The Digital Health Revolution

John Halamka, MD, MS, is an interesting man. He is the second human to have his genome sequenced, courtesy of the Human Genome Project; he runs a 70-acre organic farm and animal sanctuary, home to “Dudley,” a huge Scottish Highland Bull; he served in the George W. Bush and Barack Obama administrations, guiding America’s healthcare IT strategy; he travels hundreds of thousands of miles each year to study and advise on trends in global digital health; and he is a practicing emergency medicine physician.

In his capacities as Chief Intelligence Officer (CIO) of the Beth Israel Deaconess System and Chairman of the New England Healthcare Exchange Network, Dr. Halamka is shaping the use of digitized information to improve healthcare delivery. In his March 22 address to the ACCC 45^th Annual Meeting & Cancer Center Business Summit, Dr. Halamka shared stories of how both advanced and developing countries are using digital technologies—in ways that are both brilliant and uninformed—to improve the health of their citizens.

Dr. Halamka stressed the urgency of putting digital technology to work in healthcare. Countries across the world have aging populations, low birth rates, unsustainable healthcare costs, and clinician shortages. In this “perfect storm,” said Dr. Halamka, digital technologies can leverage scarce resources to provide more care to more people.

There are bright spots and stumbling blocks on this path. The good news, says Dr. Halamka, is that the consumer technology we need to enable appropriate, efficient access to healthcare information across platforms is already here. What’s missing is the integration that can make ease of use possible. For this to happen, a multitude of security and privacy concerns will need to be addressed, flawed data will need to be corrected, social biases will need to be recognized, and patients and caregivers will need to be comfortable with receiving care in different ways.

A subsequent session on the intersection of digital health, technology, and value featured speakers who explored the ramifications of new technologies on cancer care:

• Adam Dicker, MD, PhD, FASTRO, FASCO, Senior Vice President and Chair of Enterprise Radiation Oncology, and Director of the Jefferson Institute for Digital Health at the Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, said that today’s reactive approach to healthcare must be replaced with proactive care, where patient data is collected and harvested to formulate personalized preventive care. By leveraging patient data, said Dr. Dicker, the traditionally linear nature of today’s cancer treatments will give way to a more nuanced approach enabled by data-informed personalized treatment protocols.
• Doris Howell, RN, PhD, Senior Scientist at the Princess Margaret Cancer Centre at the University of Toronto, said there is good evidence for the effectiveness of remote patient monitoring and symptom management; however, patients lack the tools and education they need for these strategies to be effective. “Digital technologies are the Holy Grail solution to achieving the goals of the Triple Aim,” said Dr. Howell, “but adoption in the real world is still a problem to be solved.” To address this problem, she added, technologies must be workable in the everyday lives of patients, which requires a commitment to giving patients digital literacy and actionable information.
• Alexandra Quinn, MA, CEO of Health Leads, addressed the essential role social determinants of health play in wellness and patient care. “We need to get at the root of the inequities that drive disease,” said Quinn. “Tools have been designed for health systems, not communities.” To address these issues, it is important to recognize the unintended institutional inequities that affect patient health. “What can you do,” she asked the audience, “to use technology in a way that puts communities and caregivers at the center?”
• James Hamrick, MD, MPH, Senior Medical Director of Flatiron Health, said that a lot of the solutions that drive healthcare advancements will come from the private sector. He discussed the important role that portals will play in giving patients access to their health records and care teams. “We need to meet patients where they are,” affirmed Dr. Hamrick.