Op-Ed: Humans Are Getting in the Way of Digital Health

Digital technologies have transformed the very fabric of our society. The way we talk, move, work, save, and spend have all changed in the face of that innovation. But the way we do healthcare? By and large, it’s still painfully analog.

That’s not to discredit the multi-billion-dollar industry of digital health: To be clear, all corners of the care pathway have seen remarkable innovations — from artificial intelligence to next-generation tools that support diagnosis, treatment, and disease management.

But those technologies get applied in a piecemeal fashion, here and there but not everywhere. Unlike banking or logistics, where it seems the whole sector has universally gone digital, healthcare is caught between two worlds — one of yesteryear and today. One of what was and what could be.

Humans as the Ultimate Barrier to Digital Transformation

Technology doesn’t seem to be the bottleneck; we have no shortage of enterprise-worthy gadgets and gizmos with growing regulatory backing to ensure they work. Instead, the barriers to digital transformation in healthcare are often very human. A recent study by McKinsey and Company, for example, showed that mindset and culture were among the biggest hurdles preempting the influence of digital health.

Both hurdles require digital fluency to clear — something that has been neglected in many strategies and conversations around digital transformation of healthcare. Navigating the complex and ever-evolving ecosystem of digital health has quickly become a new and vital skill – so, if we want technologies to catalyze change, we have to educate and train the humans using them.

We also have to make sure we’re wielding technology responsibly: New solutions churn out every day, many of them touting unproven claims. This adds to the noise of digital health. Making the most of emerging technologies and existing solutions means all stakeholders have to learn to assess the value such solutions offer to patients so that they cut through the noise to incorporate the right ones at the right time.

Three Dimensions of Meaningful Provider Education

Provider education can (and should) take place in many ways, but the most important part is that it’s structured. As it stands now, many providers get thrown into digital health with a trial-by-fire, adapt-or-die attitude. But that’s not how we train providers on conventional therapies, so it shouldn’t be how we approach digital health education.

Training isn’t just important for medical doctors, but also for others involved in the health and social care ecosystem, including pharmacists, nurses, social workers, and other patient advocates. No matter the audience, digital health education can generate meaningful learning opportunities within three dimensions of structured training:

• Peer-to-Peer Awareness: Community learning — such as through in-person mentoring or social network sharing — can create a safe space for dialogue around digital uptake in practice. This can apply to both individual patient care and population health. Keep in mind that with digital health literacy, it’s not just the young professionals who can learn from their elders; it may often be the other way around.
• Formal Education: In addition to medical school curriculum, digital health CMEs can help bolster literacy among providers. Opportunity also abounds in existing infrastructures that help doctors stay up-to-date on advancements in their fields, such as liaison relationships with pharmaceutical or digital tech companies.
• Medical Guidelines: Embedding evidence-based solutions into mainstream guidelines and care pathways could help providers understand when to consider a digital tool in conjunction with conventional care planning. Many organizations did exactly that when releasing telemedicine guidelines amid COVID-19, for example.

Still, the ubiquity of digital tools in the clinic — along with manuals, trainings, and guidelines to use them — can run the risk of burnout. Overcoming those burdens requires that digital innovators build tools with user insights and integration in mind: Why make 10 apps that each does one thing when you can create one that does them all?

Education Without Sacrificing the Humanity of Healthcare

Equally important is the need to educate patients, caregivers, and our citizens more broadly. From encouraging the use of healthy lifestyle apps and “gamified” adherence programs to exploring the role of wearables in everyday life, hospitals and providers can help people embrace and thrive with digital health tools. More than ever, digital tools can underpin effective population and preventative health strategies.

But doing so comes with challenges. The healthcare model is one of caring — of fixing broken parts — not of coaching others to help themselves. The latter may make providers feel uneasy, like they’re being asked to do something for which they were not trained or entrusting too much caregiving power to technology that marginalizes the important human aspects of care delivery. Moreover, with reimbursement models such that they are, providers may not be incentivized to do so.

And yet, digital health solutions can indeed be inherently human if perspectives shift. Professionals need training on what matters to patients, not just what is the matter with them. Healthcare systems, working with governments and/or payors, should aspire to increase the digital health literacy of its population to support preventative strategies. Technologies can fill a complementary, surround-sound role to support health that single, periodic patient encounters simply do not.

Despite the Complications of Digital Health, Measure We Must

Even if healthcare systems employ tools and the training to provide support, they won’t know they’re successful without measurement. This harkens back to an old adage attributed to management guru Peter Drucker: if you don’t measure it, you can’t manage it.

Still, measuring digital health fluency is tricky. Organizations and municipalities have long been self-assessing their own tech literacy, but taking individual measurements — where patients and providers can understand their unique strengths and weaknesses — is easier said than done.

Add to that the challenges of reimbursement: When doctors get paid by activity-based metrics, it can drown out the contributions of digital health. These systemic concerns need systemic solutions — but with the drive for value-based care, health technologies may have even more opportunities soon.

Despite these complications, measure we must — and many strategies have surfaced to make it possible. One example is the eHealth Literacy Questionnaire (eHLQ), an assessment tool to measure consumer literacy. In the future, the onus will be on both health systems and digital innovators to keep measurement top-of-mind when developing and deploying new tools.

Healthcare Will Always Be Human

Technology offers promise, but let’s be clear: Healthcare is and will always be human.

And though digital health stands to improve many areas of healthcare delivery, it shouldn’t be viewed as something separate or different. An integrated experience combines the human aspects of healthcare with the power of digital technologies. With the right tools, training, and measurement, both elements can work seamlessly together as two halves of one stronger and more lifesaving whole.

Mark Duman, MRPharmS, is a recovering clinician and current Managing Director and Chief Patient Officer at MD Healthcare Consultants. He is a proud patient advocate attempting to make healthcare more consumer-focused.

Jacob LaPorte, PhD, is an ex-chemist, ex-Mckinsey & Company consultant who is passionate about leading digital transformations to improve healthcare for patients. He founded and leads the Novartis Biome.