Copied Notes About Digital Health

1. DIGITAL HEALTH- An
understanding for Nursing
students
Dr.Puvaneswari.K
Professor
Dept of Fundamentals of Nursing & Research
Narayana Hrudayalaya College of Nursing, Bangalore

3. “I think the biggest innovations of the
twenty-first century will be the
intersection of biology and technology”
Steve Jobs

4. Objectives of the session
 Definition- Digital health
 Driven force
 Goals/Objectives
 Digital transformation
 Future of Digital health in India
 Digital health and COVID-19
 Advantages /Disadvantages
 Challenges

5. INTRODUCTION
e- Health-
(1990 )
m- Health
(2010)-
Digital
Health
(2015)

7. DEFINITION- Digital health
“A broad umbrella term encompassing eHealth,
as well as emerging areas, such as the use of
advanced computing sciences in ‘big data’,
genomics and artificial intelligence”. (WHO)

8. Big data
 Big Data can collect all the data / information on what
constitutes a disease - right from DNA, proteins, and
metabolites to organs, organisms, cells, tissues, and
ecosystems.
 Big data analytics
 To detect spreading diseases earlier
 Generate new insights into disease mechanisms,
 Monitor the quality of the medical and healthcare
institutions
 Provide better treatment methods

9. Genomics
 Sequencing and analysis of an organism's genome
(entire DNA).
 Genomics investigates how a person's biological
information can be used to improve their clinical care
and health outcomes ( through effective diagnosis and
personalised treatment).
Eg heart disease, asthma, diabetes, and cancer

10. Artificial intelligence
 Artificial intelligence (AI) refers to the simulation of
human intelligence in machines that are programmed
to think like humans and mimic their actions.

11. Future of the health industry is a combination of
technology and traditional approach which we
can call as a hybrid model.

12. DRIVEN FORCE IN INDIA –
Digital health
 Lifestyle diseases
 Ageing population
 Rising income levels
 Increasing access to insurance
 Growing health awareness.

13. Goals/Objectives of digital
health
 Prevention of disease
 Lessens the healthcare costs
 Customization of medicines as per patient
requirements
 Monitoring and managing chronic conditions.
 Enhancing and boosting access
 Expanding and improving the quality of healthcare
 Facilitating the individuals at best

14. Digital Transformation in health
ELECTRONIC HEALTH RECORD
ROBOT ASSISTED SURGERY
SELF MONITORING DEVICES
IoMT
mHEALTH
DIGITAL
HEALT
H
TELE MEDICINE
ORGANS ON CHIPS

15. 1.TELE MEDICINE
The delivery of health care services, where distance is
a critical factor, by all health care professionals using
ICT for the exchange of valid information for diagnosis,
treatment and prevention of disease and injuries,
research and evaluation, and continuing education

16. Aspects
 Tele-Radiology (radiological patient images- x-rays, CTs,
and MRIs)
 Tele-Nursing (Delivery, management, and coordination of
care and services)
 Tele-ICU ( real-time audio, visual and electronic means
and health information )
 Tele-Consultation
 Tele-Surgery (Remote surgery )

17. Advantages of telemedicine
 Saving of cost and effort especially of rural patients
 Providing timely and faster access.
 Maintenance of records and documentation
 Patient’s safety, as well as health workers safety
 Telemedicine can also enable the availability of vital
parameters of the patient available to the physician
with the help of medical devices such as blood
pressure, blood glucose, etc for the management.

18. 2.Electronic Health Record
(EHR)
 An electronic health record is the systematized
collection of patient / population electronically stored
health information in a digital format. These records
can be shared across different health care settings.
EMR - Digital version of a patient's chart
EHR contains the patient's records from multiple
doctors and provides a more holistic, long-term view
of a patient's health

19. Electronic Health Record (EHR)

20. Examples of Software - EHR
 Vista EHR

21. Advantages of Electronic
Health Records
 Accurate, up-to-date, and complete information about
patients
 Quick access to patient records for more coordinated,
efficient care
 Diagnose patients, reduce medical errors, and provide
safer care, more reliable prescribing
 Privacy and security of patient data
 Reducing costs

22. 3. Robot-Assisted Surgery

23. Robot-Assisted Surgery
 Using the assistance of robots, doctors are able to
perform surgical procedures more efficiently.
 With the assistance of robotics, surgeons are able to
maneuver more precisely and with smaller incisions.
Advantages
 Reduced loss of blood
 Better pain management
 Quicker recovery.

24. Micro robots (Microbot)
 Microbots for diagnosis and treatment of diseases
(Capsule endoscopy, in which the patient swallows a
tiny camera so that the healthcare provider can take
pictures of the digestive tract)
Future focus
 Removing plaque from arteries.
 Taking tissue biopsies.
 Attacking cancerous tumors directly .
 Delivering targeted medication.

25. 4. Self-Monitoring Healthcare
Devices / wearable medical device
 A wearable medical device can be defined as a device
that is autonomous, noninvasive, and that performs a
specific medical function such as monitoring or
support over a prolonged period of time.
9% in 2014
33% in 2018.
(Accenture)

26. Wearable Biosensors
 It is a combination of wearable objects
and biosensors.
 It can measure the blood glucose level,
BP, heartbeat rate, and other biometric data to be
constantly measured.
 The real-time information is then
sent to the healthcare providers
and there can be two-way communication.

27. Advantages
Disadvantages
 Boost communication
 Allow multitasking
 Consistent
 Develop the
communication between
an individual and the
machine
 Provide convenience
 Work from everywhere
 Expensive
 Wearable devices can be
heavy
 Some of them consist of a
lot of wiring
 Wearable devices can
cause discomfort.
 Wired network restrictions
 Easy to loss the data if the
item is stolen or lost

28. Bio sensing / Smart Contact Lenses
 Wireless smart contact lenses could be the answer to
detecting diabetes and helping to treat diabetic
retinopathy just by wearing them

29. 5.The Internet of Medical Things
(IoMT)
 An amalgamation of medical devices and applications
that can connect to health care information technology
systems using networking technologies.

30.  It can be a combination of telemedicine, mobile
technology, wearables, including ECG monitors.
 Many other common medical measurements can also
be taken, such as skin temperature, glucose level, and
blood pressure readings.
The Internet of Medical Things
(IoMT)

31. 6. m-Health
 mHealth – also known as mobile health - refers to
the practice of medicine and public health
supported by mobile devices such as mobile
phones, tablets, personal digital assistants and the
wireless infrastructure.

32. Digital health applications for
m-Health include:
 Education and awareness
 Diagnostic and treatment
support
 Disease and epidemic
outbreak tracking
 Healthcare supply chain
management
 Remote data collection
 Remote monitoring
 Healthcare worker
telecommunication and
training
 Telemedicine
 Chronic disease
management

33. Mobile Diagnostics
 Mobile phones are enabling self diagnostics,
enabling patients to identify & manage health
 Netra-G is a device attaches
to a smartphone and enables
patients to perform their own
eye test by measuring the
refractive error of the eye

34. Mobile Diagnostics
 Heart monitoring - The device snaps onto the
iPhone and wirelessly communicates between the
app and your phone. Resting your fingers from each
hand on the electrodes, the app recognizes skin
contact and performs the ECG. While it records, it
displays and saves your heartbeat.

35. Mobile Diagnostics
 Ear view Parents can view their
child’s ear canal and eardrum, then
share images & symptoms with their
physician remotely.
 Glucose management -The meter
will automatically sync data with
the Diabetes Manager app tracking
glucose, insulin and carbs while also
charting glucose patterns over time.

36. Mobile apps:
 Diet & Nutrition apps
 Fitness (and/or tracker) apps
 Wellness apps
 Patient & Provider care apps
 Medical Device Accessory apps.

37. 7. Organs on Chips
 New treatment / medicine at the cellular level can be
best studied on the chips instead of humans/animals.
 Making advancements in DNA sequencing and
through in-depth stem cell research.

39.  They made chips of other organs like kidney, heart,
gut, bone marrow and so on.
 The organs on the chip device can provide the cells
with nutrients and oxygen, just as the cells in the
human body are sustained through blood.
 These cells grow and respond exactly like the real
cells in the human organ, and definitely much better
than the cells grown in petri dishes.

40. Ongoing initiatives in Digital
Health - MoHFW
 Reproductive Child Healthcare (RCH)
 Integrated Disease Surveillance Program (IDSP),
 eHospital, e-Shushrut, Electronic Vaccine Intelligence
Network (eVIN),
 National Health Portal (NHP),
 National Identification Number (NIN),
 Online Registration System (ORS),
 Mera Aspatal (Patient Feedback System) and
 National Medical College Network (NMCN).

41. FUTURE OF DIGITAL HEALTH IN
INDIA
 Telemedicine- 150,000 health and wellness centres
along with telemedicine (Digital health india)
 Electronic Medical Records (EMRs) can digitalise
patient’s information coming from various sources at
one place.
 Artificial Intelligence has the potential to transform
everyday health management.

42.  Robotics will play a key role through endosuturing,
sensing, image guidance, materials, manufacturing
and surveillance strategies in surgical procedures.
 Smart health monitors can collect personalised vital
signs and test results in real-time.
 Human DNA analysis enabled by increased computer
processing will enable truly personalised genomic
testing and treatment options for certain genetic
diseases.

43.  Mobile health apps can help in preventing serious
diseases by increasing patient engagement,
providing health education and expert guidance from
healthcare providers.
 Virtual reality has the potential to transform the way
we think about pain management, stress
management and
rehabilitation.

44. Few evidences on Digital
health
 Cure Fit – (2016) It offers fitness, nutrition and mental
well-being solutions through offline and digital channels.
It strengthen its technology platform by offering AI-driven
health planning, create its own fitness devices.
 DocsApp- (2015). It is an online medical consultation
platform. Investors believe that DocsApp has the platform
on-boards only specialist doctors who are then connected
with patients in under 30 minutes.

45. Patient’s perspective
 Increased ability and confidence to self- manage their
health conditions.
 Better understanding
 Increase their adherence to clinical interventions
 Improve lifestyle behaviour.

46. Digital health and covid-19
 COPAL-19 - Mobile app to track Covid patients at the
hospital in real time. They will also be able to track
discharged patients who have the potential to become
plasma donors 28 days after their recovery. – (AIIMS, IIT-
New Delhi)
 Telemedicine hub – (To provide comfort) contact tracing
and providing Covid-19-related help to the residents &
counselling , sanitisation in the area, removal of biomedical
waste, essential commodities

47. Digital health and covid-19
 Karnataka deploys tele-ICU solution to deal
with Covid-19
 The State Government has partnered with Cloud
physician, an indigenously developed tele-ICU solution, to
offer its services in Gulbarga Institute of Medical Sciences
(GIMS). The firm provides solutions to manage critically ill
Covid-19 patients using intensive EMR, audio-visuals, and
alert systems

48.  Remote monitoring-
Care at home for Covid-19 patients - Isolating at
home with mild case or pre-symptomatic case of
Covid-19 by the treating medical officer provided
with a medical kit (with a thermometer and an
oxygen saturation metre), Daily monitoring of the
vitals by a trained nurse twice a day, a tele-review /
critical alert system with a doctor every third day
as well as home delivery of medicines.
Digital health and covid-19

49. Advantages of digital health
 The patient enjoys digital data access
 Quicker access to test results
 Easy to pay the bills
 Sharing of information with your family members
 Offers clinicians notes feedback
 Patient can review information for medical errors
 Instructions and Information is simple and easy to document
 Patient has a better approach and access to the medical records
 Tool for health protection

50. Disadvantages of digital health
 Complicated and complex health information causes
concerns for the patients
 Clinician’s reports elevate patient provider’s
relationship concerns
 Hackers can approach and access patient’s records
 It needs to be upgraded on a regular basis
 Digital health records are expensive
 Complex and composite processes

51. Health System Challenge (HSC)
digital health
Population
denominator
Availability
Quality
Acceptance
Cost &
Utilization
Efficiency

52. Population denominator
 Delayed reporting of events
 Lack of quality/ reliable data
 Communication roadblocks
 Lack of access to information or data
 Insufficient utilization of data and information
 Lack of unique identifier

53. Availability
 Insufficient supply of commodities
 Insufficient supply of services
 Insufficient supply of equipment
 Insufficient supply of qualified health workers

54. Quality
 Poor patient experience
 Insufficient health worker competence
 Low quality health commodities
 Low health worker motivation
 Insufficient continuity of care
 Inadequate supportive supervision
 Poor adherence to guidelines

55. Acceptance
 Lack of alignment with local norms
 Programs which do not address individual beliefs and
practices
 Low demand for services
 Geographic inaccessibility
 Low adherence to treatments
 Loss to follow up
Utilization

56. Efficiency Cost
 Inadequate workflow
management
 Lack of appropriate
referrals
 Poor planning and
coordination
 Delayed provision of
care
 High cost of manual
processes
 Lack of effective
resource allocation
 Client-side expenses
 Lack of coordinated

57. Conclusion
Technology continues to revolutionize healthcare and
we have entered an exciting new frontier of state-of-
the-art gadgets and high-tech communication
systems. But the core concept of care and
compassion can not be disrupted.

58. Reference
 National Digital health Policy print
 Digital health in India, Legal, Regulatory and Tax Overview April 2020
 Sven Meister*, Wolfgang Deiters and Stefan Becker Digital health and
digital biomarkers – enabling value chains on health data Current
Directions in Biomedical Engineering 2016; 2(1): 577–581
 Technical series of Primary health care
 Bertalan Meskó1,2, Zsófia Drobni3, Éva Bényei4, Bence Gergely5,
Zsuzsanna Győrffy2
 Digital health is a cultural transformation of traditional healthcare
http://dx.doi.org/10.21037/mhealth.2017.08.07
 Classification of Digital Health Interventions v1.0 -WHO