Are Digital Health Applications Really Fulfilling Clinical Needs?

Arundhati Parmar

Famed cardiologist and digital health evangelist Eric Topol demonstrated the promise of digital health technologies exhorting his medical colleagues to embrace patient-generated data and adopt digital health technologies in their clinical practice at the 2015 Transcatheter Cardiovascular Therapeutics in San Francisco on Wednesday.

But at least one panelist asked whether some of the technologies being developed are being done in a vacuum.  

"I am afraid that we are a little bit avoiding our responsibility to really look at the clinical needs from our perspective and try to guide all of that is happening," said Paul Yock, Martha Meier Weiland professor of medicine and director, Biodesign at Stanford University. "These forces are working on their own without a lot of perspective from us saying, 'This is really what the clinical needs are.' So much of this technology is not appropriately need directed and a lot of money is being wasted and a lot of time is being wasted."

There is some early effort underway, however, to validate digital health applications. Evidation Health, a Menlo Park startup formed by GE Ventures and Stanford Health Care, aims to design and run studies that pull clinical data, behavioral data and contextual data, and leverage those to arrive at a quantifiable result of the value of digital health technologies.  

At TCT, another physician fretted that while digital health capabilities are "enormously impressive" he wasn't sure what the new role of the physician should be.

"Medicine still remains a healing art," said Anthony DeMaria, Judith and Jack White Chair in Cardiology and founding director of the Sulpizio Cardiovascular Center at the University of California in San Diego. "Patients may have a ton of data but I look at my 98-year-old mother and you could give her all the data in the world and there's not a snowball's chance in hell she'd know what to do with it."

Topol countered that patients can opt-in to get data if they wanted but it was important for doctors to stop acting in a "paternalistic way" and embrace data being generated outside a health facility's walls.

"We have a reluctance of a lot of physicians, obviously not all, but a lot of them who are very uncomfortable with patient-generated data in general," he said.

DeMaria said that he wasn't suggesting an either-or scenario when it came to adopting digital health.

"I think we've got to maintain our interactions with the patients while they get all of the benefits of this technology that you [Topol] underlined," he said.

While physicians at TCT engage in a vigorous debate about the digital revolution in medicine, some of the questions they raised will likely be answered in time as predictive analytics come of age to glean insights from the torrents of data generated by smart devices.

"Ultimately, the purpose of all this new data is better predictions and from those predictions to find what treatments are going to optimize outcomes that patients care about the most," said John Spertus, adjunct professor of medicine, Washington University School of Medicine.

Arundhati Parmar is senior editor at MD+DI. Reach her at [email protected] and on Twitter @aparmarbb.

[Photo Credit: istockphoto.com user SKapl]