Roadmap For the Digital Transformation of Health Care: Lead, Facilitate and Partner

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Cardiovascular medicine is inherently "high-tech." The profession has a long history of adopting new technologies (e.g., transcatheter valvular therapeutics) to improve patient outcomes.

However, health care delivery to improve efficiency and optimize prevention and health outcomes has not advanced in the same way. As a result, the U.S. still holds the title of the most expensive, least effective health care system among developed countries.

With cardiovascular disease a leading driver of health care costs in the U.S., we need solutions to improve care delivery.

Enter digital transformation. Successful digital transformation is not simply using a new digital technology – such as an app or biosensor. It's definitely not just having an electronic health record (EHR).

In fact, some would argue that EHRs are an example of failed digital transformation, increasing inefficiency and dissatisfaction.

Successful digital transformation is the adoption of technologies that make you better at what you do, whether that's improving efficiency or optimizing health and health outcomes.

Outside of health care, major sectors of the economy have undergone some form of digital transformation, such as finance, retail, entertainment and transportation.

Disruption is sexy, but given the complexities of the market, cooperation is more likely to move the needle for transforming health care.  
— Rob Coppedge, CEO of Echo Health Ventures

Companies like Cisco have cited that successful digital transformation can yield major benefits in client satisfaction, engagement, system efficiency, and employee efficiency and satisfaction.

The time is ripe for the digital transformation of health care delivery.

Kamal Jethwani, MD, MPH, senior director of Connected Health Innovation at Partners Healthcare in Boston, MA, has suggested that health care digital transformation should be centered on virtual care, remote monitoring (e.g., wearable or nonwearable biosensors), and "artificial intelligence-driven care" – using advanced analytics like machine learning to improve image interpretation, risk prediction, and support diagnostic and treatment decisions.

The technology for this largely already exists. Hundreds of digital health start-up companies, in addition to the large tech companies, with billions of dollars invested to date, are in the health care delivery market.

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Yet, a number of barriers have held back the transformation.

A few examples: too many "technologies in search of a problem to solve"; lack of payment model alignment; too much focus on data (e.g., continuous physiologic monitoring) and not enough on clinically actionable information; and significant barriers to getting information from digital tools into clinical workflow. Plus, it is a challenge to know which digital technologies to choose.

So how do we "get there" with digital transformation for cardiovascular care? In 2017, we published a "roadmap" in the Journal of the American College of Cardiology – a health policy statement on innovation in the era of digital health, along with an editorial outlining the ACC's new, ambitious innovation strategy. The core of this strategy centered on three pillars: lead, facilitate and partner.

Two years later, ACC has a rapidly growing Health Care Innovation Member Section, has become a thought leader in the digital health space, and has developed multiple successful partnerships. These partnerships are both direct with technology companies – including co-development of digital solutions – and with other innovation programs and innovative organizations in the U.S. and globally.

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Partnerships between tech, clinicians and patients are key. Alone, we cannot accomplish the successful digital transformation of health care. And this is not just about disruption, as health care is fundamentally different than other sectors of the economy.

Rob Coppedge, CEO of Echo Health Ventures, said it best in a 2017 CNBC commentary: "Disruption is sexy, but given the complexities of the market, cooperation is more likely to move the needle for transforming health care."

As clinicians, we can provide unparalleled clinical and scientific insights into the most pressing problems and inform technological solutions that can move us forward. We can also facilitate use and testing of new technologies, whether through our own practices and institutions or through community and networking activities offered by the ACC and MedAxiom.

The ACC innovation strategy is still young, but we are already showing that we can have a key role in the digital transformation of health care.

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This article was authored by John S. Rumsfeld, MD, PhD, FACC, ACC's Chief Innovation Officer and professor of medicine at the University of Colorado School of Medicine, and Rashmee U. Shah, MD, MS, an associate member of ACC and assistant professor in the cardiovascular medicine division at the University of Utah Health.

Keywords: ACC Publications, Cardiology Magazine, Developed Countries, Personal Satisfaction, Delivery of Health Care, Organizational Innovation, Health Policy, Health Care Sector, Electronic Health Records, Health Care Costs, Artificial Intelligence, Cardiovascular Diseases, Monitoring, Physiologic, Transportation, Biosensing Techniques, Innovation

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