Dr. Ashish Atreja, director of the AppLab at Mount Sinai hospital, believes that the lack of a robust body of digital health evidence is a problem. That's not an uncommon opinion. But Atreja thinks the key to improving the situation is collaboration, and at a small reception at HIMSS16 he made a plea to doctors to share their own digital health pilot data through a new data sharing initiative called NODE Health (Network Of Digital health Evidence in Health).
"We should not [have any] doctor prescribing an app until there is evidence-based digital medicine behind it," he said. "But how do we do it? None of us can do it alone, so we are launching a network. It’s an open network, which you can be part of today, and we feel ourselves like there are so many academic medical institutions, startups, and nonprofits getting together and running their pilots. But if they just do it alone there’s no supporting structures."
Atreja described it as a "clinicaltrials.gov for digital health pilots", where hospitals will share as much as they can about what they're working on in single site studies, in order to avoid duplication.
"Why do we do everything alone?" he said. "I was on a panel with Boston Children’s and Kaiser. Six of the seven pilots we were working on were the same technology! And our teams are working day in and day out on those pilots. Anything that went on in those other pilots, we don’t have to do it. We can take it to the next step."
NODE Health also has the goal of creating a framework for running these pilots in a robust and efficient way.
"It shouldn’t take nine months to bring a digital health pilot online," Atreja said. "It shouldn’t be as painful as having a baby."
In particular, Atreja said, digital health needs a standard framework for evaluating patient engagement, which is a key piece of digital medicine.
"When we started this innovation center, the goal was apps plus analytics. And I said, this is great, this is a great vision. But I think one major thing is missing. It should be apps plus analytics plus engagement, and engagement is the delivery science, which we do not measure, which we do not publish, so we do not know what is working and what is not."
Finally, NODE Health will help get the results of these pilots into journals, free of charge to the researchers.
"If there’s a multisite trial, any trial which is good, we promise to publish it for free without any access charge," he said. "Because you have done already good work, and spent so much work, we should reward it rather than charge you."
NODE Health is already sharing some evidence in a less formal way, through a blog they created last fall, in which doctors review existing digital health technology and score them on a scale of one to five based on the robustness of existing clinical evidence.