Photo credit: Brigham Digital Innovation Hub

Digital health has gone from an obscure term in the health tech world to buzz words on the lips of every hospital CEO in America. Today startups, hospitals and other stakeholders are working on systems to implement these evolving technologies in practice. 

“Obviously we’ve come a long way in digital health over the last decade or so,” Santosh Mohan, managing director of Brigham and Women’s iHub, told MobiHealthNews. “Digital health went from not being a thing at all, to being a little fragile thing in the early days. … Over the last 10 years we have come to have people in it, we’ve come to have pilots in it and we’ve come to have capital in it.” 

The iHub had an early focus on digital health. Founded in 2013, it serves as the Brigham’s innovation incubator. The team has a history of working with both health tech startups and hospital-grown tech initiatives. 

“It’s the early days for most folks, just like us,” Mohan said. “We at the Brigham are trying to deliver a structured approach with key elements of having the right mindset, the right toolset, the right skillset. [Those] are absolutely essential here.”

At HIMSS20, Mohan and his iHub colleague Dr. Mark Zhang, will be present the session "The Playbook for Getting Down and Dirty with Digital Health," which will provide audiences with tricks and tactics for implementing digital into the clinical arena. 

“I think the purpose of this presentation is to convey and share what we’ve learned [in] six-plus years of digital solutions at Brigham and Women’s. Also, just realizing that it is still early days and coming up with the processes. [We] have learned from mistakes in the past to get to a process that we think is working pretty well,” Zhang said. “At a high level, some of things we’ll be talking about include thinking about implementing digital health in a more systematic way, including a technical step to enable digital health, while also implementing processes and setting expectations and education around what it means to do digital health in an academic medical center and how to scope it for the result that the clinician or end users are hoping for.”

Unlike medication, there is no single straight path for implementing digital tools. Therefore, the pair plan to talk about setting up a structure to support innovation and implementation. 

“We are not measuring our success by the number of pitches that we listen to or the startups that we bring in to explore pilots. And we are not saying, ‘Oh look we got the operations to try new things so we are innovating.’ We don’t have that innovation theater mindset,” Mohan said.  

“We are being more strategic and going about it with a road map and a repeatable framework, building not just individual capabilities, but also portfolio capabilities so they can be leveraged to a broad initiative and strategic initiative.”

In addition to just creating the right avenues for implementation, the talk will also focus on bringing together a diverse team to work on these digital iniatives. Increasingly, hospitals and other health entities are starting tech incubation hubs, however, most of these teams have a modest number of staff on them. 

“We’re a fairly small team, and most innovation teams or teams focused on digital health … are fairly small in scope, and the task is a broad one,” Zhang said. “I think having a clarity of scope and a take is incredibly important. Our take this year is really about looking at the pulls within the system to focus on and ideally think about ways we can utilize these interventions in different ways. Like the concept of using every part of the buffalo. When we do something, we want it to be ideally reusable or have a pathway to be used in some other way.”

Santosh Mohan and Dr. Mark Zhang will be presenting "The Playbook for Getting Down and Dirty With Digital Health" at HIMSS20. It is scheduled for 10:00-11:00a.m on March 12 at the Orange Country Convention Center in room W304A.

Cindy Gaines has worn many hats over her career — she's been a nurse, a project manager, held multiple C-suite roles, and now serves as the clinical leader of population health management at Philips. She said that her experience in both the clinical and nonclinical realm has helped her in her current role of bringing the world of health IT and patient care together. 

“I come with a lot of experience having done this work. I was a customer for 10 years using a lot of our population health management solutions,” Gaines said. “So I really come in as a subject matter expert in bridging the world between our technology and our innovations, and the clients and customers, and understanding their world. I serve as that connection of understanding their pain points and then translating that and vice versa.”

Today she is focusing on bringing new technologies into the quickly changing industry of population health. 

What is changing in population health?

The primary care provider is seeing the bulk of the change when it comes to population health, Gaines said. 

“They’ve always done a great job of taking care of the patient in front of them. The patient comes in for the appointment, they address the need for the appointment and they work with that patient,” she said. “But with population health management they became accountable for what happens to that patient when they weren’t in the office. So if you didn’t come in to get your mammogram, if you weren’t following up on your diabetes care, [PCPs] have some accountability to how are they going to stay connected with you and engage with you. That has been a big transition to population health management.”

Additionally, the consumerization of healthcare has created new challenges for the PCP as well. For one, the healthcare industry is seeing the rise in retail clinics and urgent care centers. This can mean that a patients records are often disjointed. 

“Convenient care has become the demand of our consumers. It is consumer-driven. No one would like to wait. Here is the challenge of that as a PCP, I’ve become accountable for coordinating with you your care. But there are a lot of ways for you to get your care that aren’t connected to your primary care. I think our challenge is to use technology to drive information back to the primary care provider so they can really help to be that partner with that patient.”

Another rising conversation emerging in the world of population health is the role social determinants of health, in caring for patients. 

“I think it’s this realization that the health system can’t meet the patient needs and so it is really going to force us to partner with our community resources to better meet our patient needs,” she said. “I can tell you to go to the food pantry to help you with your food, but did you follow through on that and did you get what you needed? We need technology to start connecting us with resources, so not only do I say you should go but I can actually refer you. Then we can get information back on how that went. That is really helping the patient.”

However, tech has already done some work supporting population health, she said. In particular she said there is an emergence of predictive analytics that can help prevent a health emergency before it happens. 

Advice to the next generation of population health hopefuls

Gaines said there is a lot of opportunities in the field for individuals from both the tech world and the clinical world. 

“What is exciting about population health is, it is bringing together the clinical and nonclinical. It is a space that, if you want to make a difference, it feels a little unlimited,” Gaines said. “Even if you are not a clinician it’s a great space to be in. That’s what population health is about. It’s bringing together the community resources with the health system and the technology [world]. It’s just a great environment if you want to be that person who can be part of something bigger than themselves where we can partner and bring your skill set to it. We need all of those skillsets.”

For women in particular, Gaines stressed the importance of taking risks. 

“What I would say to women is to be courageous. Don't be defined by boundaries,” she said. 

Gaines explained that she graduated from college as a nurse, which has a set career path. However, she started branching out of that traditional path. 

“When you are faced with opportunities, they scare you a little bit, but be courageous and take a chance,” she said. “Don’t let your fears stop you.”