Digital health: How it’s used and where it’s headed

Improving access was the theme of 2017 Health Care Conference hosted by the Healthcare Club at UNC Kenan-Flagler Business School. The student-organized event brought together students, researchers, thought leaders and practitioners in a series of keynotes, panels and breakout sessions.

A panel on digital health examined digital wearable devices, government regulation,  artificial intelligence and privacy expectations.

The digital health market is expected to reach $200 billion by 2020, with the highest projected growth in the mobile health sector, according to Statista. With consistent IT development and strong adoption of mobile platforms, such as tablets and smartphones, the future of digital health looks promising.

But with that follows increased government involvement, a source of both initiatives and deterrents, and the unremitting question of privacy – who has access to patients’ records and what are they doing with them?

Arvind Malhotra, H. Allen Andrew Professor of Entrepreneurial Education and professor of strategy and entrepreneurship at UNC Kenan-Flagler, asked panelists about their take on the current landscape of digital health and the road ahead:

• Ed Trautman, vice president of bioinformatics and health care innovation at LabCorp
• John Rosano, strategy and business development director at Cigna
• Steve Laster, senior digital strategist at MicroMass Communications
• Peter Johnson, co-founder and principal at MedSurgPI
• Christian Nimsch, head of health care and life sciences technical and industry consulting at SAS

Regulation

As one of the most highly regulated industries, government intervention has both helped and hindered the progress of health care.

As a positive, regulation allows companies to use previous data, build on existing information and cut costs. Having standards helps promote innovation, says Trautman.

On the negative side, U.S. Food and Drug Administration (FDA) regulations and restrictions make it difficult for companies to advance. On the contrary, through FDA’s clear guidelines, companies are able to create efficient and effective products.

Nimsch sees both sides and says regulation serves two purposes: Regulation implements medical systems to satisfy regulatory requirements tied to the greater good, but also limits access to data.

Aggregate data

Rosano emphasizes the concept of being “device agnostic.” By connecting to your device, you are encouraged and incentivized. The harder aspect is keeping people consistently engaged.

Laster cites the complicated relationship between privacy laws and data aggregation. However, there is a loophole in looking at outside data to helping patients improve their lives.

“Data and wearables are a first step indicator, but they [users and patients] don’t know how to interpret the data,” says Laster. “When you take away their device, you’re taking away their motivation. What we’re trying to do is make it an internal motivator.”

Nimsch offers a different perspective, proposing that technology isn’t a barrier between having meaningful aggregate data.

“In order to get consistent data, you have to have a strong engagement model that is predictably linked to outcomes,” he says.

To accurately understand data, the first step is to understand its purpose.

Doctor-patient relationships

While technology is beneficial to monitoring and assisting patients’ health, Johnson proposes initially focusing on more personal connections.

“I think we are focusing on this technology pretty heavily, but in-fact, what we ought to be focusing on is the doctor-patient relationship that drives the awareness of how the technology can actually assist in attacking the disease process properly,” he says.

Future technology and AI

While some panelists agreed that use of new technology, such as artificial intelligence, is still in early stages as a digital tool.

Looking more specifically into data patterns is where companies like Cigna are focused, says Rosano.

Laster cited an interesting characteristic of the relationship between humans and AI or robots, as opposed to relationships in a clinical setting.

“People feel more able to be open and honest with a robot or an AI because they are not being judged,” he says, “so they tend to get more realistic, honest answers.”

Regardless of how medical technology advances, it will be quite some time before we reach that degree of sophistication.

Investing

Investing in digital health is a slow and challenging process, according to the panelists.

It’s about finding an investor who will “take the first step and be the first one out there, the leader of the pack,” says Laster.

Because of regulation and other factors, technology development usually starts in another industry and is sold into health care.

Privacy and ethics

The panelist explored why privacy expectations are far greater in health care than any other aspect of our lives.

People are more open to providing browsing data and personal records to internet service providers and other online hosts, but have concerns about disclosing information about their health records.

“What I challenge most of you is, if you’re very comfortable giving very private information right now, where is the hesitance in providing information, that in the greater scheme of things in health care, could save your life?” asks Nimsch.

If we’re already giving away that information to other non-health care providers, how much does it really impact our privacy?

Technology has come a long way, but in terms of health care, the promise of medical advances in data, engagement and wearables is exciting. It has promise for offering flexibility and reaching more people, including minorities and those who are underserved.

“Advances are a promise to serve all populations,” says Nimsch.

By Addison Lalier (BA ’18)