future challenges for digital healthcare

The digital health "revolution" appears to be well under way. According to a recent survey by the American Medical Association, the vast majority of physicians believe that adopting digital health tools will improve their ability to care for their patients.

The American Medical Association (AMA) reported that physicians want new technology to fit into existing systems. Importantly, physicians wanted to be part of the decision-making process when it comes to new technology.

The main requirement of new digital tools - including telemedicine/telehealth, remote monitoring, mobile health (mHealth) apps, and wearables such as activity trackers - was to help physicians with their current practices, rather than radically change what they do and how they do it.

Why are some healthcare professionals becoming disenchanted about the development of digital healthcare and its use in daily clinical practice? Do they view it as being based on little or no evidence?

Enthusiasm curbed as expectations not met

In a recent article in NEJM Catalyst, the authors note that "fewer [digital health] products than expected are being deployed in real-world clinical settings." This may be related to complaints that in practice, these products have failed to deliver on the promise that they will lead to improved quality and outcomes and reduced costs in the management of chronic diseases.

For instance, the uptake of wearable sensors into routine practice for monitoring patients with chronic diseases has been less than anticipated. These devices transmit real-time data to the healthcare provider (HCP) using a patient's smartphone or tablet, and in studies their use has been linked to improvements in a variety of outcomes, from quality of life to improved survival.

Until recently, however, it has been difficult to duplicate these findings in clinical practice, cardiologist and IT researcher Lee R. Goldberg, M.D., of the University of Pennsylvania, told a recent meeting of the American College of Cardiology (ACC). Some studies even reported increased costs (of utilization), no impact at all, or even harm, he added.

Physicians also say they have found that managing the data and incorporating them into clinical practice presents a significant challenge. They are also faced with patients who use their own apps and sensors - many of which are untested or unproven.

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