With the rise of telemedicine due to the COVID-19 pandemic and–before that–the increasing ubiquity of smartphones, digital medicine appears to be the wave of the future. At least that is the topic of a recent article on health care and technology in The Economist.

Despite all this hope, we are far from a fully digital health care system. For instance,

Some 70% of American hospitals still fax and post patient records. The CEO of a big hospital in Madrid reports virtually no electronic record-sharing across Spain’s regions when the irst wave of COVID-19 washed over the country this spring.

Like many such articles, The Economist reviews new exciting technologies (and frothy market valuations) for telemedicine, interoperable electronic health records, as well sensor-based and app-based offerings as well as of course the obligatory mention of “precision medicine” and “medical artificial intelligence (AI)” and how Apple, Google and Amazon–among others–plan to play in the digital health space. But perhaps most interesting is the challenges that these companies need to overcome, a subject of which I discussed on a issue panel at ISPOR Europe 2020.

The article mentions the need for partnership: (i) between tech firms and health care experts and (ii) between these partnerships and the providers on the group who are actually treating patients. With respect to the former:

Medicine is a regulatory minefield with powerful incumbents where big tech’s business models, particularly the ad-supported sort, are not a natural fit. But the pandemic has also highlighted that existing providers’ snazzy hardware and pricey services too seldom genuinely improve health outcomes. If the new generation of digital technologies is to thrive it must “improve health, not increase costs”, thinks Vivian Lee of Verily. Her firm is moving away from fee-for-service to risk-based contracts that pay out when outcomes improve (eg, if diabetics get blood sugar under control or more people get eye exams).

And the latter:

Dr [Stephen] Klasko [chief executive of Jefferson Health, which runs hospitals in Philadelphia]…is embracing the hybrid approach with gusto. “You must have partnerships with providers, not just hundreds of unconnected apps.”

Most important, the technology must not just be “cool” or “innovative”, it must have concrete evidence that it either improves patient outcomes or reduces cost (or ideally both). As in the case of the analog world, concrete evidence of value will rule the day in digital.



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