The many faces of digital health and care

What do you know about the digital health industry? It’s easy to say digital health and care. This expression, in fact, underlies many aspects of a digital transformation that has changed everything in the health care sector, from patient behavior to the way vital data is collected and monitored, to diagnostic procedures. These are all made in the name of cooperation between man and machine. We have written about some of the global trends impacting the health sector in other posts. In all countries, both developed and developing, the constant increase in the average age and the increase of some age-related diseases have, and will continue, to lead to a general increase in public spending by all governments. It is now clear that traditional treatment and prevention systems are no longer sufficient, as they are no longer able to efficiently meet citizens’ demands. For this reason, it has become strategic for all countries to develop alternative solutions, like eHealth.

 

A short definition of the digital health industry

Before analyzing the phenomenon in more detail, it is worth providing a definition. The World Health Organization defines eHealth as the use of technology (digital and non-digital) to improve human health and well-being and to enhance the services of the national health system. The term is not really a recent one. It dates back to the 1990s when the prefix e- was used to indicate all those areas “contaminated” by the technological and digital revolution of those years.

After all, it was in 1999 that the idea that the birth and development of the Internet would radically change the organization and access to health care and prevention services came to the forefront of academic circles. In particular, during the VII Congress of Telemedicine in London, it was stressed that not only the use of the Internet, but in general all information and telecommunications technologies would become key tools to improve the efficiency and effectiveness of any health system. eHealth, therefore, is a reality already known for a long time.

Therefore, eHealth is not a new concept. However, it is only recently that eHealth has shown truly exceptional growth, both economically and in terms of the solutions available to patients. Looking at the entire sector, in recent years, a series of new innovative technologies and services have been developed that have greatly expanded what can be defined as digital health and care.

In essence, under a single definition, there are many different market sectors, many different concepts of health and prevention, as well as many different technologies, services, and products that respond to specific needs and requirements.

This makes digital health and care a varied and diversified sector that contains many personalities. Let’s look at the main ones.

 

The digitization of HealthCare as a new approach to health

In a more general sense, it can be said that digital in the healthcare sector is in some ways enabling a modern, more effective relationship between patients and healthcare institutions. The doctor-patient relationship is, in fact, changing, adapting to the new behaviors imposed by digital technologies.

On the one hand, there is an increasing disintermediation of the relationship. Today, patients can turn directly to doctors without having to go through bureaucratic procedures or waiting rooms. This is happening, for example, in Italy, where doctors and specialists are increasingly using Whatsapp to get in touch with patients and vice versa, according to a study by the Osservatorio Innovazione Digitale in Sanità at the School of Management of the Politecnico di Milano.

On the other hand, the digitalization of medical-health sector tends is leading to a greater dematerialization of the same relationship, eliminating the need to be physically present during a visit and opening up the possibility of providing health services remotely. For example, in 2019, the British government launched a major health service reform plan which, among other measures, also provided that a large number of medical visits should be made via video calls using internet platforms such as Skype. Behind this rather surprising decision are two very precise objectives.

The first is to save funds and economic resources used to offer physical healthcare services—at least 30 million medical visits per year and a third of the total in Italy—through Skype, smartphones, and other technologies. The second objective is to provide a more comfortable and efficient service for users, who no longer have to go to the clinic before getting a consultation from a specialist.
 

If you digitize health you also digitize patients 

Although carrying out a medical examination via Skype can be perceived as strange, it should be noted that such measures are generally not negatively received by patients. On the contrary, they have shown to be receptive to changes that make healthcare and prevention services more digital.

Another aspect of eHealth concerns the digitization of the patient.

To say that the healthcare sector, like so many others, has undergone a digital transformation also implies that the behavior of health service users has changed, as they are adapting to increasingly digital services. For example, according to census estimates, in 2017 88% of Italians, more than half of whom are people between 18 and 24, use Google to carry out self-diagnosisThis is dangerous because it puts people at risk of believing anything that they read online, causing alarm and pushing users to adopt unnecessary or even harmful behaviors. This behavior is also a sign of something else: the internet has opened up access to information that could previously only be obtained by consulting an expert.

In this sense, doctors have to reckon with digitization, not necessarily by demonizing it, but exploiting it and monitoring the content that is spread online in order to stimulate the use of new digital channels for patient and health authority interactions in a coherent way.

The National Cancer Institute of Milan has done something similar, where it works against fake news by creating a series of initiatives, blogs, and advice on social networks. The digitization of the patient is not limited to the use of Google, of course. Italians, in fact, appear very confident even when it comes to digital healthcare.

According to research carried out by an Italian association dedicated to welfare, Italians in general, are convinced that digital innovations are valid for their own well being and therefore say they are more inclined to use them for their own health. Among the services considered most useful is the ability to book exams and specialist visits online (59%). At 48%, there is the possibility to consult medical reports and other clinical documents and to communicate with doctors via PC or smartphone. In third place, 47% responded to telemedicine, considered a valid method of support.

 

Health in an app world 

In general, patient monitoring is a central issue for the entire healthcare system and digital health and care has responded by developing a series of solutions called Health IoT (internet of things).

When we talk about eHealth we must also include within it all the digital innovations or specific devices that allow monitoring of patient health through the detection of bio-signals and bio-images in the most diverse situations. One of these situations is the use of remote examinations. For this reason, there are specific medical devices or applications for smartphones and tablets that allow doctors to monitor the health of a patient without necessarily having to be present; this falls into the category of mobile health.

These devices have the advantage of allowing the collection of an impressive amount of data and information, putting the patient in a proactive position to manage their own health. Perhaps it is because of this last aspect that the number of smartphone apps dedicated to health has increased dramatically over a short period of time. Consider that, in the English-speaking market alone, there are about 165,000 such apps. These range from apps that simply count calories to those that monitor the heartbeat and measure blood glucose levels. 

Together, all of these applications represent a new business for electro-medical companies, with a value of around $6.9 billion. 

 

The health you wear 

Thanks to the technologies described above, eHealth has managed to get inside our smartphones, literally turning them into real medical devices. But, of course, the digitization of healthcare does not stop there.

Wearable devices such as bracelets or watches have also been developed that allow users to monitor their health status. These are a further manifestation of eHealth, even more precisely of Health IoT, and certainly one of the most successful.

More than one Italian out of two considers such devices a valid means of support for their own well-being and is inclined to use them, for example, to monitor their vital and physical parameters, with an eye toward prevention, or as a stimulus to perform proper physical activity or even to remember to follow certain therapies and take medication. This includes uses such as monitoring vital and physical parameters (in terms of prevention), stimulating physical activity, and reminders for taking medication or following certain therapies. 

This positive opinion of Health IoT technology, which is not limited only to Italy, has a direct economic reflection as well. In fact, the health wearable devices sector is constantly growing. It has been calculated that there are currently about 60 million devices in circulation just for monitoring sports activity, with a value of about $3.8 billion. This number is expected to grow. By 2020, it is estimated to reach 187 million units for a total of $6 billion.

This market trend also opens up interesting consequences in the health sector, such as being able to collect, record, and analyze data not previously available, and making this data available to medical teams when they need it. 

 

Better technology for better diagnosis  in the digital health industry

A further application is for performing more accurate and precise diagnoses in a short period of time. This can be achieved by exploiting the opportunities offered by Artificial Intelligence.

This is the case of Watson, the supercomputer developed by IBM and applied to the healthcare field, in particular for the diagnosis of cancer. According to a study published in Neurology Genetics, this super-software managed to find possible tumor treatments in journal articles in just 10 minutes. The figure is even more impressive when you consider that it took a team of experts 160 hours to process the same information. Watson’s advantage, and that of AI in general, is to be able to access an endless amount of data quickly, often simultaneously, thus reducing the time needed for a diagnostic response.

An Italian company is also working on creating something similar in the form of a low-cost medical device for precise, rapid, and early tumor diagnosis using blood or urine analysis. The Adviser project is funded by the Lazio Region and will be based on the development of equipment that will have an intelligent computer system that will analyze and interpret biological data in a fully automated way and, at the same time, will allow ‘self-learning’ to perform increasingly early cancer diagnoses.

Although the list of eHealth technology applications does not end here, it is clear that the machine will now become an integral and increasingly indispensable part of healthcare services. This means that health services as we know them are destined to change, adapting to new technologies and solutions made available by technical and digital advances.

However, we must not delude ourselves that the machine can perfectly replace humans. There are aspects of healthcare, especially patient treatment, that digital technology cannot cope with. For this reason, it is important that men and machines are able to work together.

If carried out correctly, such collaboration should make it possible to combine the irreplaceable qualities of both, offering a service for healthcare and prevention that is as precise and efficient as a computer but always on a human scale.