Digital Health: "It's Not About the App"

No decent digital health conference is complete without a measure of “hype deflection” in the form of a few sobering views about the realities and expectations of AI, apps, voice technology, Big Data, etc. At the recent Digital Health World Congress in London (May 8–9), these views were thankfully in evidence, perhaps most notably in the thoughts of Søren Smed Østergaard, Novo Nordisk’s Senior Director of Digital Health Commercial Strategy, whose skepticism of the loose definitions and lazy interpretations of “digital health” was offset by his obvious passion for what the industry can and should really be looking to achieve in the digital realm.

Østergaard reiterated some of the arguments from his recent article on Linked that emphasizes the importance of reaching a definition of what digital is-and what it isn’t. For Østergaard, the hype around digital health has meant that “everyone would like to have their solutions be associated with the term”. But not all solutions are digital health solutions, and, he stressed, many of the advanced technologies are not yet ready to be trusted with patients’ lives.

Apps, for example, do not “suddenly” become a digital health initiatives just because they’re directed at patients or physicians, he said. Digital health often includes an app, but it is not at all about the app. It’s about the behavior of the individual patient. Moving information to an app as a communication channel is not what digital health is about - it’s just another communication channel. For Østergaard, it is important to remember that the industry is directing digital products to patients who don’t want actually them, because they don’t want their diseases or their conditions. “I have never met a patient that would like to have diabetes,” he said. “Why is it then that that so many solutions are being developed that require the patient to engage further with their disease?” This is like “selling meat products to a vegetarian”. Instead, the industry needs to design solutions that allow the patients to disengage from their disease, to go back to “being a person and living their life”.

“When we know more about the individual patient, we can design solutions that allow the patient to engage less, and only engage, for a minimally required time, when needed”. Simply pushing more information about a disease to patients is not the answer. Patient support programs, treatment information, disease information/education, treatment support, and adherence reminders via SMS or Whatsapp are not new concepts, Østergaard says. Moving them to an app does not bring additional value. “Where additional value can be generated is when we stop talking about patients with diabetes, for example, but start developing solutions based on information on the individual patient with diabetes.” The vast amount of data will not drive the adoption of digital health, he concluded. “The revolution will start when we get reliable, high quality data streams from individual patients -not from people like the patient.”