Prescribing digital therapeutics and monitoring
Dr. Ashish Atreja joined the successful DGTL Voices live event, to discuss prescribing digital therapeutics and monitoring. This is a whole new area of medicine that is part of that fourth industrial revolution where we progress further into cyber physical systems. Ashish is the Chief Information and Digital Health Officer at UC Davis Health and founding chair of Rx.Health and NODE.health, a network of healthcare societies, regulators, organizations and innovators dedicated to digital transformation in health.
Prescribing Digital Therapeutics and Digital Monitoring for all
As Sinai, we went from innovation to wholesome transformation. We were the second hospital in the country with a digital health innovation lab established in 2012. We truly believe that the time has come where digital health can become mainstream, but we require platforms to be able to prescribe digital health.
One of the things that unite health systems is the shared mission for population health. "If our beds are filled, it means we have failed" is a statement from the Mount Sinai CEO and is an opposing ethos to many other hospitals in the country. We believe population health through providing care at home is our mission and at many times that is the best care. The challenge we faced when embarked on this mission many years ago is: How do we really provide care at home to the patients? We need more tools. Electronic health records are typically for the physicians, but there is nothing for the patients in them. As such, we looked at digital health and creating this entire set of tools to build an ecosystem where we can start to provide a care, which is often better than hospital care but that is providing in our homes.
We looked at the emergence of this new field of digital medicine where the scalability of the technology is not linear but exponential. We are seeing virtual care, wearable sensors, AI machine learning, augmented reality chatbots and these all come together to unify us with the patient through a smartphone. How can we unify them from the care team side? By embedding them with an electronic medical record. As we know the use of wearables, implantables and digestibles has really grown, but how do we not become dependent on one device? How can we make a system where new devices and digital therapeutics can be rapidly added on?
Major challenge in digital health: Fragmentation and Lack of Evidence
The major challenge that all health systems face is fragmentation in digital health and lack of evidence. The digital health landscape has become extremely complex and fragmented. How do we get away from this point and make it wholesome again? We also want to take away the "burden of proof" and make sure that everything we bring into our ecosystem is evidence-based. We have a trust based in prescribing a medicine, because it is FDA approved, but how can we build a trust where it can actually be better for the patients and we can prescribe digital health applications? Our answer to this was to create the society NODE Health, a network of digital medicine health systems, including AMA, ACC, Academy Health and HIMSS. We aim to bring together startups with new solutions, health systems, and health plans, and the industry leaders to support the solutions which have the right evidence.
How do you make evidence-based digital health available to patients?
How do you reduce evidence-based tools to practice? How do you bring it to your patient so that no researcher or clinician gets left behind? For the last four years at Mount Sinai, we have been assimilating things together and really leveraging a platform approach to be able to do that. We came up with the concept of the digital daisy as the roadmap for digital health adoption...
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