PHA 336 - Digital Health, HIT, Telehealth, Access L17

Digital health technologies (DHTs) definition

Technologies that collect, track, and use health data for patients and clinicians

Dual purpose of DHTs

Patient use (self-monitoring) and clinician/researcher use (quality improvement)

Example of DHT

Continuous glucose monitor (CGM)

CGM function

Continuously measures glucose levels and provides real-time data

CGM advantage

Provides continuous data instead of fingerstick readings

Target glucose range

70–180 mg/dL

Time in range (TIR) definition

Percent of time glucose stays within target range (goal ~70%)

Recommended A1C goal

Key issues with DHTs

Data ownership, integration, access, patient trust, reimbursement, literacy

Data ownership issue

Device companies often own raw data; providers receive summarized data

Patient data rights

Patients must give informed consent for data use

Patient trust concern

Uncertainty about who accesses and uses health data

Improving patient trust

Transparency and patient control over data sharing

Health information technology (HIT) definition

Technology used to store, share, and analyze health information in clinical settings

HIT and pharmacy

Supports medication management, monitoring, and patient care decisions

Digital divide definition

Unequal access to technology, internet, and digital literacy

Population-level digital divide

Unequal access to devices and internet

Individual-level digital divide

Lack of digital literacy and telehealth support

Manufacturer-level digital divide

Limited access to apps and technical support

Digital literacy definition

Ability to understand and use digital health tools

Impact of low literacy

Reduced ability to engage in telehealth and understand health info

Digital health counselor role

Support patients with technology, literacy, and telehealth navigation

Digital health counselor responsibilities

Improve access, teach literacy, troubleshoot, explain data, facilitate telehealth

Integration challenge for DHTs

Difficulty syncing device data with EHR systems

Data overload issue

Too much raw data may overwhelm clinicians

Compatibility issue

DHT data may not integrate across all EHR systems

DHT malfunction consequence

Delayed care or unnecessary emergency visits

FDA role in DHTs

Evaluates and approves technologies used for medical purposes

Reimbursement issue

Limited evidence makes insurance coverage inconsistent

Role of evidence-based medicine (EBM)

Supports reimbursement and coverage decisions

Return on investment (ROI) concern

Need proof of long-term benefit for widespread adoption

Cybersecurity concern

Protecting patient data and system security

GLP-1 medications examples

Ozempic, Wegovy, Trulicity, Victoza, Rybelsus

GLP-1 cost issue

High cost (~$800–$1000/month) limits access

Direct-to-consumer (DTC) issue

Misleading online claims about weight loss products

DTC red flags

“100% natural,” unclear testing, vague claims, unknown sources

DTC safety concern

Potential harmful ingredients and drug interactions

DTC dosing issue

Mismatch between labeled use and actual duration of effect

Telehealth definition

Virtual connection between healthcare providers and patients

Telehealth purpose

Reduce barriers to in-person care

Telehealth requirement

Access to internet, devices, and ability to self-monitor or test

Telehealth types

Real-time, store-and-forward, remote monitoring, audio-only

Real-time telehealth

Live interaction between patient and provider

Store-and-forward telehealth

Transfer of data/images for later review

Remote patient monitoring

Collection and transmission of patient data for monitoring

Audio-only telehealth

Healthcare provided via telephone

Telehealth benefit (providers)

Convenience and reimbursement opportunities

Telehealth benefit (patients)

Reduced travel time and increased access

Geographic benefit

Access care regardless of location

Barrier to telehealth

Sustained access to internet and mobile devices

Financial barrier

Limits ability to maintain technology access

Alert fatigue definition

Overload from frequent telehealth messages

Technology barrier

Hardware/software issues and lack of support

Housing instability barrier

Difficulty maintaining care, medication access, and privacy

Impact of housing instability

Lost medications, missed follow-ups, reduced privacy

Dissemination organization role

Local organizations helping distribute medications and services

Advantage of dissemination organizations

Familiar, accessible, improves medication delivery and trust

Limitation of dissemination organizations

Limited hours, availability, and patient comfort

Pharmacist role in telehealth

Enhance access, educate patients, interpret data, support adherence

Opportunity for pharmacists

Improve digital literacy and patient engagement

Future telehealth opportunity

Expand access, improve coordination, reduce digital divide

Key takeaway

DHTs can improve care but may worsen disparities if access issues are not addressed