Posted: 23 Mar. 2021 12 min. read

Digital-medicine products and the Future of Health: A Q&A with AWS and the Digital Medicine Society

By Brett Davis, general manager, ConvergeHEALTH by Deloitte & principal, Deloitte Consulting LLP 

Digital-medicine products and digital companions are beginning to reshape the health care landscape. Digital-medicine products are a subset of digital health and include evidence-based software and hardware products that measure and/or intervene in the service of human health. This includes fitness trackers, nutrition apps, and medication-reminder apps. Digital companions provide services and insights for patients to improve medication adherence and health outcomes, manage symptoms and side effects, and enhance their overall experience with a therapy. Companions can also help caregivers and physicians monitor patients and make treatment decisions. Examples of digital companions include ingestible sensors and connected drug-delivery devices, according to the Digital Medicine Society (DiMe).

The Deloitte Center for Health Solutions recently published a report that explores the role digital medicine and digital-medicine products could play in defining the Future of HealthTM.

I spoke with Jennifer Goldsack, executive director of DiMe, and Lita Sands, head of Deloitte’s Health Care and Life Sciences Alliance at Amazon Web Services (AWS), about our new report and the role digital medicine and digital health products will likely play in the future, and some of the challenges that need to be overcome. Here’s an excerpt from that conversation.

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Personalized Therapies in the Future of Health: Digital-medicine products are transforming research and care models, and changing regulations aim to expand access. Join the conversation about effectively capitalizing on these opportunities in a special workshop cohosted by Deloitte and the Digital Medicine Society (DiMe) on March 25. Register today. https://us02web.zoom.us/webinar/register/WN_ZyFcPGWWQk-_DvYrbMuQBA

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Brett: Over the next 20 years, Deloitte expects there will be a greater focus on health and well-being and less focus on care as we get better at detecting disease in the earliest stages or preventing it altogether. We also expect that access to health data will help to empower consumers to make informed decisions about their health. What role do you expect digital-medicine products to play in that vision?

Jennifer: Tiny snapshots of data are generated when people meet with a clinician. That information might wind up in an electronic medical record or in a paper folder. Digital-medicine products create an opportunity to build a much more holistic view of a person’s health and well-being. Sensor-driven tools offer a density of data that we haven’t had before. In some cases, these tools can identify the early triggers of disease. There are also opportunities to empower patients with richer health data, but they must first have access to it. Historically, we haven’t been terribly good at that, but patients are starting to demand it. Having access to data is the first step toward actually being able to do something with it. Right now, there’s a wealth of information in the digital health data we already have, but most of it is just sitting in silos. 

Lita: The treatment journey for many disease states is complex, and clinicians and health care providers are often overwhelmed. Digital-medicine products can help fill in some of the gaps in treatment, make sure patients are adherent to their medications, and that they understand the treatment protocol. That could lead to improved outcomes at lower costs.

Brett: Instead of limiting data collection to clinical visits, digital-medicine products allow data to be gathered continuously as people go about their daily lives. How is this information being used?    

Jennifer: We are still learning how to use data that we capture in the wild. For example, we know how to interpret blood-pressure data when it is measured in a clinical setting. But we are still learning how to interpret the data we measure as people go about their day.

Lita: A blood-pressure reading in isolation, or even a series of readings over time, might not be very useful. But if that information is gathered more periodically in a home setting, and combined with other streams of biometric health data, you start to drive insights that help patients understand their health and how to improve it. We are becoming more aware of bad habits that can negatively affect health…like not sleeping long enough each night or sitting for long periods. Sitting is being referred to as “the new smoking.” Now we are getting access to tools that might help us understand how our habits impact our health.

Brett: What do health systems, clinicians, health plans and other health stakeholders have to gain from digital-medicine products?

Jennifer: If those stakeholders aren’t gaining something, then we shouldn’t be implementing a digital-medicine solution. I don't care how many widgets, gadgets, or algorithms we have at our disposal, if we’re not using technology to solve problems, we’re not gaining anything. And neither are these stakeholders. We want to make sure that digital-medicine products are deployed to realize the full extent of their promise and to mitigate a variety of risks that might not yet be fully understood.

Lita: My advice to any stakeholder working on a digital-medicine project is to start with the customer and work backwards. Be comfortable if you wind up with a low-fidelity or non-technological solution. That’s fine as long as it's effective and solves the problem. Not everything is about technology.

Brett: What role can digital-medicine products play in improving health equity?

Jennifer: First, digital-medicine products shouldn’t make health equity worse. That might sound like an obvious statement, but it is important and often it's often overlooked. Think about a technology company. Rather than building something around 5G or requiring broadband, developers could consider a 2G connection, or create technology that will work on a flip-phone and doesn’t require a continuous internet connection. We need to be intentional in the design and deployment of these tools to make sure they are a solution rather than a technology that exacerbates existing challenges. 

Lita: Consider how some older people are struggling to find appointments to get a COVID-19 vaccine because they can’t access a website or don’t know how to navigate it. We are missing the mark when it comes to reaching that group. At AWS, we try to work backward when developing a new technology. We produce an internal press release that outlines the customer need, the benefit of the proposed solution, and the overall customer experience. That helps to put us in the shoes of our consumers. We get to the essence of how a problem could be solved in a very simple and elegant way.

Brett: The Digital medicine Society is only a couple of years old. What was the impetus for this organization?

Jennifer: That’s right. We were founded in May 2019. Our mission is advancing the safe, effective, ethical, and equitable use of technologies to improve lives. We see enormous promise in the use of digital-medicine products to improve health, to improve health economics, and to move health out of the clinic and into the home. More than 2,000 organizations from 43 countries on six continents are a part of our Society—from data scientists to white-hat hackers to regulators to clinicians and engineers to regulators. We are drawing on each other’s expertise so that we are all speaking the same language. We want to be sure that we aren’t just furthering technology for technology's sake, but really using thoughtful and evidence-based technology to improve lives.

Brett: How should developers of digital-medicine products think about data sharing and interoperability?

Jennifer: When I imagine health care in the digital era, I imagine data no longer being locked in filing cabinets and transferred by fax machines. Every decision will be informed by data. I imagine an evidence-driven learning health system that works both for patients and for the clinicians who are trying to treat them. It will work for the health plans. It will work for public health organizations responding to pandemics. This future requires a steady flow of data, but we have to be sure that we don’t introduce new problems by sharing that data. We have to have checks and balances that keep data safe and secure. We also have to ensure that consumers are in control of their data.

We're at a fork in the road. There is a huge amount of promise, but there are also risks. There are risks around the potential misuse of data. There's a risk of making things worse across the digital divide. There is a risk of doubling down on the surveillance economy rather than doing high-quality, evidence-driven precision medicine. How can we make sure that when we deploy these digital tools that we also minimize the risk? That's really our sole focus.

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