What is Digital Health?

What do you think of when you hear the words Digital Health? And what could that mean to an anesthesiologist? 

In this episode, I try to explain my thoughts when I hear those words. It's a pretty broad definition - that can include your health provider going paper-free, telehealth options, artificial intelligence, and apps on your phone.

These technologies won't replace the need for healthcare professionals, but whatever digital health means to you, healthcare IS changing. So I hope to get you as excited as I am about how digital health can increase access, improve efficiencies, and empower patients to learn more about their health.

Topics include:

• A conversation I had with a woman who questioned the relevance of talking about technology as it relates to healthcare
• My definition of what Digital Health means
• Examples of digital tools that you might come into contact with 
• Examples of digital tools that you might already have seen in a health context
• Why does this matter to an anesthesiologist? And why am I so excited about what Digital Health can do?

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Disclaimer
The information in this podcast is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or treatment.

The personal views expressed by guests on Women's Digital Health are their own. Their inclusion here does not constitute an endorsement from Dr. Brandi, Women's Digital Health, or associated organizations.

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Transcript

As a prelude to episode three, which is about, you know, what is digital health? After I created episode two, I had a very interesting conversation with a woman yesterday that I wanted to bring in here to kind of describe the philosophical dilemma that I have as I talk about technology and digital health. So this woman who's she's extremely intelligent woman. She's got her own marketing firm and she was telling me this story about she had a smartwatch and she's working out with her trainer and her heart rate goes up to 200 and she's feeling short of breath and the smartwatch starts asking her, you know, do you have chest pain? Do you have shortness of breath? Because if so, you need to get to the emergency room. And she recognizes the urgencies of the situation and is making arrangements to get to her nearest hospital, but she's got a son. She's a single mom and she's got to take care of her son. So instead of going immediately to the emergency room, she picks her son up and then she makes sure that he's tucked in. And at this point, it's feeling even more short of breath. It's feeling more like, I can't even get up the steps. She immediately goes to the emergency room. They tell her, yeah, you are actually having a heart attack. And at the end of the conversation, she was sharing that story to say, Dr. Brandy, I want you to understand that this is my reality. These are the social factors that impact my ability to access care. I am a mom and other things sometimes take a priority over my health. And to be honest with you, when I heard her tell this story, sort of the underpinnings of this story, honestly, I felt like she was saying like, Dr. Brandy, I think you're out of touch with reality. I think that when you're talking about technology, you miss the fact that I don't necessarily have the same access. to care that everyone else has. And I can't just drop everything and take care of myself because other people are depending on me. And I went into a panic When I tell you a panic, I caught up everyone. I caught up my health equity experts, Dr. Mary Fleming. I talked to experts in the fertility space. I was talking to everybody. Like, am I being elitist talking about digital health? Am I being elitist when I'm trying to explain to you that the ecosystem of health care is changing? It's already changing. and that my goal is really to express to you how to use these technologies and not to be shocked when you find out that your health encounter will be changing, that you're getting the same 15 to 30 minutes with your doctor, but they expect you to know more. There's assumed expenses, including increase in co-pays and out-of-pocket expenses that come along with your care. And that in order for you to get access to information, you're gonna have to find more resources on your own, and that these things won't be, they won't be given to you. And I don't have all the answers. I can't remove all the barriers. And that's pretty much the conversations that I was having with my friends is accepting that I cannot remove all these barriers. My job is to give you the information about technologies that you can use along with your physician's expertise to give you the best chance of adapting to this new ecosystem. And I don't mean to sound as if it's a have or have not. I want you to be a part of this experience. But I recognize that there are social challenges, that there are limitations to your access, that, you know, you may not necessarily understand all that's going on. And I hope in this podcast to really be able to help you understand some of those challenges and to create a community where you can get that information. But I'm a human. I'm not going to be able to fix it all. And I just wanted to come on here before I introduce, you know, what digital health really is and what it can do to help you understand. I get you. I hear you. I understand your social challenges. I understand that there are tons of barriers. I'm just trying to remove some of them so that you can get the best experience in the health care system as it exists today. Welcome to the Women's Digital Health Podcast, a podcast dedicated to learning more about new digital technologies in women's health. We discuss convenient and accessible solutions that support women with common health conditions. Join us as we explore innovations like mobile health applications, sensors, telehealth, and artificial intelligence, plus more. Learn from a board-certified anesthesiologist the best tips to fill in some of your health experience gaps throughout life's journey. All right, so welcome back. Welcome back to episode three of Women's Digital Health. I'm your host, Dr. Brandy. And today's episode is all about what is digital health? You know, and what does that mean to an anesthesiologist to even explore digital health? Like, why does an anesthesiologist even care about any of this stuff? So to start answering some of these questions, you know, we have to define what digital health is. And simply put, digital health is exploring technology as a method to improve the quality of your health. That's all digital health means. The easiest way to think about it is going from paper to a paperless ecosystem. And that's essentially what I think the 21st century reflects in technology today is that more and more healthcare experiences are becoming paperless. And so it means that the technologies are now using your smartphones, your laptops, and your emails to exchange in health information. And that health information comes in many, many flavors. You know, the ones that we're going to be talking about here on Women's Digital Health are largely, you know, patient slash consumer focused. In other words, you are the person that's looking for a way to improve your health and you're looking for different health apps, different devices to improve, you know, how you engage with your healthcare system. But there are so many other flavors of digital health that I'll explore in this episode. But just in general, just think about digital health. When I hear the word digital health, I think of it as an academic term. It's just a way to describe and organize these various paperless forms of improving your health. And there's so many different flavors of digital health. There's mHealth or mobile health. Those are typically your health apps. There's telehealth, where you're engaging remotely. using the audio and visual technologies of your smartphone or laptop to encounter a healthcare provider or even be monitored remotely by your doctor or healthcare professionals. There's artificial intelligence where you might be seeing automated chat bots where people are engaging with automated services to describe signs and symptoms and those those platforms are helping to triage or determine whether or not you need to see a doctor or if that's something that they can help you with online. There's all these different wireless medical devices that are also under digital health, including different sensors and trackers that can offer a continuation of tracking what's happening to you even when you leave the hospital or healthcare setting. There's digital therapeutics. These are like, you know, a combination of medical treatments and therapies that combine cognitive behavioral support to help you make a behavior change. Suppose you have like diabetes, And, you know, you need to take a certain medication. Well, digital therapeutics just describes, you know, the support that is now offered digitally to help you create the behavior change. And so a lot of these therapies are happening rapidly. A lot of these different digital health technologies, they are evolving so quickly. And it's the reason why I started this podcast because I'm like, whoa, like they're coming out so fast that I don't have an Instagram or even a newsletter that's big enough to capture everything that's going on. But I do hear time and time again from many of you are saying like, man, my health care experience is changing. My health care system just came out with this app. I have to now, you know, get my appointments through this app. I pay my bills through this app. I have to message my health care professionals through this app. And that's just scratching the surface. And so I really want to help you understand that, you know, that's the beginning. You're going to start to see many other changes in the way in which you engage the healthcare system. Hey listeners, it's Dr. Brandi. Thanks for listening to this episode of Women's Digital Health. Subscribe to Women's Digital Health on your favorite podcast platform. If you want to know even more about how to use technology to improve your health, subscribe to our newsletter on womensdigitalhealth.com. Follow us on Instagram, Facebook, YouTube, and LinkedIn. Enjoy the rest of this episode. All right, so that's the definition of digital health. So the second part of this is, you know, why does an anesthesiologist care about digital health? What does this, what does all of this even mean to an anesthesiologist? And I'll start by saying that all of these digital health technologies, you still will need the advisement of a health professional. They are not standalone. You know, we are seeing more and more of the FDA even cracking down on some of these digital health devices that are promoting this idea that you can take care of your health on your own. And it's, it's not true. You still need the advisement of a healthcare professional to guide you in the best way to use these technologies. The difference now is that, you know, most of the care that we were delivering before required you to be in person for all of your visits. And without a doubt, I'm not saying that we're all going virtually and you will never need to go into a clinic. That's just not true. That's not going to happen. You will still need some degree of physical encounters. But what digital health, when it is safe and when it is used along with a healthcare professional offers, is this continuum of care. You can see and engage in your health care beyond just what happens in the clinic. And that's the whole point is to, first of all, increase the accessibility that people have. reduce some of the inefficiencies like you having to come in for every single visit. It can reduce the costs in care because maybe you don't necessarily need to be admitted to the hospital now. Maybe we can monitor you remotely and really address some of these prevention challenges that many of us are having simply because the education is only limited to the visit. If we can use some of these technologies to reinforce some of these behavior changes, you know, throughout your life, well, you, we may be able to kind of catch some of these things before they become full on crisis conditions. And so anesthesiologists, as an anesthesiologist, I'm like super excited about this because it means for me that we can have more to the story of who you are. And I'll just use blood pressure as an example. So last time we were talking about what blood pressures, heart rates, and blood sugars really mean. And I'm going to give you a little bit more context to what anesthesiologists do and why I'm so excited about this. So as I said before, anesthesiologists, you know, our job is to put you to sleep and wake you up. Part of doing that means that I have to make a decision before you fall asleep as to whether or not it's safe to even do it. Before I even give you the happy juice, I got to make a decision before that says yes or no, is this person healthy enough to put you to sleep? So that involves a few forms of digital health that are not, that you may not be aware of. The first is data exchange, right? So Another flavor of digital health is actually electronic medical records. So I, as a physician, I'm putting in data into a computer and it allows me to put that information in, but it also allows me to receive historical information about you from other doctors. And that's super important when I'm trying to figure out who are you before I decide to put you to sleep. The second thing that I'm also doing is thinking to myself, well, what was the most recent blood pressure? Because blood pressure really matters when you're going to surgery. I can't emphasize enough, tracking your blood pressure on your own in between your visits is so helpful. And as an anesthesiologist, when I look at digital health, I'm like, Wouldn't it be nice if a person felt empowered enough to know what their blood pressures were before I put them to sleep? So if you knew your blood pressure was above, you know, 130s or 140s, and you knew that there was an opportunity, there was time for you to reach out to your doctor and say, Hey doc, I've been checking my blood pressures at home and they're a little high. Maybe there's an opportunity for you to have a conversation with your doctor about increasing your medications or adding new medications to really give you the best chance to have a good outcome. When your blood pressures are high before surgery, that can impact your risk of having a good outcome. And if there's any opportunity to track that before you go to sleep, let's get on board. So I'm super excited about that. In addition to that, in the operating room, a large part of our job is looking at your data. I'm looking at your blood pressures, heart rate, your oxygen, and other variables for hours, right? And it's telling me a story about what's happened before you even came into the operating room. I mean, it is eye-opening how much I know about what's going on with you just by looking at the patterns of your vital signs, your oxygenation, and your blood pressure, and your heart rate, and your carbon dioxide, and all of these other things that I know about you, even though this is the first time you've ever even encountered me. And I want you to have that information. I want you to own, you know, that, hey, like this is my data. This is what my body is producing. And I have just as much access to understanding that as the doctor does. And in fact, if I know more, I can change more. I can I can do more to improve my health. So I'm super, super excited about all of the new opportunities that digital health offers. I also truly believe that these digital health devices still need the support, still need your health care professional as a part of your team. They are not standalone. And many of them require a lot of safety evaluations that, you know, in this podcast, we will we will discuss, including privacy, security challenges and their true effectiveness. And a lot of the guests that we even have on you know, point to trusted sources as a way in which to delineate those that, you know, may need to evolve, may need to include improved safety and security and privacy needs that digital health devices will need as they grow. But nonetheless, this is a great opportunity. This is a great opportunity to increase our access. This is a great way to improve efficiency and effectiveness. And it's a great way to empower people to learn more about their health beyond what they're experiencing in a healthcare setting. So that concludes episode three. I hope you learned a lot about what digital health is, why I, as an anesthesiologist, I'm so excited about what digital health can offer, how much it can help you track and improve and understand what your own body has been doing for a very long time. And I look forward to teaching you more about how to use some of these technologies. Although I'm a board-certified physician, I am not your physician. All content and information on this podcast is for informational and educational purposes only. It does not constitute medical advice and it does not establish a doctor-patient relationship by listening to this podcast. Never disregard professional medical advice or delay in seeking it because of something you heard on this podcast. The personal views of our podcast guests on women's digital health are their own and do not replace medical professional advice.