Just as other aspects of our everyday lives have benefited significantly from the advancement of technology, so has our health. These advancements in technology not only provide us with tools to encourage us to monitor our health, but also help us stay healthy and prolong our life expectancy.
Digital health is the utilisation of digital technologies to promote health, healthcare, and social wellbeing, as well as to improve medical technology (i.e. medicine, medical equipment, surgical equipment, monitoring system, etc.)making it more personalised and precise.
In 2015, the World Economic Forum (WEF) identified six tech-related megatrends shaping the future of society: 1. People and the Internet; 2. Computing; 3. The Internet of Things (IoT); 4. Artificial intelligence (AI) and big data; 5. The sharing economy and distributed trust; and, 6. The digitisation of matter. Although these are listed as trends shaping the future, all of the above mentioned are increasingly relevant to, and embedded in, our lives today. Many developments related to digital health can be out into these six categories.
The practical applications of technology to health
Where can the practical applications of digital health be seen? There are plenty of examples that are becoming, or have already become, the new norms.
Data related to our health is registered, stored, and shared digitally. The cloud is increasingly replacing the traditional way of storing information: paper. Electronic medical records and electronic prescriptions are some of the everyday examples of health information and communications technology (ICT). Telehealth and telemedicine are enabled by the use of ICTs to access healthcare services remotely. These technologies are improving access to healthcare services, especially for those living in remote areas, or with limited mobility. For instance, people can use their mobile phones or other devices to log health-related information, such as the medication they took and their blood sugar levels, all of which can be reviewed by nurses remotely.
Mobile health (mHealth) benefits both medical practitioners and consumers. Professionals can use mobile health technologies to support their clinical decision-making, while patients can track their health by using wearable devices, such as Fitbit and Apple Watch. However, the accuracy and effectiveness of wearable devices remains questionable, as regulations on these devices are insufficient. A positive example is a Bluetooth enabled pacemaker, which continuously sends the patient’s heart rate data to their healthcare provider for monitoring. It is a cost, time, and energy saving solution for heart patients who otherwise had to constantly travel to the hospital for regular consultations.
With the increase in the amount of data stored and made available, medical treatment and services will improve in accuracy and in quality. Precision medicine can contribute not only to improving patients’ health, but also to removing financial, physical, and psychological burdens shouldered by various actors in healthcare services. Predictive analytics is another example of mass amount of data being the main instrument. By using AI, it can predict health outcomes and tailor treatment for each patient. Introducing AI to health check-ups is a forward-looking approach that will enable people to take proactive measures accordingly to their situation.
Thanks to the continuous advancement in engineering, medical tools and assistive technologies are modernised to provide better healthcare and services. Medical robots complement their human colleagues, from aiding in complex surgeries, to running errands for nurses. Design and production techniques of prosthetics have dramatically improved owing to 3D printing technology. Prosthetics are now more affordable, with the possibility of being fully customised to fit the wearer. 3D printed prosthetics provide the wearer with both physical and social comfort.
Biotechnology and bioinformatics are interdisciplinary approaches to health, particularly when it comes to analysing genes. The evolution of computing capability has enabled the pharmaceutical industry to develop effective drugs, and geneticists to manipulate genes and increase the beneficial characteristics of humans. The computation technology to study genetics is marketised to consumers, producing DNA tests and genetic analysis software to discover one’s ancestry and make health predictions.
Digital health also exerts its influence in public health, especially in epidemiology. Digital epidemiology is about understanding trends and patterns of disease outbreaks by observing data that is produced by ordinary people and exists online. There are several digital observatories to map and monitor the spread of diseases, such as influenza and dengue fever.
These technological advancements are happening so fast that we cannot yet fully understand their long-term impact, implications, and possible trade-offs. What are the risks of digitalisation in health? What actions are required to address the issue?
The digital divide is one of the major issues related to digitalisation. One needs to have access to the Internet, ICT, and digital devices to be able to fully embrace the benefits of digital health. This raises the question: Will bridging the digital divide reduce health inequalities? For poor, marginalised populations, and racial and ethnic minorities, gaining access to healthcare is often a challenge. The data shows that these same people are less likely to have access to the Internet. To ensure health equality in the digital era, the solution requires a holistic approach to address encompassing issues such as the digital divide, access to education, access to decent employment, etc.
Data integrity, safety, accountability
When we discuss digital and digital-related technology, there is a general sense of fear or a way of thinking that humans will be replaced by robots. This argument is valid to some extent, for instance when it comes to low-skilled labour. However, if this logic is applied to a medical setting, it could create moral hazards among medical practitioners. They may take more risks when they think that the decision making is outsourced to robots or a computer, and they are not liable themselves. The approach that we should take is to consider that the technology’s role is to complement human characteristics.
Changes brought by digitalisation in health are irreversible. It has fundamentally changed the way we think about health. As much as we benefit from technological breakthroughs, it is also important to address issues that it has brought. The challenges cannot be solved by a single actor, they require co-operation and collaboration between all stakeholders. In April 2019, the WHO issued its first guidelines on digital health intervention, which include recommendations on the ways in which member states can apply digital technology to healthcare services. The political momentum of digital health persists. In October 2019, the World Health Summit was hosted in Berlin with the support of Germany, France, the European Commission, and the WHO. The international conference on health hosted six panel discussions that are related to digital health, signalling the strengthened interest in the topic at the intergovernmental level. Given that the innovations surrounding health are unlikely to slow down, policy-making needs to pick up its pace and catch up with the speed of technical innovations and continue the political momentum to address the existing policy gaps.