Dad used to teach me how to fill challans to withdraw money at banks. Then I taught dad how to withdraw money from ATMs. Now, I’m learning online or mobile transactions. The concept of money had existed for ages when they exchanged goods for food grains, until now when money has become virtual. By the 2010s, the digitalization of healthcare became inevitable.
Digital health is defined as “the cultural transformation of how digital technologies accessible to both caregivers and patients leads to an equal doctor-patient relationship with collaborative decision making and democratization of care”. Even when Dr. Laennec introduced the first stethoscope as a hollow wooden tube in the early 19th century, it took decades to speed the idea of improving care with an innovation. Since then, healthcare has become dependent more on technologies but neither the medical curriculum nor guidelines reflected upon this development.
So, the importance behind the theme for this years’ WORLD HEART DAY could not be understated. “Harnessing the power of digital health to improve awareness prevention and management of cardiovascular disease”.
The Paradigm shift
Internet access and smartphone penetration along with medical technologies like AI, Robotics, Genomics, Telemedicine, Virtual reality, and a large amount of open-access medical information have led to patient empowerment. Collaborative decision-making is the norm. Physicians are no longer the authority but a guide in taking decisions for the patient. Patients want to be part of it, and also involve other caregivers and fellow patients in gathering information and deciding their treatment options. ‘HIERARCHY’ in traditional medicine has changed to ‘PARTNERSHIP’ when it comes to the doctor-patient relationship. In such an era, the IVORY TOWER concept of medicine is unsustainable.
The Challenge
Digital health also leads to some ethical considerations and challenges the policymakers in a big way. Misinterpreted information, unreliable online sources can endanger lives sometimes. The risk of de-humanizing the care cannot be overlooked. Lack of participation of medical experts in digital health will only lead to the growth of online quackery.
Digital innovations in General & Cardiovascular care.
General-
1)Education: 3D modeling, AI bases platforms, Distance learning, E-library, Peer group learning
2)Out-patient clinic: Patients data processing, Tele-medicine, Rural health via online consultation, Wearable devices (ECG/BP/ Blood glucose)
3)Research: Genome-wide association studies, Pharmacogenetics and personalized medicine, Research big data
4)Hospital: E-health records, Medical image data, Billing data
5)Pharma: e-prescriptions, e-pharmacy, virtual clinical trials
Cardiac-
6)Online risk scores- Risk assessment calculators for various cardiac conditions and emergencies
7)ECG: wearable ECG device in T-shirt (smart cloth) with FBG sensor, wrist bands, etc.
AI interpretation of ECG, Implantable devices for heart rate
8)ECHO- smart auto-EF measurement with algorithms
9)Remote auscultation: cardiac and lung sounds (EKO, CliniCloud)
9)Genetic risk assessment: FUTURA genetics
10)Cathlab: Robotic Angioplasty, Real-time Intravascular imaging
The Future
Doctors have a huge responsibility in involving patients and guiding them across a mess of information wealth and a myriad of digital technologies. Innovations help remove repetitive parts of a job and let us spend more time with skills that are hard to replace such as empathy, social care, and a human touch. For today’s generation-so called “digital natives”, it is inevitable to turn to digital platforms to look for medical issues. So, failure to cope with the shift poses a threat to their health.
SCIENCE PROGRESSES THROUGH A SERIES OF PARADIGM SHIFTS WHERE A NEW MODEL CONTRADICTS AN OLD ONE, CREATES TENSION BETWEEN THE STAKEHOLDERS, AND GRADUALLY BECOMES THE DOMINANT MODEL.
Even as I’m signing off, an ECG pops up on my smartphone tagged “chest pain, opinion please?” at 1 am. As I’m trying to respond that, I got kicked out of bed already. Is this called Paradigm shift. God. Help me!
Article on Digital health- a cultural transformation in health care by
Dr. Vivek Muthukumarasamy, MD(Internal Medicine), DNB(Cardiology), Consultant Interventional Cardiology,
Dr. Mehta’s Hospitals, Velappanchavadi.