Digital Strategy in health and medicine comes in many forms. Pharmaceutical companies use digital strategies to increase sales and marketing. Big data offer analyses in drug research and development, as well as data sharing and the ability to compare large-scale studies across various environments. Medical devices using sophisticated software are now the norm in hospitals and medical centers and clinics.
On the personal care side, Digital Strategy can be as simple and beneficial as an alert app, reminding people when to test their sugar, take their blood pressure, or to take prescribed medication. This is particularly helpful in cases where pain management or psychotropic medications may affect memory or perception of time.
Even the popular and often lampooned “I’ve Fallen and I Can’t Get Up” devices have gained from digital opportunity. These devices can now connect via cellular and WiFi, enabling alerts and contacts across many disciplines. Doctors, neighbors, relatives, friends and other emergency contacts can receive alerts. This is a major improvement on the single call recipient of early electronic alert devices.
The adoption of computerized methodologies and data management technologies throughout many areas in healthcare and medicine has brought about a vast array of services and improvements. Any number of advanced treatments, practices, testing methods and the like have enriched the lives, if not saved those lives, with the advent and acceptance of digital strategies. Complex medical research, once beyond imagination, is possible today with just a few keystrokes.
Digitally enabled "beyond the pill" solutions offer not only medications, but also monitoring sensors capable of collecting and then analysis of data on a condition. This data and information is collected and can help in patient care between visits to doctors. This helps both doctor and patient alike. Desired outcomes, constant tracking, and data generated both for the patient and for the larger view for health care providers and pharmaceutical research are the benefits.
Go one step further from keystrokes to devices and the leap in medical devices is yet another breakthrough made possible by adoption of digital services and computing in the era of ubiquitous connectivity. Robotics also plays a key role. Developments in digital and fabrication have paved the path for acceptance by the general public and adoption by health care providers.
Scientists in the Netherlands are at work on a biopsy robot that will combine traits of MRI and ultrasound with a goal of improving breast cancer and muscle disease diagnoses. This is known as MRI and Ultrasound Robotic Assisted Biopsy (“MURAB”). The procedure will take less time than present day MRIs and will decrease the number of false positives. The MURAB project is funded and underway, with academic, hospital and enterprise support.
Technology has become a part of everyday life, which has brought about a synthesis of legacy medical information, personal infomatics as gathered by pedometers, Fitbits, etc., plus the integration of social or shared media. John Brownstein, PhD, who heads up the Computational Health Informatics Program (CHIP) at Children’s Hospital Boston, discusses the emergence of Digital Phenotypes. In the Harvard Medical School’s Labcast he describes how every data point an individual posts, be they on social media, a blog, or from data derived from one’s personal measurement devices, creates and adds to the Digital Phenotype:
All of that data collectively can build a pretty rich characterization of an individual. What we’re suggesting is that that data is becoming increasingly important and ultimately should end up feeding back into clinical decision making [and our] understanding of population health in very new ways—especially when it comes to health behaviors.
He carries the explanation a bit deeper in a paper he co-authored in Nature Biotechnology:
Through social media, forums and online communities, wearable technologies and mobile devices, there is a growing body of health-related data that can shape our assessment of human illness.… Through the lens of the digital phenotype, an individual’s interaction with digital technologies affects the full spectrum of human disease from diagnosis, to treatment, to chronic disease management.
In effect, one’s own personal digital activity, self-management and productivity adds to the phenotype. Thus participation in one’s data gathering becomes a part of everyday life. Unlike past pre-digital times when monitors or testing was neither portable nor integrated into everyday life with simplicity, the gathering of health related data can be an ongoing aspect of one’s life without the sense of interruption or being ungainly.
A decade ago the idea of a doctor’s office or medical practice being digital, with a work station (then) or tablet (now, in some cases) at hand during a visit or a procedure, was unusual. Now it is the norm and not the exception that medical facilities have digital capability. Health records, pharmaceutical regimens, and all manner of health related information is recorded and stored.
In the past year Apple, IBM, and Google have all launched or amped up their activity in these personal digital health areas. Google has Verily, a life sciences initiative. Verily is active in research in cancer, heart disease and diabetes. It has a research program dedicated to multiple sclerosis, combining wearable sensors with traditional clinical tests. It gathers biological, physiological and environmental variables in its analyses. Watson gathers information worldwide, creating a medical data cloud.
Apple’s ResearchKit is a mobile health program. It enables users to use their iPhones sensors as processors to track movement, take and record measurements. This varies from diet to exercise to other personal health apps and tracking opportunities. The software is open source, which allows development to go beyond the walls of Apple’s Silicon Valley headquarters. The personal information, in the user side, is not shared, as part of Apple’s overall respect of personal information being the property of the individual. From the ResearchKit website: “We know how much you value the privacy of your information, and ResearchKit has been designed with that in mind. You choose what studies you want to join, you are in control of what information you provide to which apps, and you can see the data you’re sharing.”
IBM launched Watson Health in April of 2015 as a part of its global ambition to bring software and data analytics to health care and ultimately improve the quality of life, worldwide. Since then it has acquired numerous companies in the health care data arena. Health records, medical science and research all go into the Watson Health Cloud, designed to amass social data and clinical research from a diverse range of health agencies. This cloud based data sharing hub will be powered by Watson, which IBM claims as the most advanced cognitive and analytic technologies.
These and many other initiatives large and small, corporate and personal, private or social (or shared or open source) offer a multitude of activities and opportunities for digital strategies to improve both personal health and medicine, worldwide. The integration of technology with data acquisition, research in disease prevention, health management, medical robotics and telemedicine all point to improved access and use of information. The medical, pharmaceutical and biotech industries will benefit. Best of all, so will patients and individuals throughout the world.
