The digital “revolution” of health seems to be very advanced. 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 main requirement for new digital tools, including telemedicine/telehealth, remote monitoring, mobile health applications (such as Pharmamedic) and portable devices such as activity trackers, was to help doctors with their current practices, rather than radically changing what they do and how they do it.
Much of the new digital health technology, especially applications, lacks a evidence base. Commercially successful applications do not necessarily have a medical value for physicians to apply to decision-making for patient evaluation, diagnosis, treatment, or other options. For this reason, many PCPs are cautious about using them.
“It is very difficult for a PCP to know what a good application is and what is not, which are evidence-based and which has been validated. I don’t want to re-intervention one of my patients unless I know there’s evidence that it works […]is the same as with medications.”
Dr. David M. Levine
A big problem for today’s practice is that many digital health tools don’t connect with each other. Interoperability, i.e. systems and devices that exchange data and interpret shared data, “therefore remains largely unattainable”. The integration of new technologies is very important, emphasized Dr. Levine, particularly the development of technologies that are more easily incorporated into electronic health records (called “Plug and Play”).
We want everything to be visible to our entire health team so that anyone can log in and be all in one place,” Dr. Levine said. Currently, most of these applications build their own platform with their own set of logins and their own security issues and alerts. Connectivity is a big problem for the future because “often that’s what keeps us from using some of these digital health solutions now
Dr. Levine
More clinical guidelines are needed
WADA and AHA, together with the Society of Information Systems and Health Care Management and the DHX Group Non-Profit Digital Health Group, have established an organization called Xcertia, dedicated to improving the quality, safety and effectiveness of applications provide guidance to develop, evaluate or recommend applications, but will not certify them.
How will doctors be able to choose the most appropriate technologies for their practice in the future? Maybe independent organizations will test apps in collaboration with practicing physicians, producing recommendations online. One suggestion is that professional medical associations produce application “labels”, listing the characteristics and warnings of each application for both patients and physicians.
