Publication date: May 19, 2019
That was my key take-away from a fascinating and constructive meeting, the Harvard Digital Medicine Symposium, I was privileged to participate in earlier this week at Harvard Business School, organized by Business School Professor Ariel Stern, Brigham Women’s physician Will Gordon, and Elektra Labs CEO Andy Coravos.
As Coravos discussed on her recent Tech Tonics podcast (here), and explains (along with co-authors) in more detail in a fantastic primer, recently published here, digital medicine: -describes a field, concerned with the use of technologies as tools for measurement, and intervention in the service of human health. … As a discipline, digital medicine encapsulates both broad professional expertise and responsibilities concerning the use of these digital tools.
Digital medicine focuses on evidence generation to support the use of these technologies. “
The challenge addressed by the symposium was how to bring the digital and data fluency we see in the rest of our lives, along with integration so deep we don’t even think about it, to healthcare – not as precious innovation projects but as a foundational enabling technology that advances the goals of patients, physicians and other caregivers, and developers of therapeutics.
Context, Ethics, and Evidence In a thoughtful talk of considerable breadth, Eric Perakslis of Duke University (his Tech Tonics episode here) pointed out that most of the data about patients isn’t in their health records, but rather, it’s in the digital exhaust of their daily lives – the patterns around where they live, eat, and travel, and shop.
Perakslis also emphasized the importance of balancing benefit and risk from the use of digital technologies, asking -how do we keep the positive energy [associated with digital] from leading to harm?”
He emphasized that the key for digitalization is -relevance to clinical problems,” and highlighted the need to -construct an evaluative framework” for digital technologies that includes measurement verification, consideration of cybersecurity and data governance, consideration of usability from both patient and clinical trial research site perspective, and validation within the intended context of use.
Liza Hoffman, a clinical social worker and clinical director of the digital psychiatry division at Harvard’s Beth Israel Deaconess Medical Center, discussed the challenge presented by consumer-oriented health apps; her research found that patients tend to select apps based on cost (preferably less than a dollar, and ideally free) and reviews; she described her efforts coaching patients to consider additional qualities such as credibility of source and data protection afforded.
Forbes colleague Greg Licholai (also a lecturer at Yale School of Business, the co-director of the Yale Center for Digital Health, and the CMIO of the contract research organization PRA) offered a -recipe” for digital medicine: trust, reliability, and quality, and emphasized both the promises of digital medicine (access, convenience, efficacy, personalization, reduce stigmatization, and evidence) as well as what will be required to deliver this (safety standards, quality standards, interdisciplinary collaboration, education, business model and pricing, responsibility).
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