Digital health

The prominence of Digital health in the past century has culminated for the emergence of three reasons, stated by both Professor John Powell and Professor Theodoros N Arvanitis "the development of new technologies... and also trends towards smart, wearable and pervasive technologies; the need for health services to find new approaches to addressing the demands of an ageing population... and the role of the empowered patient and the shift in models of health service delivery towards patient-centred care, and patient-led care." These three points have directed and motivated the rise in the elements that play a crucial role in the creation of Digital health care services. Primary Care Services The first group of these services is known as primary care services in the domain of digital health. These services include wireless medical devices that utilize technology such as Wi-Fi or Bluetooth, as well as applications on mobile devices that encourage the betterment of an individual's health as well as applications that promote overall general wellness. For example, researchers developed a digital service to help elderly people with balance disorder and risk of falling. As prominent sociologist Deborah Lupton states, "Health promoters have experimented with using text messages, social media sites and apps to disseminate information about preventive health, collect data about people's health-related behaviours and attempt to 'nudge' members of target groups to change their behaviour in the interests of their health." In other words, Lupton states that various media technologies that can be found on mobile devices are being utilized to try and better certain groups' behaviors in concern with digital health. Acute Care Services The second group of these services is known as acute care in the digital health domain. These services include telemedicine which is defined as handling patients over some sort of streaming device and is targeted towards areas where the population is more widely scattered, medical devices that incorporate different aspects of software otherwise known as SaMD, and examples of these devices are pacemakers. The final example of acute care services is the 'interoperability' of 'Health IT, Cybersecurity, and Medical Devices', Health IT is how the electronic database stores, processes, and analyses personal health information and how this information can be utilized by medical personnel and organizations around the world of easier access of information, Cybersecurity which then plays into the storing of personal health information in how this information is secured and protected in the interest of personal safety of the individuals whose information is being stored, and Medical Devices that are able to communicate within each other to better care for a patient by transmitting what needs to be done on one machine to another. Lupton concludes that despite the innovation of various elements in this digital health area, there are still multiple issues that need to be organized and dealt with for the continuation of the revolution of Digital Health. Other Digital Health Elements The rest of the elements of Digital health that do not fall so squarely into acute or primary care services are listed as the transmission of medical education and information between practitioners and researchers through the utilization of digital technologies and applications that can be employed by doctors for risk-assessment regarding patients. Devices that can be utilized for the improvement and management of bodily purposes as well as the encouragement of the education of digital health to the public. There are also patient-based applications that can be utilized to share information by individual patients as well as encourage the usage of drug trials. The tracking of outbreaks of disease by the use of mass media that social media has developed has also come about through Digital Health. Finally the recording of the environment around sensor devices that are being utilized for the betterment of the community. ==Technologies==

Digital health technologies come in many different forms and extend into various parts of healthcare. As new technologies develop, digital health, as a field, respectively transforms. The three most popular domains of digital health technologies include telemedicine, wearable technologies, and augmented and virtual reality. Telemedicine is how physicians treat patients remotely and the different technologies needed to make the process more efficient and faster. The other main side of digital health is data collection and how to provide on-demand medical information for patients, which gave rise to wearables. Wearable technologies hold the promise of bringing personalized data and health-related tracking to all users. In terms of digitized treatment, augmented and virtual reality can create personalized regimens for patients that can be repeated and tailored to treat many conditions. In fact some of these technologies are being propelled by the startup space, which has been followed via Internet or online media sources such as podcasts on digital health entrepreneurs. The National Institute for Health and Care Research (NIHR) has published a review of research on how digital health technologies can help manage health conditions. Electronic medical records have multiple functions in the medical field. Some of the functions include documentation, communication, and management of patient data. However, despite the many similarities in both health applications, they are not the same. Telehealth is an umbrella term that encompasses various applications of electronics in medicine. The more common uses of technology involve calling patients to let them know their lab results are in or communication between emergency departments. On the other hand, there are more complex uses of technology called telesurgery. While there are two extremes of the uses of telehealth, the more recent applications of telehealth involve patient and healthcare-professional interaction. A 2025 systematic review found that audio-based telehealth, such as telephone consultations, has been found to be comparable to in-person or video-based care for managing chronic conditions, with some studies suggesting benefits for quality of life in cancer and noncardiac chest pain management. For diabetes management specifically, a 2025 systematic review found that supplementing usual care with audio-based interventions provided moderate certainty evidence for modest improvements in glycemic control (A1c reduction of 0.20%), with greater effectiveness when interventions included monthly contact and remote monitoring tools. In Europe, some private telemedicine platforms combine remote consultations with digital prescription services fulfilled through partner pharmacies; media reports have cited services such as ZAVA and DoktorABC as examples of this model. Such services may rely on asynchronous consultations or structured questionnaires and are subject to ongoing regulatory and professional scrutiny. Benefits The benefits of telehealth are vast and stem from its application. One of the benefits of telehealth is the time-saving element. Patients no longer have to think of wait times in hospitals and offices or spend commuting to and from doctors' appointments. Instead, they can log onto their device and see their healthcare professional virtually. This is especially beneficial for those who live in rural areas where specialized hospitals are scarce and far away. The public now has access to doctors who specialize in certain diseases instead of having to drive and commute long distances to have a simple consultation meeting. Additionally, patients no longer have to worry about taking an entire day off work for a regular health checkup. They can simply block out enough time that is required for their appointment which results in fewer travel costs, less need to find childcare services, and privacy. Another benefit of telehealth is the reduction in face-to-face contact. By using video conferencing, patients are less likely to contract germs from others at the hospital and limit the spread of germs themselves. It is important to remember that online visits should only occur when in-person care is not needed. Another obstacle to using telehealth is the potential for technical difficulties and concerns about security breaches. Moreover, the rules and regulations governing telemedicine vary by state and are always changing. According to The Journal for Nurse Practitioners, "The rapid expansion of telehealth, especially during the COVID-19 pandemic, paired with variable regulations and guidelines creates increased potential for liability and legal issues." Digital healthcare interventions Digital healthcare interventions (DHI) has been used to a wide range of applications across various aspects of healthcare, such as self-management tools, where patients use applications and platforms to manage chronic conditions like diabetes or hypertension; self-education and health promotion tools, that provide educational material designed to leverage the population's knowledge regarding one specific health topic and promote healthy behaviors, and digital therapeutics (software-based interventions designed to prevent, manage, or treat medical disorders). Wearable technology Wearable technology comes in many forms, including smartwatches and on-body sensors. Smartwatches were one of the first wearable devices that promoted self-monitoring and were typically associated with fitness tracking. Many record health-related data, such as "body mass index, calories burnt, heart rate, physical activity patterns". The convergence of digital health with wearable technology and the Internet of Things (IoT) has led to the emergence of the Internet of Medical Things (IoMT). Unlike traditional healthcare, which often relies on episodic clinical visits, IoMT ecosystems utilize interconnected devices—such as smartwatches, continuous glucose monitors, and bio-patches- to facilitate the continuous, real-time tracking of physiological data. This constant stream of information allows for a shift from reactive to proactive care, enabling the early detection of health anomalies through predictive analytics and fostering personalized medicine by integrating patient-generated health data directly with clinical records. Augmented and virtual reality In digital health, augmented reality technology enhances real-world experiences with computerized sensory information and is used to build smart devices for healthcare professionals. Since the majority of patient-related information now comes from hand-held devices, smart glasses provide a new, hands-free augmented way for a doctor to view their patient's medical history. Another similar technology space is virtual reality, which creates interactive simulations that mimic real-life scenarios and can be tailored for personalized treatments. These advanced simulations are able to be repeated, replicated, and tailored to any research area. Health systems engineering is another subset of digital health that leverages other engineering industries to improve upon applications include knowledge discovery, decision making, optimization, human factors engineering, quality engineering, and information technology and communication. Speech and hearing systems for natural language processing, speech recognition techniques, and medical devices can aid in speech and hearing (e.g. cochlear implants). Digital hearing aids use various algorithms to reduce background noises and improve perceptual performance, which is a significant improvement from regular hearing implants. ==Implementation==

National electronic health record (EHR) systems National digital programs exist to support healthcare, form meaningful indicators, and facilitate population-based studies by providing clinically procured data in an open-source and standardized digital format. These can inform public health decisions, which are especially crucial in low-resource settings. The World Health Organization's Global Observatory for eHealth (GOe) conducts and reports a worldwide survey of its 194 member nations on their progress towards EHR implementation as well as universal healthcare coverage. In their latest issue in 2015, 73 Members (58%) responded with having some eHealth strategy in place, a count that has increased since 1990. By 2014, 75% of Canadian physicians were using electronic medical records. In Uganda and Mozambique, partnerships between patients with cell phones, local and regional governments, technologists, non-governmental organizations, academia, and industry have enabled mHealth solutions. In the United Kingdom, the National Health Service (NHS) has commissioned a report on how to integrate digital healthcare technologies into the next generation of medicine. The "Topol Review" recommended an expansion of education for both patients and providers of next-generation technologies such as Whole Genome Sequencing, and has also created Digital Fellowships for health professionals. The United States has also embarked on a nationwide health study known as 'All of Us" to bring together a variety of health indicators in a digital format for researchers around the world. On the other hand, the implementation of these innovations has also brought to light societal risks and regulatory needs, which are certainly challenging the current governance structures in the health sector. Innovation cycle The innovation process for digital health is an iterative cycle for technological solutions that can be classified into five main activity processes from the identification of the healthcare problem, research, digital solution, and evaluating the solution, to implementation in working clinical practices. These commonly follow a user-centered approach to design, which are evaluated by subject-matter experts in their daily life using real-world data. During the COVID-19 pandemic, regulations and enforcement of digital psychiatry apps were relaxed to facilitate use and reduce in-person contact. International Standards At an intergovernmental level, the World Health Organization is the United Nations Specialized Agency for health, and the International Telecommunication Union is the UN Specialized Agency for ICTs, the Agencies collaborate in their work on digital health, such as the H.870 standard on safe listening, as well as the ITU-WHO Focus Group on Artificial Intelligence for Health, a subsidiary of the ITU-T Study Group 16. In traditional healthcare, doctors conducted medical practices with a limited number of tools, and got more experienced over time. Since becoming a doctor required experience and knowledge, very few took up the profession. The lack of communication between people in different places caused new technology to spread slowly. Since doctors were seen as experts in their fields, patients would have very little decision on how they were treated. Although there's been an extensive change in technology, the current health care system doesn't reflect on the changes in treatments. During the 2010s, healthcare knowledge continued to grow rapidly, and patients began to get frustrated due to the vast knowledge out there that physicians didn't know or use. The number of and the cost to treat chronic illnesses increased, and the World Health Organization estimated that there was a worldwide shortage of 4.3 million healthcare workers. During the transition from traditional healthcare to digital health, the amount of access to high quality health technology and medical records and studies increased. The transition also gave patients the option of self-care because not only did it change the technology accessible to patients, but also the patients' ability to choose their way of treatment. Although this new way of treatment has given patients a role in treatment, it has led to difficulty with patients choosing the best treatment options. According to the article, Digital Health is a Cultural Transformation of Traditional Healthcare from the National Library of Medicine, "The success of providing care depends on collaboration, empathy and shared decision making. What is needed for this is a newly defined co-operation between patients and their caregivers." In this quote, health care experts explain that they need to collaborate with patients and respect their decisions in choosing treatment options for them. The article then explains how a strong relationship between physicians and patients help influence what treatment options they choose, and how empathy is an important characteristic for physicians to have. In May 2018, the World Health Organization passed a global strategy for digital health. There were four major goals for the strategy. The first goal was for nations and companies to collaborate more in making new treatments and technology. Two other main goals for the strategy were to increase the implementation of national strategies towards digital health, and to increase authority over digital health from global to national levels. The World Health Organization also made guidelines in regulating certifying digital health medical devices similar to how medicine and vaccines are tested. The strategy was also made to list health data as a public health good, and made an outline for how research and data are shared, and how Artificial Intelligence is used. It even endorsed people-centered health systems that used digital health. While the World Health Organization was pushing their strategy, other groups are also developing strategies to make digital health more available in communities that don't have it. Before this strategy was published, the World Health Organization made a plan around the beginning of 2015 to use digital health to end Tuberculosis. The following reasons why this strategy was passed included how health care managers didn't have the resources for prevention of Tuberculosis. There was a need for a step to step plan to include digital health for the End TB Strategy. The plan would also give opportunity to improve health care technology and increase efficiency and sustainability of efforts. The plan focused on treating and preventing tuberculosis, and giving treatment options for patients suffering from Tuberculosis from national to international levels. the following steps included functional laboratory information included using digital technologies to diagnose patients, providing secure data transmission and storage, and using data to store patients' results. Some of the technologies used in the campaign were Video Treatment Support, and eHealth Portal. == Criticisms ==

Digital healthcare presents a wide range of complex and sometimes novel regulatory challenges, including questions about how to balance public interest concerns against an individual's right to privacy as well as the risks of 'pseudo-experts' providing medical advice. Meanwhile, the explosion in the number of uses and applications seen during the COVID-19 pandemic has also brought to light the limitations of existing legislation and other regulatory tools to grapple with these concerns (or, in some cases, been enabled by changes in legislation that groups such as the Varieties of Democracy have argued have produced a 'pandemic backslide' in human rights protections). Ownership of health data At a global level, the implementation of digital health solutions depends on large data sets, ranging from simple statistics that record every birth and death to more sophisticated metrics that track diseases, outbreaks, and chronic conditions. These systems record data such as patient records, blood test results, EKGs, MRIs, billing records, drug prescriptions, and other private medical information. Medical professionals can use this data to make more data-driven decisions about patient care and consumers themselves can utilize it to make informed choices about their own health. Given the personal nature of the data being collected, a crucial debate has arisen amongst stake-holders about one of the challenges induced by digital health solutions: the ownership of health data. In most cases, governments and big data and technology companies are storing citizens' medical information, leaving many concerned with how their data is being used and/or who has access to it. Google faced a major lawsuit over a data-sharing agreement that gave its artificial intelligence arm, DeepMind, access to the personal health data of 1.6 million British patients. They concluded that clinical data should be a form of public good, used for the benefit of future patients and that the data should be widely available for the development of knowledge and tools to benefit future patients. From this, they drew three main conclusions. Firstly, if the clinical data is really not owned by anyone, those who interact with it then have an obligation to ensure that the data is used for the benefit of future patients in societies. Secondly, this data should be widely shared for research and development, and all the individuals and entities with access to that data, then essentially become stewards of that data and become responsible to carefully safeguard the privacy and to ensure that the data is used for developing knowledge and tools for the good. Thirdly, patient consent would not necessarily be required before the data is used for secondary purposes, such as AI development and training and testing, as long as there are mechanisms in place to ensure that ethical standards are being followed. According to this proposed framework, the authors propose that it would be unethical to sell data to the third parties by granting exclusive access in exchange for monetary or any kind of payments that exceed costs. Misinterpretation of data Although the data and information provided by personalized health platforms may give reassurance to users, they might simultaneously induce increased anxiety and obsessive behavior. As seen with platforms like WebMD, the misinterpretation of data can further contribute to patient hysteria: having increased access to information on oneself is not always positive. Institutional ageism Ageism is defined as the process of systemic discrimination against the elderly. As digital health becomes more prevalent in our society, those who lack strong digital skills and the technical know-how needed to navigate these platforms will be put at a disadvantage. This doesn't just apply to current seniors. They represent an untapped user group. Digital divide Worldwide, the UN estimates that 3.8 billion people are offline and even in the US, 19 million people do not have reliable connectivity access. Other barriers to access include a lack of basic digital literacy required to use many digital health platforms. Bio-surveillance risks In the age of the COVID-19 pandemic, the use of digital health platforms as a means to contain the spread of the disease has been accelerated worldwide. Governments in many economies, including South Korea, Taiwan, India, Italy, Poland, and China, have implemented strict digital track and trace systems to both identify those infected with COVID-19 and to ensure that they obey quarantine guidelines.) have suggests that such programs have been beneficial in combating spread, some critics worry have continued to express strong concerns about the potential loss of civil liberties associated with individuals handing over their private health data to government entities; this includes whether new or emergency regulations will stay in place in a post-pandemic world. Additional legal and regulatory issues In the United States, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 was the first comprehensive framework that aimed to protect the personal data of patients. With major companies like Facebook and Apple moving into digital health, critics question whether existing regulations are comprehensive enough. Electronic Medical Records (EMRs) Due to the initial gap between the expectations and performances of electronic medical records, they are frowned upon by clinicians. The initial failures have shaped physicians' perceptions of EMR. Therefore, before considering adopting the EMRs in the medical field, the quality of the information system has to be accounted for. Younger primary care physicians (PCP) find the technology easier to use as they have more knowledge about technology, therefore were inclined to use EMRs than older physicians with less knowledge of technology. Other negative experiences and challenges encompass frustrations stemming from communication problems, reduced physician-patient interaction, inadequate resources, increased workloads, system complexity, difficulties in accessing information within Electronic Health Records (EHRs), and limited access to web-based information stored in digital systems. Additionally, clinicians often find themselves overwhelmed by the sheer volume of data and alerts generated by digital tools, which can hinder patient-centered care. In this digital healthcare landscape, emerging fears are prevalent, including the fear of change and potential job replacement, the fear of forgetting crucial patient information, and the fear of misinterpreting patient data. These fears contribute to increased stress and anxiety when new technologies are adopted. Furthermore, a sense of confusion is reported by some clinicians, stemming from a conflict between digital tools and their professional identity. This conflict revolves around concerns related to work visibility and perceived threats to professional autonomy. == References ==