In conversation with Naomi Fried, Ph.D, Founder and CEO of Health Innovation Strategies.
There has been a trending topic on finding a way to define what digital health is. How do you position digital health? What are those components for you?
The definition that I’m working with my clients on that really seems to resonate is that digital health leverages technology – that’s hardware and software – to deliver care and information to patients and providers that can be more convenient, more cost-effective, and more personalized. Software could include apps, computer programs, games, virtual reality, and chatbots. On the hardware side, it means phones, cell phones, and in particular, computers, but also sensors, wearables, robots, monitors. What’s exciting about digital health is that it has the potential to improve outcomes, decrease costs, improve efficiency, and deliver care and information in entirely new ways because it’s digital.
What do you think the real drivers for digital health are? Is it economic or the enhanced health care component, or a mixture?
It’s certainly a mixture, and one of the things that’s important with digital health innovations is to recognize what the value is. One of the challenges of digital health is that it often requires new business models to think about delivering value in a different way and thinking about who’s going to pay for it.
You wrote an article recently saying in the next few years our healthcare experience will be radically different. How’s that really playing out?
I expect that eventually, healthcare will fully embrace digital health as a safe, effective method for delivering care. I had thought that the adoption of digital health would continue to happen incrementally, but things changed a lot in 2020. COVID-19 has really been almost a discontinuous radical acceleration in the adoption of a lot of areas of digital health. Now, things are happening faster and hotter, and at lower activation energy barriers. I personally have been advocating for telehealth for more than 15 years. Today, we are seeing virtual visits being used everywhere, which is exciting.
I think everybody agrees that this is a really good way to provide better health care. But how does that all fit in with digital health as opposed to the broader concept?
I think it’s the patient care piece that really holds the greatest promise to improve health care. There are four major categories when thinking about patient-facing digital health. The first is diagnosis and evaluation, where providers use clinical-grade, highly specific, digital information that’s generated to evaluate and make decisions about patient care. One example is a company here in the US called nQ Medical, which monitors and evaluates a person’s typing patterns, whether it’s on a keyboard, phone or tablet and uses that test to diagnose and track Parkinson’s disease.
The second is delivering patient care, virtually, which includes telehealth and remote patient monitoring. Through this, patients can get care where they are, which provides a convenience that really delights patients.
The third area is one that I think is particularly exciting, and not everyone’s heard about, which are digital pharmaceuticals, or “digiceuticals.” They are digital therapeutics that are administered through apps, games, or software, that treat a patient’s condition or disease. For example, today there are apps that can treat depression, attention deficit disorder, insomnia, panic attacks, chronic pain, smoking cessation, the list goes on.
Finally, the fourth category is medication compliance. Again, these are apps, sensors, games, even ingestibles that remind patients to take medication and provide information to doctors or caregivers about a patient’s adherence and compliance.
Recently, telehealth has been getting a huge amount of publicity in the pandemic. Which of these areas you mentioned do you think will have the greatest impact?
Where we’re going to see the biggest growth in digital health will be in digital health diagnostics. We’re already seeing diagnostics for sleep, sleep apnea, pain, Parkinson’s Disease, even things like concussions.
For example, Prevent Biometrics has a mouth guard that athletes can wear to instantly detect a concussion, which then notifies the coach via an app. Mental health is another area where there’s a lot of digital diagnostic work. Sound Health has developed a digital health solution that analyzes a person’s voice and how they are saying something to evaluate their mental health. By identifying the digital biomarkers in a person’s voice, they can measure symptoms of depression or mild traumatic brain injury, or concussion.
Even cancer is being diagnosed with digital health tools. The digital health app, BiliScreen, uses smartphone cameras to detect pancreatic cancer by measuring the bilirubin levels and the whites of a person’s eyes, which is what causes pancreatic cancer patients’ eyes to take on a yellowish tint as their condition becomes more advanced. What makes BiliScreen special is it can use this camera to detect very low levels of bilirubin, before the yellowing is visible to the naked eye, and indicate possible disease. Ultimately, this is an easier, cheaper diagnostic than a traditional blood test and can be done before any symptoms start to show.
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