Commentary: The truth about EHR and digital health 'snake oil'

HIMSS Executive Vice President Carla Smith and PCHA EVP Patricia Mechael caution against applying the phrase to all digital health apps and tools. Instead, executives and innovators should align emerging technologies with consumer demand.
By Carla Smith and Patricia Mechael
07:07 AM

The healthcare industry is at a unique crossroads in regards to innovation. Has the urge to innovate accompanied with the consumerism of care driven us down a path that could impact clinical quality? Perhaps. At least that is what American Medical Association's (AMA) CEO James Madara, MD cautioned in his original and expanded comments regarding digital health technologies as the 21st century’s “digital snake oil.” These three little words generated strong reactions on both sides.

HIMSS, PCHA and many others agree that misleading technologies guised as clinically valuable applications have no place in healthcare. But we must be careful not to lump all digital health technologies under one umbrella as many have already had a positive impact on people’s lives and our healthcare system as a whole.

Let’s celebrate how far digital health has come
Digital technologies have already improved care delivery in a number of areas. Organizations such as the Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center (UPMC) have implemented digital technologies that provide warning alerts for patient deterioration; in the program’s first year, UPMC clinicians prevented 132 intensive care unit visits for children and $5 million in savings. Missouri Health of the University of Missouri Hospital demonstrated the power of clinical decision support with catheter removal procedures as they reduced their Catheter-Associated Urinary Tract Infections by 25 percent (rates went from 6.0 to 4.5 in one year).

These are just two from hundreds of examples across the U.S., Canada, and around the world. And clinical studies have time and time again demonstrated the value of remote monitoring technologies. 

Mobile apps, sensors and remote monitoring devices and trackers are also demonstrating significant benefits in improving health, wellness and clinical outcomes. For example, congestive heart failure patients monitoring their vital signs and then transmitting personal health data to their provider, reduce their hospital readmissions by over 50 percent. Mobile apps and texting programs help to improve medication adherence and empower individuals to make important behavior changes to better self-manage their health and wellness.

Digital health: onward
Health and wellness tech have the highest Compound Annual Growth Rate (CAGR) in the mobile market (48.1 percent); and 78.5 million consumers will use home health technologies by 2020, this market represents a significant opportunity. As Christina Farr of Fast Company wrote, however, “not every app is created equal.”

Two things to keep in mind: first, as with any new market, there’s a flood of products – some good, some bad. This is healthy because an environment of innovation and creativity is in the best interests of the consumer. We need tools like data analytics, clinical testing, product evaluation, and design and needs assessment; all of which help ensure a more personalized and seamless experience for users.

Looking ahead, we must work to bridge the “app and research gaps” – i.e., aligning product development with consumer needs. A body of evidence substantiating the tangible value of health IT is freely available online to  help users understand how to extract value from adopted technologies and achieve long-term successful use of personal connected health devices.

As an industry, our focus is clear:

  • Person-centered design is a must. Personal health technologies and devices must be plug-and-play, easy-to-use and intuitive.
  • Reimbursement for connected health devices will be key to achieving widespread support and adoption from clinicians and engagement by consumers.
  • Interoperability, the seamless, standards-based, secure exchange of personal health information between individuals and their care team, is a must as well. PCHA's Continua Design Guidelines, as well as cross-sector alliances such as IHE and the CommonWell Health Alliance are actively ensuring the right information is available to the right people at the right time.
  • Personalization is necessary in order to achieve long-term engagement. Data analytics allows us to finely tune the messaging and interactions, thereby creating a highly personalized experience to keep an individual engaged and motivated to achieve their health goals.

Consumer choice driving innovation
“Snake oil” and the degree to which it has captured headlines is indicative of the crossroads we have reached. We can innovate and move forward, but we must do so within the Hippocratic oath, to “first do no harm.”

The sector must ensure that there is a systematic way that consumer-facing mobile apps and other digital health technologies are being clinically validated.

As consumers, we all also have the responsibility to use the power of choice to our advantage. We have the ability, and duty, to make informed choices about what gadgets we put on our bodies or technologies we use to improve our health. Consumer demand and preferences for digital health technologies, accompanied by ongoing product innovations and highly-credible studies to evaluate effectiveness, will drive health improvements over time and leave accusations of “snake oil” in the dust. 

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