Building the Evidence for Digital Health- A Framework

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This week I am attending the Health Experience Design Conference in Boston, hosted annually by Mad*Pow. Many speakers have referred to the need to develop and evolve the evidence base that design informs in the digital health space. We are at an exciting inflection point where health needs to innovate beyond the current state- I am personally excited by the prospect of service design being a key ingredient in how we deliver the health care of tomorrow. More and more health systems are engaging patients in designing ways to support them on their journey whether their health issues are acute or chronic.

A new paper by Abhinav Sharma and colleagues from Duke in North Carolina published in the Journal of the American College of Cardiology outlines a structure for how digital health technology can build the evidence base to deliver better care. The paper is a report out on a think tank held in DC in late 2016.

The proceedings produced a framework for how various stakeholders can engage to leverage digital health technology in healthcare delivery and clinical trials. The authors acknowledge success will be contingent on broad and complex partnerships between payors, regulatory agencies, industry, patients, healthcare providers, academic researchers, technology developers, and professional societies.


The authors report the functions each partner can lead. Payors can develop value-based payment models which will improve quality of care, industry (pharma) can conduct research and development and integrate solutions into existing pharma/device models, Regulatory agencies can develop standards for digital technology, and patients can advocate for solutions and supports that put them at the center of care rather than being passive recipients. Health care providers can best determine how the digital technology can be integrated into clinical workflows and how electronic medical records can make it easy to deploy the solutions and track results. Academic researchers can conduct efficacy and effectiveness research and share learnings rapidly. Technology developers work with patients and clinicians to identify where gaps in knowledge exist and co-create ways to close those gaps. Finally, Professional Societies can develop the standard of evidence for digital technologies and also build registries to track data over time.

It is clear that a shared language and shared understanding will be needed for all this to succeed. One could argue the recent appointment of Atul Gawande to lead the Amazon, JP Mogan, Berkshire Hathaway health company may genuinely deliver on the promise of health care disruption. All eyes will be on this endeavor as it unfolds. The framework outlines above may inform how we move forward to create a more affordable health care system in the USA as of today, medical debt is the number one reason for bankruptcy so change is welcome.

Thanks for reading- Trina
(Opinions are my own)


Using Digital Health Technology to Better Generate Evidence and Deliver Evidence-Based Care

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