This monthly series will explore how the digital health revolution is disrupting medical practice.
“DIGITAL health” is an umbrella term for a range of medical technologies. Some examples include wearables that measure real-time physiological outputs, genomics and personalised medicine, online doctor services, telemedicine, artificial intelligence (AI) that reviews medical scans, and electronic health records (EHRs).
Proponents argue that greater connectivity between patients, doctors and digital health technologies will vastly improve the detection and prevention of diseases. However, what truly distinguishes digital health from other advancements in the field of medicine is that digital health promotes a cultural shift to health care delivery that sees patient control as a fundamental and necessary norm of practice. Patients will monitor their own health on their own devices, they will partner with you on decision making, and they will control the data – they will review it, share it and sell it.
Eric Topol, a world-renowned digital health author and cardiologist, suggests that the natural progression is that patients will own their health data, and he contends that this is their civil right. If this is indeed the way that we are headed, perhaps the future will also see that patients require a script in order to purchase digital health applications or devices. This may become a necessary government intervention to curtail the misuse of the technologies that could result from a lack of oversight. The debate on the consumerisation of digital health care will be discussed throughout this series, and we will consider the advantages and disadvantages of different approaches.
Indeed, the major question for our generation is whether these digital health technologies and the new wave of medical practice will achieve a net benefit to patients and the whole of society. It is reasonable to suggest that, in an age of evidence-based medicine, proponents should “prove and explain [the] value” of adopting digital health technologies. This series hopes to shed light on the value of digital health with reference to the evidentiary support outlined in research studies.
An important consideration for technologists and digital health proponents is, according to the Future Health Index 2018 report, that:
“Healthcare professionals are unlikely to adopt new tools when they’re presented as a ‘fait accompli’ by technologists. Creating EHRs and AI solutions in collaboration with both healthcare professionals and the general population will have a significant impact on successful integration.”
In this series, we will discuss a range of topics, such as the technological advancements making their way into various medical specialties, and the evidence base for digital health, with reference to meta-analyses and systematic reviews. The My Health Record system will be discussed, including findings from the Senate inquiry. We will consider whether adopting digital health leads to increased litigation, as well as other legal considerations. International approaches will be explored, and we will discuss the shift to long-standing paradigms of clinical practice that will result from digital health disruption.
It is hoped that the series will promote discussion among peers about the future direction of medicine, and perhaps it will provide some reassurance that despite the technological world’s determination to deliver digital health direct to the consumer, the future of digital medicine is in your hands.
Bianca Phillips is a Victorian lawyer conducting medical law research. She completed her Master of Law at the University of Melbourne with her thesis on telemedicine, and is currently completing a doctoral thesis on the law-making of the digital health revolution. She has authored articles on the digitisation of medicine in both legal and medical publications. She can be found on Twitter @biancarphillips.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or MJA InSight unless that is so stated.