How do we unlock the potential of digital health?
‘Digital health’ has been heralded for some time as a new era in patient outcomes, offering increased access to care, enhanced clinical decision-making, and greater efficiency in healthcare delivery.
There have been successes – automating data processing to reduce waiting times; wearable sensors and apps for remote patient monitoring and chronic disease management in conditions like diabetes; and remote consultations between patients and doctors, some of those accelerated by the COVID-19 pandemic.
Yet, these last ten years are also littered with failures.
Health tech company Theranos may be an extreme example, after its CEO and president were imprisoned for fraud, but ensuring transparency and data privacy has proved difficult for health tech so far, with one Canadian study finding 79% of mobile health apps were sharing data outside of the app, with varying degrees of transparency.
Adoption, too, is not guaranteed, with the failures of Google Health or Microsoft Health Vault blamed on a lack of interoperability, ultimately limiting their usefulness.
Regulatory troubles are also common, as with ancestry tech company 23andMe’s failure to gain FDA approval, which its founder said was due to the regulatory issues being “new territory” for both the government agency and the company.
And scalability has seen off many, with the demise of US health insurance exchange website Healthcare.gov, blamed on an underestimation of the computing power required for the necessary data processing.
So, how do we tackle these issues and unleash the potential of digital health? We believe there are five elements in place in the UK currently which could hold global lessons for how we can address some of the barriers.
1. Clinically verified science
British universities are at the forefront of cutting-edge, applied research, with experts continuing to work in-clinic, as well as leading data-driven laboratories. Edinburgh professor and consultant cardiologist Nick Mills, for example, has created an algorithm for early diagnosis of heart attacks. And clinician scientists Jonathan Fallowfield and Tim Kendall led the co-development of a data commons for liver disease research that is enabling new industry collaborations.
One new digital tool out of Edinburgh to aid earlier diagnosis and monitoring of neurodegenerative diseases has 600 patients and several industry partners involved in design and testing, supported by Edinburgh Innovations, the University’s commercialisation service.
Involving patients, doctors, and industry in product and service design will ensure clinical validity and better adoption rates.
2. Data access and compatibility
Unusually in the world, the UK’s National Health Service (NHS) assigns an individual patient number at birth, meaning historic, linked health data is obtainable, going back as far as the 1970s in the case of Scotland, which has one single health provider. This comprehensive data can also be linked to other national data sets, such as the biomedical database UK Biobank or the Future Health research programme, as well as anonymised for use as synthetic data.
3. Good data governance
The UK has successfully focussed on strong data privacy and security, through initiatives such as the Scottish Safe Haven Network, which provides a secure platform for the use of NHS electronic data in research feasibility, delivery, and drug monitoring, with trained staff operating to agreed principles and standards. DataLoch, part of South East Scotland’s Data-Driven Innovation programme, brings together routine data collected as part of people’s day-to-day interactions with health and social care services, while protecting the individual identities of those involved. Extracts can be made available to researchers from the public and private sectors and NHS staff in a data-secure environment.
Similarly, the UK is a world leader on AI standards and regulation, all of which helps to build public trust in the benefits of data sharing.
4. Digital health scalability relies on significant AI and compute capabilities
The University of Edinburgh has been working in AI for 60 years, and will host the UK’s first exascale computer from 2025, helping researchers to improve products and services including drug discovery and engineering biology. Edinburgh recently announced the Causality in Healthcare AI (CHAI) hub, which will develop new ways of unearthing important links in complex health data.
5. New product and regulatory pathways
These are crucial, and we need novel collaborations, instead of the same old silos, to accelerate this development. Our two organisations are both part of the NEURii collaboration launched last year, which brings together global pharma (Eisai), philanthropy (Gates Ventures), research and data (the University of Edinburgh, national health data science organisation Health Data Research UK, and medical research charity LifeArc) to harness data and digital to tackle dementia.
The organisations will work together to remove the barriers for three pathfinder projects launching this year, be they regulatory, financial or data access-orientated, to develop the proof of concept for market-ready digital products and services within a year of launch. Many of the pathways they develop will be adaptable for others.
The unique interplay of these factors in the UK – of translational research expertise; high quality data sets utilised in a trusted environment with strong governance; AI capabilities, and an entrepreneurial, collaborative mindset - could help finally harness the huge potential of digital and data to improve patient outcomes globally.
About the authors
Dr Ricardo Sainz-Fuertes is global director of digital health solutions at Eisai, Co. He is a psychiatrist, neuroscientist, and pharmaceutical physician with a special interest in digital biomarkers and digital therapeutics (DTx).
Dr Andrea Taylor is interim CEO of Edinburgh Innovations, the University of Edinburgh’s commercialisation service. She has over 25 years’ experience in innovation, commercialisation, and deal-making in the life sciences and deeptech sectors across academia, industry, and the public sector.
