Digital Disruption in Health Care: Implications For Clinicians and Patients

"This is a 'world is flat' moment in medicine," says Harlan M. Krumholz, MD, SM, FACC, acknowledging that the access to data through digital health is a game changer.

The digital platforms being built will provide an infrastructure for research and data generation that is "more relevant to the patient in front of us," he says, along with being faster and cheaper. People will be partners in the research team, part of the engine of knowledge generation. Key to this is that patients must have agency over all their data in their health records and in clinical trials.

Yesterday, immediately following the presentation of the Apple Heart Study, a panel of leading physicians and thinkers in the space started the conversation about what's needed to usher in the digital transformation of medicine.

Moderated by ACC Chief Innovation Officer John S. Rumsfeld, MD, PhD, FACC, they tackled evidence, patient information, clinical integration, regulatory and payment issues and more.

Many declare that digital health is the future of health care, says Rumsfeld, because it carries the promise of more efficient care, better patient-physician engagement and partnership, and better health and health outcomes.

But, what's needed to make the most of virtual care, remote monitoring, wearable and nonwearable technologies, voice technologies and artificial intelligence-driven care, and more, to harness its possibilities for a successful transformation? And what is its value proposition for patients and clinicians?

Patient Advocate Bray Patrick-Lake, director of Stakeholder Engagement, Duke Clinical Research Institute, noted that along with earlier identification of disease and novel strategies for behavior change, she sees "frictionless research participation" as a benefit to patients and clinicians.

Large, pragmatic trials not only will unlock greater insights at a faster pace, but trials with self-enrollment of patients can address the issue of disparities and help ensure a broader representation of patients.

Unlocking the potential of digital health will require generating evidence that the technologies are high-quality, safe and provide value to patients and clinicians. The Apple Heart study is an initial phase helping to understand the capacity and safety of large pragmatic trials.

Recruitment will start soon for the next step, the HEARTLINE study, which will examine the impact of the Apple Watch on the early detection and diagnosis of atrial fibrillation and the potential to improve outcomes, including myocardial infarction, stroke and death. Key to it all is generating actionable information and knowledge.

What will drive clinicians to integrate digital health and wellness into practice? Efficiency, improved patient outcomes and cost, explains Maulik Majmudar, MD, vice chair of ACC's Health Care Innovation Section, and chief medical officer at Amazon.

Look for more from the panel's conversation in Cardiology magazine.

Keywords: ACC Publications, ACC Scientific Session Newspaper, ACC Annual Scientific Session, ACC19

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