Digital Health — Use Cases and Enabling Technologies
We all have the experience of being sick and being treated by doctors or other healthcare professionals. Usually these experiences include getting an appointment, waiting for a doctor, buying medicine, claiming health insurance, etc. Digital healthcare aims at using technology to simplify these procedures and make healthcare more accessible.
Let’s take a few examples and see how technology can be/has been used in this domain..
Getting a doctor’s appointment
This is a very common digital health use case. Most countries have online appointment systems where patients can look up doctors by name, specialty or hospital, and make an appointment for a convenient time. These services may include mobile notifications on doctor arrivals, provisions to collect more information about the patient and make those available to doctors/hospitals (e.g. COVID vaccination status) in order to reduce waiting times.
Explaining health conditions to doctors
This might not be a comfortable experience for some. We are not sure whether we can cover all symptoms during a conversation with the doctor. Also, if we are visiting a new doctor, she might not know our past illnesses and treatments.
This is where Electronic Health Records (EHR) can play a big role. Digital health systems (specifically EHR systems) collect and store our medical records securely and make those available to healthcare professionals based on our consent. This allows doctors to browse our medical history during (or before) the consultation. In addition, it is also possible to integrate data from medical devices (e.g. blood pressure meters) and wearable devices (e.g. heart beat, body temperature, physical activity) with digital health systems, so that doctors can know up-to-date health conditions even without speaking to patients.
Doing a medical test
A doctor may ask us to do a few medical tests (e.g. full blood count, X-Ray, ultrasound scans, etc) as a part of the diagnosis process. With digital health systems, doctors can assign these tests to the patient’s profile, so that patients can go to any laboratory and get the required tests done by just presenting the identification. Once test reports are ready, laboratories can attach test reports to the patient’s digital profile and relevant doctors can view them subjected to the patient’s consent.
Buying medicine
Integration among multiple entities is required to facilitate this scenario. A list of approved/available medicines can be made available to doctors via digital health systems. After completing diagnosis, doctors can select required medicines from this list and assign those to patients’ digital profile. Patients can simply go to a pharmacy and provide their identification, so that pharmacists can browse medicines assigned to the patients profile and issue those accordingly.
Of course, it is necessary to have additional security measures such as patients’ consent for exposing prescribed medicines to a particular pharmacy (for a limited time period) and ability to selectively expose certain medicines. As you can see a centralized medicine registry and a user profile management system is required for implementing this scenario.
Claiming health insurance benefits
Once our treatment is complete, we should be able to claim associated healthcare costs from our insurance policy. In a digital health environment, this should be a seamless experience for the patient.
All healthcare providers (hospitals, laboratories, etc) involved in a certain treatment can access patients’ insurance policy details via their digital profile. Patients can see all expenses occurred at various healthcare providers and select which expenses need to be claimed. Such selected providers can make relevant treatment and cost details accessible to the patients’ insurance companies. Then insurance companies can assess available details and pay selected providers.
Enabling technologies
We have so far discussed a few scenarios where digital health systems are used. Now we can focus on some key technologies that are vital for implementing such digital health systems.
Connectivity
Above examples show that almost all digital health implementations need connectivity among multiple entities. Examples would be connections between patients’ mobile phone and online appointment system, between hospital and insurance company, between electronic blood pressure meter and EHR system, etc. In order to facilitate such connections, various networking technologies are required such as LANs, mobile networks, wireless networks, Internet, etc.
Digital identity and profile management
Usually digital health services are associated with patients’ digital health profile. For example, in order to implement an electronic prescription system, both doctors and pharmacies need to access prescriptions associated with patients’ digital profiles. Ideally, this has to be implemented as a centralized digital health profile system (e.g. by governments). However, if such a centralized system is not available, it may be required to federate among multiple identity/profile systems and share health information.
Authorization and consent management
Patients should be the owners of their health records. Therefore, patients should be able to decide who can access which parts of their health records. This requirement has to be covered by consent management technologies in digital health systems. For example, a patient might want to allow an ENT surgeon to access her chest X-Ray but not the blood report prescribed for another treatment.
Security
Given the sensitivity of health records, security is an important factor in digital health. Whenever medical information is collected, systems should store those securely, transfer securely only to authorized parties and retain those only for the authorized time period. In addition, each access to health records needs to be logged for auditing purposes. For example, systems should always encrypt health data before storage and use TLS for any health data transfers.
EHR systems
Most digital health use cases require access to patients’ health records, usually stored in EHR systems. However, there can be multiple EHR systems involved in certain scenarios as healthcare providers have their own EHR deployments.
IoT
Connected medical devices and wearable devices can play a major role in digital health. These devices can provide continuous and up-to-date health data about both local and remote patients, which facilitates quick and accurate diagnosis. In addition, availability of large amounts on data from those IoT devices can be used to detect patterns and train AI algorithms.
Healthcare systems integration
Multiple systems, devices and inputs from healthcare professionals need to be properly integrated in order to provide a simple and convenient experience to patients. For example, implementing a complete healthcare scenario may require integrating multiple EHR systems, medical devices, pharmacy systems, insurance claim management systems, etc. Such systems may use different protocols, message formats and communication patterns. All these differences have to be bridged and the flow of relevant use cases needs to be implemented using healthcare integration systems.
Practical user interfaces
Given that users of digital health systems are mostly healthcare professionals, user interfaces need to focus on making information accessible with minimum user effort. For example, a doctor cannot spend time searching for health data about his next patient. Instead, ideally this information should appear automatically on the doctor’s screen before the patient shows up.
