We need to systematically evaluate digital health technologies

An old colleague once told me: “When you assume it makes an ass out of u and me.”

Many of us would consider being an ass a bad thing.  If so, why are we making so many assumptions about digital health?  Belief in the power of digital technologies to solve a host of pressing problems in health has us poised to devote billions of dollars to their adoption and development.  But are these beliefs based on solid evidence or wishful thinking?  I’m afraid it’s the latter.

Given the austerity trends currently shaping the health industry, it is somewhat surprising that digital has gotten a free ride.  Partly due to the Affordable Care Act (ACA), physicians, hospitals and pharmaceutical companies are being financially incentivized to deliver high-quality, evidence-based care, products and services.  No matter what happens to the ACA in the Supreme Court, physicians will continue to be under ever-increasing pressure to adjust to this new financial reality.

Clearly, there’s a big focus on measuring and favoring medical interventions with proven benefits.  Given this, whither evidence-based digital health?  For the most part, we don’t know.

Why this state of affairs?  One major reason is that digital health technologies are in their infancy.  The health industry has struggled to catch up with consumers who have embraced online, social and mobile technologies.  Another has been psychological.  Technology has improved our lives so we assume it will do the same in health.

The time to begin systematically evaluating digital health technologies is now.  The costs associated with obesity, smoking, depression cancer and other conditions are staggering.  Not knowing whether mobile, social media and other digital tools can help people prevent or better manage disease is a big problem.  These technologies could deliver tremendous economic benefits to the public and private sectors.  Yet, if we don’t measure we won’t reap the rewards.

Some have begun answering the call to build the foundation for evidence-based digital health.  For example, Johns Hopkins recently launched a project designed to determine which mobile applications actually improve health and wellness.  The social network PatientsLikeMe has conducted research suggesting joining the site significantly increases medication adherence.  We have contributed by developing a framework for measuring the economic benefits associated with social, mobile and online content that activates or sustains positive health behaviors.

However, in our quest to measure digital health, we must avoid the mistakes of the past.  One criticism of evidence-based medicine has been the slow pace of research and translation of study findings to clinical practice.  To prevent this we must develop and use measurement methodologies that are appropriate for digital and allow for the rapid collection and dissemination of data.

In the meantime, we must not allow the fact that many digital health technologies are unproven inhibit experimentation.  We should follow the mantra of “first innovate, then measure.”  Doing so will encourage the spread of new, but proven digital tools that improve health and well-being.

If we don’t measure its luminosity, we’ll never know how bright digital health’s future will be.

Fard Johnmar is founder and president of Enspektos.  He blogs at Walking the Path

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  • RAStegwee

    One of the most interesting differences between evidence based medicine an health technology assessment in the traditional sense and the application to meHealth technologies is the fact that in a number of cases we do not have to justify an extra cost of new medication or medical technology. If meHealth applications are designed well the total cost for the treatment can be significantly less. However, this needs to be established on a case by case basis and can differ greatly across applications! On the other hand, meHealth applications can be easily used as an instrument to constantly monitor the effect and outcome of the treatment. This opens up novel ways of establishing evidence!