Digital health, hype or hope? The answer is “evidence-based” and digital literacy.

DigitalUHealth
Sep 2, 2018 · 4 min read

by Dr. Nino Cartabellotta, Specialized in Gastroenterology and Internal Medicine, in 1996 he founded the Italian Group for Evidence-Based Medicine (GIMBE)

Digital health today identified countless technologies: m-health, telemedicine, online health communities, health robotics (systems for the production of “made-to-measure” drugs, surgical robots, automated pharmaceutical cabinets, robotic trolleys for the distribution of therapies, etc.), wearable, ingestible and implantable technologies, 3D printing of prosthetics and aids. Obviously, all the technologies are effective and reliable, aimed at innovations in the essential levels of assistance. But the rush to technological armament produces inevitable paradoxes. On the one hand, we have witnessed the early diffusion of surgical robots, while rigorous independent evaluations are even more limited and limited: yet in Italy, there are over 100 paid with public money. On the other hand, the paradox of telemedicine for home monitoring of patients with chronic diseases is under everyone’s eyes: despite the evident evidence of effectiveness and cost, it is not yet included in the essential levels of assistance.

Furthermore, information technology in healthcare is an example of unacceptable illiteracy, also considering the hypotheses: digital healthcare continues to remain outside the degree and specialization programs, making the gap with the other countries unbridgeable and ignoring that the new generations of health professionals are “digital natives”. With respect to the potential contribution to the sustainability of the NHS, referring to the waste taxonomy elaborated by the GIMBE Foundation of the #salviamoSSN campaign, an adequate implementation of the telehealth required to recover about 3 billion euros, accepting two conditions. The first is to recognize that the digitalized bureaucracy does not generate economies of scale, ie IT facilitates the re-engineering of processes, but we must change the way we work and not inform the existing. The second one is accepted that more investments in information technology are accompanied by a reduction of personnel, especially of the administrative staff.

DigitalUHealth, the future is interdisciplinary.

edited by Dr. Nicola Marino, Co-Founder DigitalUHealth

What has been narrated by the protagonists and pioneers of the change in digital healthcare in Italy has the sole purpose of stimulating the reader to critical reasoning and to share non-vertical aspects of technologies in medicine.

The effort is to provide an overview and collaborative progress in health care that is ready to undergo profound changes thanks to the emerging technologies now available to us. The most radical change has never been considered as a process of digitization of health protection interventions but a re-design of the entire supply chain. To proceed towards this result it is necessary a choral use of the most disparate professional figures belonging to converging sectors, from medicine to engineering passing through economics, social sciences and genetics.

This goal emerges strongly in recent years thanks to the extreme technological scalability in terms of quality and quantity. Not just new sensors and processors but increasingly smaller and more widespread. It continues to be part of the development of electronics and information technology that continues inexorably to respond to a growth rate predicted by Moore’s Law — the complexity of a microcircuit double every 18 months -.

To understand how much this is “disrupting” let’s take the case of progress in the field of genomics. The sequencing of mankind took 10 years and cost approximately 30 billion dollars to be completed. Today, thanks to the growth of computational capacity, it is possible to obtain sequencing of the entire genome at the cost of about 500 rpm and that’s not all. The Oxford Nanopore company was created with a portable reader capable of sequencing the genetic material in just a few minutes. Regarding the conditions in medicine, the element that has completed the research in the academic field.

Digital gold, however, is the way to see the greatest things about digital health, is not to miniaturize reading systems. Returning to the genome mapping in fact, companies like 23andme base their business precisely on this concept.

What has been said is very important as far as the point of view is concerned, the second is ethical.

First of all, to have such a large size as a computational time such to be able to subject these problems to the fine analysis of enormous systems, in addition to the analysis of a lack of information useful for medical research.

On the other hand, investments are necessary, it is a system of calculation, management and management of personal data, privacy issues and governance of the health data.

Come in a few lines, digital healthcare opens a new frontier for the prevention, treatment, and care of the patient, but also leaves space for unexpected multidisciplinary problems.

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