Beth Israel, Dana-Farber leaders offer a prescription for better digital health: Actionable data at the point of care

For digital health to fulfill its promise, there needs to be clear evidence of improved health outcomes and it needs to integrate into physicians' workflow. (uzhursky/Shutterstock)

BOSTON—With an all-time high $14.6 billion in funding going toward digital health startups globally last year, investors are betting big on the promise of tech to address major healthcare challenges and disrupt the industry.

Are these digital solutions delivering?

They could be doing more, according to John Halamka, M.D., chief information officer at Beth Israel Deaconess Medical Center and professor of medicine at Harvard Medical School.

There are early successes, such as artificial intelligence and machine learning that are aiding radiologists, pathologists, and oncologists by analyzing reams of data and providing more effective clinical decision support. And physicians—armed with data from wearables and medical devices—can diagnose and treat patients quickly using telehealth visits, Halamka said while speaking at the Digital Health Impact conference in Boston this week.

“As we move towards value-based care, healthcare systems will use digital health to deliver the right care, at the right time, to the right patient," he said.

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But all that data has led to its own problem: It's overwhelming clinicians.

A common refrain from health system leaders speaking at the conference, hosted by the Massachusetts Biotechnology Council, is that all this data from apps, wearables, devices, and digital tools needs to be turned into actionable insights and treatment recommendations at the point of care.

"I often hear from clinicians 'If a [digital health solution] is not in our health record, we’re not going to use it because it’s not in our workflow'," said Lesley Solomon, senior vice president and chief innovation officer at the Dana-Farber Cancer Institute, speaking on one panel.

We have to make our data flow more effectively, Solomon said: “We have to go faster.”

Speaking on another panel, Iya Khalil, Ph.D., chief operating officer at GNS Healthcare, noted that AI has the ability to improve the clinical trial process and accelerate drug development to enable patients to get the right treatment based on their biology.

“We must do more to accelerate the feedback loop between data, insights, and intervention,” she said. "Right now we're way too slow and that is impacting patients." 

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Many healthcare providers and payers remain skeptical about digital health tools without clear real-world evidence that the technologies help to improve outcomes and lower healthcare costs. 

A study published in Health Affairs in January found that the leading digital health companies have not yet demonstrated a substantial impact on disease burden or cost in the U.S. healthcare system. Most studies conducted on digital health products and services enrolled healthy volunteers and few enrolled high-burden, high-cost patients, said the study authors.

The U.S. Food and Drug Administration launched a software precertification program last year designed to streamline the approval process for digital health to keep pace with health IT innovation. The FDA launched an initial pilot of that program with nine companies—including Apple, Fitbit and Verily—to develop a working model that evaluates software developers rather than individual devices.

That software precertification program offered a more formalized process for digital health technology development, according to Raolat Abdulai, M.D., clinical research director at pharmaceutical company Sanofi. "That program was helpful to physicians as it provides more confidence about the use of digital health tools in their clinical practice," she said.

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The biggest potential impact of digital health will be the democratization of care, Solomon noted, where evidence-based insights can be taken out of one place, put into a technology platform, and made available to the rest of the world. 

Solomon pointed to a partnership between her organization, Dana-Farber Cancer Institute, and health IT vendor Philips to use the cancer center's clinical pathways to develop best practices in cancer care. Those best practices have been incorporated into Philips' oncology platform to help oncologists with clinical decision making.

"There are some community hospitals that are using breast cancer treatment guidelines from five years ago," Solomon said. "Digital health can help solve that problem. That is a clinical decision support system that is now available anywhere."