthcare right now is digital health- the convergence of technology and medicine [1]. With the emergence of tools such as wearable devices, electronic health records and the widespread use of computers and
mobile phones, we are living in a time where the way healthcare is delivered can radically change.
Digital health encompasses a variety of categories including mobile health (mhealth), telehealth and telemedicine, health information technology (health IT), wearable devices, and personalized medicine [2]. Here’s a quick breakdown:
mHealth uses mobile devices to deliver healthcare services [2]. That mobile app you use to track your health behaviors or talk to your health care provider- that’s an example of mHealth. Telehealth, as defined by the World Health Organization, "involves the use of telecommunications and virtual technology to deliver health care outside of traditional health-care facilities" [3]. This includes non-clinical services such as online trainings or continued education [3, 4]. Telemedicine, a subset of Telehealth, is used to describe remote clinical services [4]. During a Telemedicine appointment, you can speak with your doctor without scheduling an in-person visit. A great example of a telemedicine company is Awarenow, a 24/7 mind-body coaching ecosystem where clients can connect to health coaches or providers over their secure platform. mHealth, telehealth and telemedicine exist to increase access to care and health information.
Health Information Technology is used for storing, sharing or analyzing health information [2]. Electronic health records (EHR), also called electronic medical records, are health IT systems used by healthcare providers to store your medical information [5]. Before EHRs, this information was stored using paper files. By storing your medical information electronically, it’s easier for providers to access your information and share it with other providers, when needed. Personal Health Records (PHR) are becoming a popular form of health IT. Using these systems a patient can log and track their medical information, such as when they visit their doctors, what they are eating, their vital signs, or their health behaviors [5]. At Neolth, we are creating a clinical support tool that does just this: connects patients with the wellness behaviors appropriate for their health goals, monitors engagement in those behaviors, and sends a report back to your health care provider. E-prescribing is a form of health IT where your doctors can access your health information to make informed decisions about your prescriptions. Doctors can see your prescription history, allergies and insurance information. They use this information to choose the best medication for you and then send that information to the pharmacy without the need for a paper prescription [6]. Wearables are health devices that can be worn to help monitor and store health information. Fitbit is a popular example. These health IT systems help increase efficiency of storing and sharing health information and increase patient engagement in their healthcare.
Personalized medicine often refers to pharmacogenomics, using genetic information for targeted healthcare interventions. When working with an individual diagnosed with cancer doctors may analyze the genetic makeup of the tumor tissue to determine which drug will have the best effect. For example, scientists discovered that a point mutation of the BRAF gene occurred in about 50% of their melanoma cases [1, 7, 8]. By administering a BRAF inhibitor doctors were able to decrease cancer cell growth [1, 8]. However, the drug was only effective in patients with the BRAF mutation, thus the need for individualized treatment based on the patient’s genetic profile.
Overall, there is great promise to digital health. Not only can it be used to increase the precision of medications, but it can be used to increase access to care. Patients can use 24/7 platforms to connect with providers without leaving their homes. Digital health also increases the ability to monitor health behaviors and the ability to share health information. Health care providers can communicate more efficiently with each other by sharing digital records rather than paper. Patients can track their wellness behavior or health symptoms in real time and share that information with their provider. Radical innovation is within reach.
References
[1] Topol, E. (2012). The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. New York, NY. Basic Books.
[2] Speights, K. May 9, 2017. What is Digital Health? Retrieved from https://www.fool.com/investing/2017/05/09/what-is-digital-health.aspx
[3] World Health Organization. 2018. Telehealth. Retrieved from http://www.who.int/sustainable-development/health-sector/strategies/telehealth/en/
[4] Smith, A. December 4, 2015. Telemedicine vs. Telehealth: What’s the Difference? Retrieved from https://chironhealth.com/blog/telemedicine-vs-telehealth-whats-the-difference/
[5] HealthIT.gov. January 15, 2013. Basics of Health IT. Retrieved from https://www.healthit.gov/patients-families/basics-health-it
[6] BlueCross BlueShield of North Carolina. 2018. What is ePrescribe. Retrieved from https://www.bluecrossnc.com/providers/pharmacy-program/eprescribe/what-eprescribe
[7] Gutkind, L. & Kennedy, P. (2012). An Immense New Power to Heal: The Promise of Personalized Medicine. Pittsburgh, PA. In Fact Books.
[8] Morris, V. & Kopetz, S. (2013). BRAF inhibitors in clinical oncology. Prime Reports, 5:11.
