What is Digital Health?
Digital healthcare is an extensive and wide-ranging field that brings together concepts from both technology and healthcare to improve the overall standards and efficacy of healthcare delivery. It makes use of the rapid progress in the technological and digital sectors in order to remove traditional hurdles in accessing healthcare and collectively facilitate those seeking medical treatment. There are various reasons why the use of technology in healthcare delivery has risen all around the world. It is important to situate and contextualize these reasons.
First of all, access to proper healthcare is a serious problem, especially in the developing world. Developing countries do not have well-equipped hospitals, they lack professionally trained medical doctors, and the cost of medicine is very high (in the context of per capita income). Secondly, people who are situated in villages and far-flung areas lack the mobility to move to urban centers to access healthcare—owing to the high cost of transportation and general lack of mobility infrastructure. Lastly, poverty is another issue that prevents people from accessing traditional healthcare. According to WHO, for example, approximately half of the world’s population lacks access to basic healthcare, and an estimated 100 million fall below the poverty line due to rising healthcare expenses.
The aforementioned problems associated with traditional healthcare have coupled with an interesting phenomenon—one which has allowed technology and digital experts to counter the problems faced by people in need of medical treatment. This phenomenon is the rise in technology and digital transformations that have allowed a revisioning of traditional healthcare, especially with regard to making healthcare more accessible with the use of technology. Additionally, the use of digital technologies by people has significantly increased as well. For example, according to GSMA, 67% of the world population uses mobile services with around 700 million more users expected to join by the year 2025. This shows that digital technologies are approachable to a lot of people around the world.
It is interesting to note that digital health is not a monolith in itself, and while the larger types of digital health would be discussed later on, it is significant to note certain categories of digital health now. These categories include mHealth (mobile health), which primarily refers to the use of mobile phones and other similar technologies for healthcare provision. Additionally, and quite similar to mobile health is the use of wearable devices, such as smart watches, that can track and assist medical patients. Other categories include telehealth and telemedicine, digital health care insurance, and personalized medicine.
The aforesaid categories of digital health show the rapid burgeoning of digital health in recent times. It is worth noting that various governments around the world have also pushed for digital health through reform and by creating space for newer and advanced technologies in the provision of health. For example, a key aspect of Barack Obama’s Affordable Care Act (dubbed Obamacare) was the promotion of technology and digital platforms in healthcare. Special investments were made to bolster healthcare information technology—which primarily involves the use of technology and data services to improve access to healthcare and patient health in general. Healthcare informatics allow medical patients to easily access healthcare facilities in their own homes and allow medical professionals to assess areas of improvement within healthcare.
Why is Digital Health Important?
It is significant to note the importance of digital healthcare as it stands. First of all, any field—be it construction, banking, or indeed healthcare—can evolve and improve over time if newer technologies and novel ways of working are embraced instead of treating these changes with skepticism. Healthcare, which was previously riddled with red tape and the employment of traditional ways of working, has taken a step forward with the use of newer technologies—as exemplified by digital health. Secondly, the current Covid-19 pandemic has shown that access to healthcare is always needed, and it might not always be feasible or possible to go to the hospital for medical treatment. Digital health, in this regard, and especially during the pandemic, has allowed people to monitor and access healthcare in their homes. This has not only allowed for an efficient dispensation of healthcare but has also prevented huge patient inflows in certain areas. Thirdly, with the use of digital health people can monitor and regulate their health at all times. This can prevent disease or at least allow people to catch their health problems at the earliest, in turn, allowing for better recovery.
Lastly, it is worth mentioning that, according to Precedence Research, digital health globally will see a rise of 28% by 2027—with an expected market value of $833.44 billion. These figures are promising and show the vigor with which technology experts, medical professionals, and people are approaching digital health.
Types of Digital Health
Health Information System
The first type of digital health that we would discuss is called the health information system (HIS). This comprises the operational administration of a hospital or a system that supports the formulation of healthcare policy, as well as systems that gather, preserve, organize, and distribute a patient’s electronic medical record (EMR).
HIS is designed on the premise that correct information at the correct time has the potential to save lives. Healthcare administrators, such as doctors, medical professionals, and nurses, rely on important data regarding patients’ health in order to take correct and effective decisions. Therefore, it is essential for these professionals to have adequate data available at all times or presented to them swiftly when required. This is where HIS, with its reliance on technology, comes into play.
HIS works on three levels to assist healthcare management in a particular area. First of all, it works on an individual level, where a doctor or a nurse can track a particular patient’s medical history and other medical records in order to assist the patient in the best possible way. Secondly, HIS works well on an institutional level as well, whereby a hospital can track, for example, the number of people admitted, number of deaths, and performance of various medical professionals and departments. This allows particular hospitals to reorganize resources in a way that uplifts their underperforming departments, and holistically, can improve healthcare provision on an institutional level. Lastly, HIS also helps medical professionals to assess macro trends in health, especially related to the community in which a particular hospital is located. This, collectively, allows hospitals to be better prepared in order to fight disease outbreaks, community-specific health issues, and other macro-health-related problems.
Another significant type of digital health is telemedicine, which allows medical doctors and nurses to assess, diagnose, and treat patients with the use of telecommunications technology. While digital health—in itself incorporates a range of services—telemedicine usually refers to the provision of remote clinical healthcare services. In essence, telemedicine is a way of providing healthcare treatments to patients without an in-person presence through the use of technology and digital communications. Follow-up visits, managing chronic illnesses, monitoring medications, expert counseling, and a variety of other healthcare services that can be delivered virtually via private video and audio links are all often handled using telemedicine technology.
Mobile Health (mHealth)
Furthermore, another type of digital health is mobile health or mHealth. mHealth is a fast-growing and bolstering sector that is providing support, delivery, and treatment for medical patients through mobile technology including smartphones, tablets, and wearables. Mobile phones are now the most widely used platform for mHealth delivery, although the term “mHealth” applies to all mobile devices that have the capacity to receive and transfer data.
Another extension of mHealth are health insurance applications. Health insurance applications store patients’ medical history, their medical insurance claims, and other related data. It is particularly useful for companies to have health insurance apps as it allows them to monitor, assess, and regulate the health insurance packages given to employees, which in turn, creates a more robust and professional system for the provision of healthcare services as required by the employees.
Lastly, it is worth mentioning that various types of digital health services have led to an increase in health surveillance as well, which primarily refers to ongoing checks and monitoring of health data, with a view to planning, implementation, and evaluation of health practice. Health surveillance is especially important for public health systems, which have the responsibility to assess larger trends related to health in order to respond to health problems that are faced by people. While governments and pharmaceutical companies had previously relied on paper records in order to examine health-related trends, the bolstering of various digital health technologies has paved the way for these public and private organizations to collect data easily and more efficiently. This ease in surveillance brought on by digital health means that health-related problems can be treated more quickly and newer medicines and vaccines can be created much more rapidly.
Understandably, digital health has become an important part of our daily lives, although, it does have some downsides and challenges as well.
Digital Health Challenges
There is little doubt in the fact that digital health has made important contributions in the field of medicine and has become an important part of our lives. However, there is also no denying that significant challenges remain in the field of digital health that impede proper provision and access to health. This section would highlight some of these impending challenges.
Data Protection and Negative Effects of Data Breach
One of the biggest challenges faced by digital health comes in the form of data protection. People who use digital health share sensitive data—which includes their medical histories, their medical record, and other data regarding the medical problems they face—which can be leaked or misused in absence of strict laws and complications of technology. There are two parts to this larger problem. One is related to the technology itself. Though it is understandable that technological advancements are welcoming and in most cases are here to stay, there is little to suggest that technology is completely full proof. In fact, most technologies that we use, including those employed in digital health, have various shortcomings that manifest in the shame of software malfunctions, data leakages, and misuse of data. If the technology used in digital health is not made full proof, important medical data can be exposed forcing many people to choose traditional practices of health over digital health—effectively pushing back the gains of recent years.
Secondly, as digital health is a recent phenomenon, laws made by governments that govern this space, are currently not very well versed. These laws pertain to doctor-patient confidentiality, privacy laws, and data protection laws.
Additionally, data-intensive healthcare applications present another challenge to digital health. These applications rely on medical histories and background information from users, and user interfaces are built on personal data that is uploaded to the app. A lot of these applications face the problems that are mentioned above with regard to data leaks, hacking, and cyber-attacks. However, there is another problem that is specifically attached to these data-intensive health applications. That is that a lot of these apps have conditions that allow these health app companies to share personal data and information with third parties in order to market their own app. This sharing of data is done for marketing purposes under the garb of creating personalized content for the users—which in turn—creates a huge ethical dilemma for advocates of digital health. It is understandable that sometimes data would be shared with medical professionals who are assessing patients or with government bodies who are examining general trends in health. However, in all other circumstances, sharing of data should be actively discouraged through the passing of and implementation of data privacy and cyber security laws.
In this regard, it is important for governments and officials to understand that laws are important, and laws should be there to specifically enhance privacy and security. However, such laws should not be too expansive and should allow for digital health companies to enforce their ideas within the medical world. Any expansive or overly restrictive laws can hollow out the many meaningful changes that have been brought about by digital health. It is thus in the best interest of all stakeholders that government bodies around the world find the right balance in advancing digital health and countering issues of privacy and cybersecurity at the same time.
Bias and Discrimination
The Covid-19 pandemic has shown us that bias and discrimination are a common part of various healthcare systems around the world. Research from the USA shows that people from minority groups in the USA are twice more likely to be hospitalized due to Covid-19 and are twice as likely to die of it as well. Hospitals in minority areas are underfunded, they lack basic facilities, and do not have skilled staff, all of which impede people from minority groups from the provision of healthcare. Even in affluent areas, minority groups are discriminated against in hospitals through racial profiling, long waiting times, and wrong medicines. Unfortunately, bias and discrimination in healthcare have extended to the digital sphere as well.
In this regard, the collection of data that makes discrimination possible is one of the biggest challenges. Understandably, digital record keeping is strengthened through the collection and storage of medical histories. However, a lot of the time digital health records, including mobile applications, ask for extensive details on the racial background of people. Evidence suggests that this personal data on the racial background of people is misused widely. This can restrict access to healthcare to people on basis of race, color, and ethnicity, something which does not bode well for a progressive idea such as digital health itself.
Additionally, it is become known that bias can be and is present in algorithms that make digital applications functional. For example, algorithms that run digital applications should ideally cater to a lot of diverse groups of people regardless of race, class, and financial background. However, such a far-reaching worldview is not always present in applications as the creation of algorithms is not always done by a group of diverse people. So, for example, computer scientists in their twenties might not have a very diverse worldview as compared to a collection of people or samples based on large and diverse data sets. Secondly, algorithms are dependent on data, and when the data itself is based on restricted samples, then algorithms might not be able to cater to a lot of people with diverse backgrounds. This naturally brings bias in algorithms, which in turn, can lead to discrimination.
It has also become known that digital health companies have marketed their services and medicines to people in a way that only targets certain sections of a particular society—perpetuating discrimination on the basis of class, color, and ethnicity. This culture of “targeted online marketing campaigns” is not just present in digital health—and extends to pretty much every sector. For example, Twitter and Facebook also at times discriminated through these targeted campaigns. What it does is that it excludes certain communities from the entire setup, they would not be able to know about a new discovery in health, a new drug, or other things which they are seeking. This exclusion only increases discrimination within healthcare in general, and mechanisms should be made to ensure that all people are included in marketing campaigns.
Other forms of discrimination are also present within digital healthcare, which include bias on the basis of economic influence, inequality on the basis of internet speeds, and prejudiced hiring practices, all of which are major challenges that need to cater if digital health is to fully prosper.
How to Overcome Digital Health Challenges?
Some of these challenges pertaining to bias and discrimination can be curtailed if those involved in the service understand that diversity is a basic aspect that is present in almost all countries. Instead of shunning diversity and making “profits” as the basis of healthcare delivery, digital health professionals and companies should embrace the very eclecticism present in our globalized world. Moreover, standards with regard to data collection should be made to ensure that people are not excluded on the basis of color, class, and ethnicity. Additionally, hiring practices with every aspect related to digital health—from medical professionals to software creators—should reflect the diversity of our modern societies. If there is diversity in the workplace it would reflect in the policies and practices as well. Lastly, governments around the world should regulate digital health and ensure that discriminatory practices are outlawed.
The paper covered various aspects with regard to digital health including divulging the field of digital health itself, causes for its rise, its importance, its various types, and the challenges associated with this burgeoning sector and how to overcome them.
Digital health is an example of how using newer technologies has advanced the healthcare industry. The present Covid-19 pandemic has demonstrated the need of having access to healthcare, even if it may not always be practical or possible to seek treatment at a hospital.
There is little doubt that digital health has significantly advanced the profession of medicine and significantly impacted our lives. It is also undeniable that there are still major obstacles in the way of proper healthcare delivery and access in the area of digital health. In this regard, the paper looked at various challenges faced by the digital health industry such as the presence of bias and discrimination, and problems related to data breaches and cyber security. These challenges show that digital health technology is not full proof, and more regulations and efforts are needed to fully utilize its many advantages. All in all, digital health has revolutionized the way healthcare is delivered, and it would further bolster and expand if the industry sincerely tackles the various challenges it faces.