Digital Health Inside Pharma

New columnists Tina Boggiano & Doug Haggstrom explore pharma's role in digital health.

Welcome to our new column “Digital Health Inside Pharma".

This column will be an insider’s guide on topics decision makers in the pharmaceutical industry and those who see pharma as potential partners should consider when navigating the emerging digital health space.

Digital health has the potential to empower patients and their doctors to achieve longer, healthier lives, while in the process saving the healthcare system billions. This potential has seen companies rushing into this space, all hoping to capitalize on the tremendous growth opportunities. In January 2015, Rock Health, a digital health seed fund, reported that 2014 investment in digital health ventures had exceeded the three previous years combined at over $US4 billion. Investments came not just from traditional healthcare investors, but also from consumer and media giants such as Apple and Google.

With most pharma companies having a stated objective to offer value “beyond the pill,” they clearly have a role to play in fulfilling the promises of improved outcomes and efficiency using digital health approaches. But to date, aside from some modest efforts, the industry has not seemed to fully embrace digital health and has brought few workable solutions that deliver results to market.

Based on our experience with innovative digital health initiatives inside pharma, we will offer our perspectives on pharma’s role in digital health: when and why it should adopt certain types of digital health initiatives or avoid them; once committed, how can common pitfalls be avoided and how can pharma maximize the opportunities of digital health.

The main focus of our column will be digital health solutions. These are solutions that are focused on the needs of patients, and that help them, their health care providers and their caregivers to make a positive impact on their health, whether it be through behaviorial change, better decision making, or in some other way. 

Our next column will be entitled “When pharma should not build digital health solutions”. In it we will look at why pharma should choose to build and own a digital health solution and when it makes sense to enter the space in another way.

Other future topics will include:

  • The digital brains of Pharma
  • Redefining our definitions of assets and value for digital health
  • The role of the healthcare professional in digital health

We’d like to use the opportunity of this introductory article to cover our working definitions of some of the various terms that we’ll use in future articles.

Digital health terminology

The lexicon is evolving and includes seemingly competing terms such as integrated health, digital health, mHealth, telehealth, telecare, telemedicine and eHealth. Here’s an attempt to untangle these terms and to provide our working definitions for the purposes of our ongoing discussion in this forum.

eHealth is a broad term that encompasses most of the others. It also includes such things as electronic health records (EHR or EMR) and other types of web-based health information consolidation services (e.g, Apple Healthbook, Microsoft HealthVault).

Integrated health refers to the use of various tools and methods, including behavioral intervention techniques to impact healthcare in a more holistic way. However, integrated health need not necessarily utilize technology and can in fact be quite low tech, such as multidisciplinary care teams.

Digital health solutions -service-based tools and services which incorporate the engagement and holistic, person-centric approach of integrated health along with the technology, sensors, diagnostics and other tools, including mobile phones, utilized by many of the other domains described below. Digital health solutions may or may not actively involve a healthcare professional.

Telemedicine refers to the use of video conferencing (e.g., via Skype, FaceTime or other services) used by physicians to conduct remote consultations with patients.

Telehealth, also known as remote patient monitoring, refers to the use by physicians of medical equipment placed in the patient’s home to monitor a specific condition, for example when a person with hypertension regularly measures blood pressure. With telehealth, the monitoring can be limited in duration and beyond taking measurements does not necessarily involve active engagement with the data on the part of the patient.

Telecare refers to (usually home-based) sensors such as the ubiquitous “panic buttons” found around the necks or on the wrists of millions of elderly persons and can be as sophisticated as high tech smart homes. The key difference between telecare and telehealth is that telecare monitoring is usually safety-oriented used more by caregivers than physicians.

mHealth is the use of mobile phones by individuals to monitor or otherwise engage in their own health, including improving logistics and access, usually in the form of apps. mHealth is a subcategory of and is utilized by most of the domains of eHealth.

Digital health technology refers to wirelessly enabled (or otherwise connected) medical equipment (e.g., blood pressure cuffs, blood glucose monitors and Lab on a Chip devices) and/or other sensors (e.g., fitness activity monitors like Fitbit®).

Big data is a broad term for data sets so large or complex that traditional data processing applications are inadequate. In the digital health context, big data can come from a variety of sources including EHR/EMR, remote monitoring and wearable devices, genetics and diagnostics.

When we use the term, we are principally referring to the use of predictive analytics or other certain advanced methods to extract value from data. Examples include algorithms that provide insights to patients that drive behavior change, or insights to the physician that aid clinical decision-making. In the digital health space such algorithms can be subject to regulation as medical devices.

We would also like to note that we view the outcomes-focused digital health space as distinct from social media or digital marketing, the use of technology to engage stakeholders for promotional purposes such as increasing awareness and/or sales. Pharma-specific examples include electronic sales aids, and apps that provide minimal data to patients. Likewise, the application of digital technology to efficiency or quality of clinical trial data is another parallel area that we will not address in depth though as the field develops it may overlap more with digital health solutions. The reason we give these topics less attention is they are principally product-focused activities, while we see digital health solutions and the pursuit of behavior change leading to improved outcomes and efficiency as uniquely and essentially patient/user/person/human-focused.

We look forward to sharing our experience on the thought-provoking topics in this exciting space. We would also like to hear from you with any suggestions of topics you would like covered and welcome any comments.

A trained engineer and avowed gadget geek, Tina Boggiano has over 20 years of commercial pharma experience, with the past five years spent in commercial and product development roles in digital health initiatives. Tina understands both the technical as well as the human sides of digital health design and she possesses unique insight into the challenges pharma companies face when trying to innovate in this promising and evolving space.

Doug Haggstrom, a trained chemist and engineer, worked in Drug Development before venturing into a career in Strategy, Media and IT development. He has worked within and advised companies ranging from multinationals to startups. He has most recently been advising a developer of patient tools and supplier to the Pharma industry. He is able to bring influences from outside the industry and translate them into a pharma context.

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