Jun 30 2023
Patient-Centered Care

What Is Digital Health and How Is It Evolving?

Digital health can mean different things to different people, but the field is growing rapidly as healthcare organizations focus on improving patient and clinical experiences.

Long gone are the days when physicians made house calls to care for their neighbors and got paid directly with cash or even goods and services. As healthcare and technology have advanced over the past several decades and payer models have evolved, so have the expectations of physicians and their patients.

Patients started making appointments to visit doctors’ offices, and doctors began keeping paper records. That eventually evolved to electronic health records, which were easier for clinicians and other stakeholders to access. However, patients had no way of receiving that information. This led to the creation of patient portals and increased communication between patients and providers between visits. Patient portals led to healthcare apps, then application program interfaces and “everything became instantaneous,” says Dr. Shafiq Rab, chief digital officer, system CIO and executive vice president at Tufts Medicine.

“The doctor orders a lab, you go to the lab, and 15 hours later you get the result electronically,” he says.

A doctor now can ask patients to wear a watch to monitor how much exercise they’re getting, and that data can be delivered to the provider via the cloud. At the same time, mature data analytics and artificial intelligence (AI) programs are transforming the way healthcare organizations receive and act on patient data.

“Digital health is not something somebody does to you. You are digital,” Rab says.

He notes that a person can tell a cellphone to open any app using a voice command, and it will do so. The technology integrates with people using voice commands, fingerprint scans, facial identification and more. Technology can act an extension of ourselves, and digital health technology should make the healthcare experience just as seamless for patients and clinicians.

While digital health has clearly evolved over time, what it means today to health IT leaders tasked with shepherding digital transformation depends on who is asked.

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What Is Digital Health?

“It’s such a simple question, but everybody defines digital health differently,” says Dr. Denise Basow, Ochsner Health’s first chief digital officer. “It certainly means everything from using artificial intelligence to help with diagnosis and drug development to health apps and wearables.”

She says that digital health also includes virtual care solutions such as telehealth that aid in chronic illness care.

“I’m not sure that there’s a single definition. We just keep adding to that list,” says Basow.

While digital health can refer to many different types of technologies in healthcare, Basow points out that the focus shouldn’t be on what digital health is exactly, but what healthcare is like in a digital world. The same thing applies to a digital strategy: She says it’s not about having a digital strategy, but about having a strategy for a digital world.

Rab defines digital health as the use of digital technology to serve the consumer and the provider in a way that allows them to have an intimate relationship that improves health. Ultimately, it’s about technology facilitating a connection between a doctor and patient.

How Can Health IT Leaders Best Implement Digital Health Tools?

One way many healthcare organizations are addressing an increasingly digital world is by creating a chief digital officer role. Sometimes the CDO and CIO roles are combined to form a chief digital and information officer role.

The pandemic led to more demand for virtual visits and remote work. Rab says that amid this changing landscape, the CDO emerged to accelerate the delivery of care from the traditional in-person environment to homes or wherever care is delivered.

“The role of the CDO is not only to increase the business and revenue but to deliver a quality care experience,” he adds.

EXPLORE: How to transform the patient experience with cloud tools.

That experience must apply to all patient touchpoints, especially as patients increasingly demand digital-first access to providers and experienced clinicians. Rab emphasizes the importance of using digital health tools to achieve the Quintuple Aim.

“The chief digital officer needs to understand the business, speak the language and have the passion to bring that change,” he says, adding that another important characteristic in a CDO is empathy. “Without that, your passion will not come forward. Your business mind will not come forward. Because who are you doing this for? You’re not doing this for your own personal glory. You’re doing this for the greater good of society and humanity.”

Basow says that a hospital CIO traditionally focuses on technology related to workflow and the electronic health record, as well as all the traditional IT that supports the organization. While traditional IT is critical to the operation of a healthcare organization, she says she views her role as a CDO as someone who thinks about the evolution of care in a world of fast-moving technology advances.

“In many cases, the technology is the easy part,” she says. “It’s about the care process, the people who go around that technology, and how it influences how we see patients. The promise of digital health is that we can become more efficient, predictive and preventive in how we care for patients.”

She also says that it’s also important for CDOs to focus on clinician wellness. When implementing technology such as a new telehealth platform, Basow explains, understanding the process around that technology is as important as sorting out technical issues.

Dr. Denise Basow
In many cases, the technology is the easy part. It’s about the care process, the people who go around that technology, and how it influences how we see patients.”

Dr. Denise Basow Chief Digital Office, Ochsner Health

“If there’s a patient waiting in the office and the physician is late, the patient doesn’t leave. If a patient is on Zoom and the physician is late, the patient leaves,” she says. “There’s all the process that goes into how you schedule things so that the physician can be on time and the patient can be engaged while waiting if needed. The technology itself is easy. It’s all the process around it that becomes much more complicated and, frankly, even more interesting.”

Many patients want to see the consumer-focused approach of non-healthcare industries applied to healthcare, meaning more choices and better access.

“It’s not OK for patients to wait six months for an appointment. We have to be way more consumer-friendly, not just in the timing of access but also by allowing patients to schedule visits when and how they want,” says Basow. “That’s not something that health systems have traditionally focused on.”

Disruption to traditional care models can be beneficial for healthcare access, but Basow warns that it could also disrupt continuity of care. Part of the CDO’s role is to use innovative technologies and processes to maintain continuity of care in the face of changing care models and industry players.

Tips for the Successful Implementation of Digital Health Technology

The healthcare industry is often described as slow-moving, but factors such as the pandemic, a growing number of digital health startups and disruption from non-healthcare companies is speeding up digital transformation in the space. With this desire for change comes the need for agile change management.

“We’ve been operating virtually the same way in healthcare for decades, and now we’re asking people to think differently,” Basow says. “One of the ways we’re asking people to think differently is to not focus on cramming technology into what you do today. It’s really about rethinking what you do today.”

When it comes to telehealth, Basow says, adding new technology to an already existing workflow won’t work. The implementation’s success relies on rethinking how appointments are scheduled using this new care delivery model.

LEARN MORE: How virtual care solutions are addressing rural healthcare challenges.

The addition of multiple new technologies and apps over time can lead to workflow challenges. Ochsner Health created a nursing innovation group that set out to rethink how nurses are operating due to nurse burnout and shortages that were leading many to leave the profession.

“We had to make their lives better. We put together a group of leaders, and before we could even start to talk about some of the interesting technologies available, we realized we had to go back and solve some of the basics,” Basow says, adding that nurses were having to log in to different devices and apps dozens of times a shift, which took up valuable time in their workflows.

Rab agrees that workflow considerations are key when implementing a new technology. He explains that when the EHR was implemented in many healthcare organizations, they did not build the workflows and processes in a digital way with interoperability in mind.

“We just dumped it in, and right now we are trying to change that,” he says.

It’s important to consider workflows as well as preferred outcomes for patients and clinicians when undergoing digital transformation. Basow emphasizes the importance of being clear on the organization’s desired outcome and the key performance indicators for achieving those goals rather than simply focusing on the technology itself.

“You don’t want to design a project and find out six months later that it wasn’t right. You want to design smaller steps and milestones along the way,” she says. “I think that’s really critical. If you don’t have those things defined upfront, it’s hard to get buy-in and deal with the change management required.”

In addition, all stakeholders must agree about these goals and the path to achieving them.

“Everyone needs to be aligned for one purpose,” Rab says. “Don’t just talk to a doctor or a nurse, but also talk to a patient, because who are you doing this for?”

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What Does the Future Hold for Digital Health?

When it comes to the future of digital health, Basow anticipates an increased focus on AI algorithms to improve patient outcomes.

“There’s a lot of promise, and we’re only scratching the surface,” she says.

However, the digital health technology Basow is most excited about are tools to help remotely manage patients. It’s possible to measure blood pressure and oxygen saturation and do some simple blood tests at home. She says that once it’s possible to measure all of those results using a cellphone, it will open more possibilities for remote monitoring. Not only could such advancements improve care but they can also help healthcare organizations evolve their care algorithms overall with data collected over time.

“We’re getting volumes of data about patients that we’ve never had before,” she says, adding that data has the potential to improve predictive and preventive care initiatives.

Rab says that he believes that rapidly advancing digital health tools will enable precision medicine.

“Each one of us is a unique individual. There is no one exactly like us,” he says. “Therefore, our treatment will also become unique and unprecedented.”

He points out that, going forward, digital health tools must be meaningful and pleasurable to use. Just being useful isn’t good enough, he says. For example, apps like Spotify bring people joy without requiring training to use.

“That means that your experience in digital health should not need training. It should be adaptive and automatic. It should be easy to use,” he says.

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