Unlocking the Exploding Field of Digital Health: A Framework for Understanding Digital Health

By Naomi Fried

About the author: Naomi Fried, PhD, is the CEO of Health Innovation Strategies, which provides digital health strategy and innovation-program design and optimization consulting to healthcare stakeholders including pharma, payers, and providers. Her previous positions include the first Chief Innovation Officer at Boston Children’s Hospital, Biogen’s VP of Innovation and External Partnerships, and VP of Innovation and Advanced Technology at Kaiser Permanente. Follow Naomi on Twitter @NaomiFried.
In the next few years, our healthcare experiences will be radically different.
When we’re sick, our first line of care will be to tap our mobile phones for diagnosis and advice. We’ll avoid our physicians’ offices and instead get care at home using technology to communicate with care providers. Digital tools will effortlessly collect clinically important information about us, enabling providers to make better, quicker decisions about our care. Digital solutions will remind us to take our medicine – and our social network will nudge us when we forget. Games and digital solutions will drive us to be active participants in our own care.
In short, digital health will be the dominant form of non-acute care.
Many investors are starting to get it. Venture capital investments of $2 million or more in digital health reached a record-breaking $3.5 billion in the first half of 2017 alone. To put that in perspective, for all of 2016, Rock Health recorded $4.3 billion in deals that size. The field is growing by leaps and bounds.
What is Digital Health?
But what, exactly, is “digital health”? Simply put, digital health uses technology to deliver care and information to patients and providers that is more convenient, cost effective, and personalized. It takes advantage of a variety of hardware (such as cell phones, computers, cameras, and sensors) and software (including mobile apps, games, computer programs; and social media.) Digital health has the potential to improve outcomes, decrease costs, improve efficiency, and deliver care and information in entirely new ways.
Yet the explosion in digital health technologies has created confusion about this broad field. For consumers, there are more digital “health and wellness” solutions than any other type. That’s why, when many people think of digital health, their minds turn to the ubiquitous activity trackers that dangle from our wrists or the nutrition and weight management apps that fill our smartphones.
But many of these trackers and apps, which are easy to build and require no regulatory oversight, have little clinical impact.  Last year, the head of the American Medical Association went so far as to label them "digital snake oil." More recently, the CEO of a healthcare investment firm declared that “Digital health is dead.”
They’re both wrong.
What’s worse, such pronouncements distract us from the tremendous potential and transformation digital solutions can bring to healthcare. They’re right about one thing, though: consumers, healthcare providers, and investors are confused about what digital health is. They think of consumer wellness apps when determining that digital health is of little value.
There’s much more to digital health than wellness apps, though, and the clinical opportunities for digital health are immense. Today, however, healthcare providers and investors have a hard time distinguishing between the froth and technologies that add true value. Confusion still reigns.
Digital Health Framework Reveals Value
There are many exciting, innovative, and game-changing solutions within digital health. What’s missing is a way to understand the value of digital health – a way to categorize and identify important new digital health solutions. We need a framework to guide our exploration of the exploding world of digital health, so we can see clearly which solutions offer high impact and high value, and which do not. Without a framework to understand the landscape of digital health, key stakeholders, including investors, miss opportunities.
To that end, I’ve developed a structure to guide us through the vast and growing field of digital health. From the patient’s perspective, digital health solutions come in many forms: digital patient care, education, health and wellness (where we find those trackers and fitness apps), and transactional or administrative functions.
Of the many types of solutions, digital patient care holds the greatest promise for improved outcomes and transformed healthcare. It’s made up of four categories that track with a patient’s healthcare journey:

  1. Diagnosis and Evaluation. Providers can use “clinical-grade digital information” to evaluate and make decisions about patients. This digital health data is collected from or about a patient and acted on by a physician. Physicians can look forward to using a trove of new, highly useful data generated from digital tools to help manage their patients. Examples include digital tools that provide cognitive testing or measure gait for patients with neurodegenerative diseases.
  2. Virtual patient care. Delivering patient care through virtual, digital means includes telehealth and remote patient monitoring, which allows patients to get care at home, work, or school. The convenience of a virtual visit delights patients. For example, parents and kids appreciate having a pediatric visit conducted via video conference at home, rather than in-person. Within virtual care, remote home monitoring for chronic conditions, such as diabetes and congestive heart failure, is booming.
  3. Digiceuticals. These “digital pharmaceuticals” are digital therapeutics that are administered through apps, games, or software to treat a patient’s condition or disease. Apps are available to treat depression, attention deficit disorder (ADHD), insomnia, panic disorder, chronic pain, and substance abuse. For more and more conditions, we can now say, “There’s an app for that.”
  4. Medication compliance. These apps, sensors, games, and even “ingestibles” are next-generation technologies that remind patients to take medications and provide doctors with information about compliance. Digital health will make adherence to a medication regimen easier – and maybe even more fun – for patients.

In the future, I’ll be delving into each of these categories, so bookmark this site and check back for more information.
Structure Your Digital Thinking Now
We are rushing headlong into a future where care is delivered digitally. In the next few years, we can look forward to the full flowering of the digital health revolution. Patient care will improve, becoming faster and cheaper and changing in ways we can’t even imagine today.
It’s time to prepare for the future, organize our thinking, and focus on the high-value solutions in digital health.