Digital health technologies offer myriad opportunities for innovation in cardiology, but there are challenges to be worked out as well.
Writing in JAMA Cardiology, authors from Stanford University School of Medicine and Center for Digital Health point to the proliferation of smartphone applications, remote monitoring technologies and expanded reimbursement for telehealth among the exciting developments.
At the same time, they acknowledge a number of challenges, including:
- Making data useful: While electronic health records display data well, they must better aggregate in context to stave off information overload. Adding more data from wearables and remote monitoring will only exacerbate the problem unless there are meaningful ways to sift through the data and effectively take action from it, the authors say. This applies not only to clinicians, but patients as well, as they gain access to more of their own data.
- Mobile applications: While health apps are sprouting up everywhere, so far they’ve not been shown effective as stand-alone therapeutics. Interventions, such as one-way text messaging to improve medication adherence, still require active oversight by the care team to keep patients engaged. That means they have to be integrated into an overall care model, the authors write.
- Gathering evidence: Citing consumer diagnostics company Theranos as an example, the authors call for rigorous study of validation, effectiveness and implementation in real-world healthcare settings for new digital technologies. In many cases, implementation studies might be more effective than patient-level randomized trials, they say. They suggest providing incentives to hospitals to share their implementation stories and acknowledge the need to train clinicians in digital health.
The good news, they say, is that healthcare organizations and vendors increasingly are collaborating to work out these problems.