Health IT Or Digital Health? The Gary-Rule Helps!
When it’s difficult to draw a line between health IT and digital health, the “Gary-rule” as a general rule of thumb could help. It means that any tech-related issue in a healthcare setting that Gary, the IT guy can solve belongs to health IT. On the other hand, problems in the medical-technological universe, which cannot get resolved without the involvement of other stakeholders of healthcare constitute the terrain of digital health, writes Dr. Meskó in his article published in the latest edition of the Journal of Clinical and Translational Research.
It’s hard to draw a definitive line between health IT and digital health issues, although delineating a clear territory for them might help caregivers use new technologies to improve and expedite their job so that in the end they may spend more time with patients. The two areas are often intermingled while their nature and the solution they require are different on many scales. In a nutshell, IT issues impact physicians’ everyday job the most but can be dealt with in the short term. Digital health has more impact on cultural changes and entails a long-term process.
To make the difference crystal-clear for medical professionals, policy-makers or anyone interested in the future of healthcare, Dr. Meskó suggests using the Gary-rule.
If a technological issue comes up in a healthcare setting such as the antivirus software becomes outdated or the electronic medical record system stopped working, and we have to call Gary, the IT guy, as he is alone capable of solving it whatever methods he uses, it’s an IT issue. If Gary is not enough to address the problem because more stakeholders of healthcare must get involved, (e.g., letting patients bring the data of their trackers into the medical practice and merge that with electronic medical records, or allowing physicians to do remote consultations on a regular basis), it’s digital health.
Health IT – WannaCry, anti-virus software and communication failures of EMR
Do you remember the WannaCry scandal, the global cyberattack that infected 300,000 computers in 150 countries using hacking tools? It also crippled the National Health Service (NHS) in the United Kingdom. UK hospitals were shut down and had to turn away non-emergency patients after ransomware ransacked its networks. That was the complete and utter failure of the health IT infrastructure. Since that attack, not only hospitals doubled down on cybersecurity, but Microsoft also started to take cybersecurity in healthcare as seriously as never before. The ransomware exploited a vulnerability Microsoft had created a patch for two months prior, but many organizations — including hospitals — had not appropriately updated their systems before the attack.
Failures of health IT issues on a less systemic level are not as visible but could be just as crippling for patients and medical professionals. It could even endanger patients’ lives. For example, in February 2016, an anti-virus software started running on a computer that monitored a patient who was undergoing highly sensitive heart surgery in a US hospital. The monitoring equipment failed during the operation. An investigation by the Food and Drug Administration (FDA) found that anti-malware software was responsible for the failure of the equipment, as it was set to scan for viruses every hour, against the recommendation of the equipment maker. The problem, which sounds banal and devastatingly scary at the same time, can be instantly resolved by turning off the scanning function of the software. That’s health IT.
Digital health – Where robots are members of the healthcare team
Digital health issues are different in nature. Patients bring data they measure with sensors for their health or medical condition to the doctor-patient meeting and expect their caregivers to address technological questions in addition to medical issues. A medical robot can be a valuable asset to the team in a healthcare facility to deal with the labor burden during night shifts when fewer people are working the floors. While the robot can facilitate the caregivers’ job, it takes time and effort to get accustomed to a robot being a member of their team.
Medical professionals use technologies daily as medical records are being digitized worldwide, and smartphone apps are widespread. Since the dawn of digital health, medical professionals have gradually had to accommodate health sensors and internet-based services. Using digital health is a team effort. Thus the era of lonely doctor heroes will end. The success of providing health services depends on collaboration, empathy, and shared decision making. What’s necessary for the implementation of care in the digital era is a newly defined cooperation between patients and their caregivers that allows room for new technologies.
Digital health is a cultural transformation
Despite popular belief, disruptive technologies cannot bring change on their own. Social media, artificial intelligence, robotics, 3D printing, virtual or augmented reality and health sensors have no effect whatsoever without a change in stakeholders’ attitude and the structure of the system. That’s what digital health is bringing to the table.
As patients started to gain access to information through the Internet and all kinds of technologies from health sensors through VR until smartphone apps that before were only available in the so-called ‘ivory tower of medicine,’ patient empowerment was born. This made patients proactive and wish to have an equal-level partnership instead of a hierarchical dependence on their physicians. They want to take an active part in the decision-making process regarding their health and contribute data they measure at home.
This is a cultural transformation. A shift that changes the essence of the doctor-patient relationship and the entire structure of current healthcare systems. And a change that Gary, the IT guy cannot bring about to happen, only stakeholders in healthcare together can.
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