Move over digital health, cutting-edge hospitals are prepping for digital medicine instead
The future of healthcare is not a device or a drug thus far undiscovered. No, it’s digital and that’s no surprise — but it’s not nearly as simple as today’s digital health.
Rather, forward-looking hospitals including Mount Sinai, LifeBridge Health and Thomas Jefferson, in fact, have clinical innovation teams working on digital medicine projects.
The difference? Ashish Atreja, MD, chief innovation and engagement officer at Mount Sinai said that hospitals must apply the same principles to digital medicine that they do to plain old medicine.
That means doing no harm, delivering effective and patient-centered care, and doing so in a timely and efficient manner — which is not at all the way EHRs currently operate.
Rigor and risk
Mount Sinai’s App Lab and “little big data group” are innovating and cultivating technologies widely considered to be digital health today into the digital medicine of tomorrow.
Atreja said digital medicine will be built on so much more than electronic health records. Artificial intelligence, machine learning, virtual and augmented reality, just to name of a few of the emerging technologies that will be critical.
The biggest challenge and opportunity, however, are more about mindset than IT. “We have to apply the rigor of evidence-based medicine to digital technologies,” Atreja said. “We do not have rules when it comes to digital health.”
That means considering exactly who you are designing an app or new tool for and ensuring it addresses a real pain point or existing problem, said Neil Carpenter, vice president of strategic planning and research at LifeBridge Health.
“Think about the business case,” Carpenter advised, adding that innovation is not just enabling clinicians to do new things but often about reducing costs or even headcount. “Those are business cases that real CFOs will sign on to.”
Veteran CIO Ed Marx added that for clinical innovation teams to thrive they also need to take some risks.
“We’re very risk-adverse and we need to blow that away. We need to take many more risks and embrace failure,” said Marx, who is CIO at The Advisory Board. “We need to move that whole mindset so it’s just a natural part of what we do to take advantage of the available technologies and then we’ll see true transformation.”
Fitbit vs. Pokemon Go
Blending innovation, business cases and risk means that hospitals have to experiment because sometimes what even the smartest people think will soar merely sputter and, on the flip side, some apps will surprise.
“We cannot always predict how tech will interact with people and processes,” Atreja said. “In one study people who had Fitbit actually lost less weight than people who didn’t. And now Pokemon Go is considered the biggest fitness app ever. We don’t know what will work.”
That proves that innovation comes down to problem-solving and not simply technology for technology’s sake, said Robert Neff, Director of Innovation Technology Solutions at Thomas Jefferson University.
Thomas Jefferson’s two-year-old innovation team did not know which projects to purse at first and so it began with kind of a reactive posture, Neff said, but fast forward two years and the team earned rock-solid credibility to become a proactive group that is engaged at the onset and aligned with the overall vision of the hospital system.
“We have a Chief Digital Officer and at that level the changes we make as a digital organization can be very impactful,” Neff said.
Think big and do it again
Mount Sinai’s Atreja and health IT consultant Shahid Shah agreed that hospitals should not limit themselves with small pilots that operate independently from each other.
“Innovate at scale,” Shah said. “Only when you innovate at scale can you find serious problems you have to address.”
Marx added that the technologies have to be easy enough that anyone can use them.
“No one taught me Uber, no one taught me iTunes,” Marx added. “As the next generation comes in, it has to be natural.”
And any innovative tools or practices that hospitals create must be reproducible.
“Any tech that cannot yield the same result, again and again, cannot be prescribed,” Atreja said. “No medicine would get approved by a single study, why would digital medicine get approved by a single study?”