This post has been updated from its original version
This weekend, American Medical Association CEO Dr. James Madara addressed the AMA’s annual general meeting and offered some wide-ranging criticism of digital health. He described many of the digital health technologies currently available as so much snake oil, comments that seemed intended to provoke:
From ineffective electronic health records, to an explosion of direct-to-consumer digital health products, to apps of mixed quality.
This is the digital snake oil of the early 21st century.
Even those digital products that might be helpful often lack a way of enriching the relationship between the physician and the patient. It’s like trying to squeeze a 10-gallon product idea into a 2-gallon health care knowledge base.
More and more we’re seeing digital tools in medicine that, unlike digital tools in other industries, make the provision of care less, not more, efficient. And these digital tools often don’t connect with each other—interoperability remains a dream.
Let’s be clear. Madara was not dissing all digital health software; just the ones that don’t consider physicians’ and patients’ needs, make managing electronic health records, the push for interopability and managing personal health more difficult rather than easier and just create new silos of information.
“…digital tools that would simplify and better organize our lives, and also adapt to the natural variations in our practices—those that would free more time for patient interactions—that’s what we want.
Tools like that we’d love—love, love, love. There are too few of these today.
Still, it’s a little harsh to use that term snake oil to cover so many different companies. There’s a difference between well-meaning healthcare entrepreneurs that fall short and companies that are reckless with advertising and make false promises their technology can’t deliver. The Federal Trade Commission has singled out a few of them.
Madara calls for a few different things in this speech. He wants to boost the clout of the AMA and promote user-centered design. But what isn’t totally clear is whether he’d like to see the AMA have a more well-defined role in vetting or validating digital health apps. He also sees a lot of direct-to-consumer health apps as wasteful and unproductive. A report by the IMS Institute for Healthcare Informatics on the direct-to-consumer app front in 2013, a revisit of that report reached a similar conclusion.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Happtique had ambitions for serving as a clearinghouse for mobile health apps that would be vetted by a team of physicians and developers to establish some order in the Wild West of digital health apps. Instead, it lost credibility when it was found to be certifying apps with little in the way of decent security of personal health data. Social Wellth later acquired it.
Madara’s veiled references to Theranos and the premature optimism surrounding that diagnostics company along with the idea that patients should be in a position to order blood tests themselves seem a little out of place in a criticism of digital health tech.
It’s also a little curious that Madara only gives a passing reference to the innovation studio the AMA has invested in called Health 2047, launched at the JP Morgan Healthcare Conference in January this year. Part of the purview of this innovation studio are digital health technologies such as data analytics. It envisions bringing together multi-disclipline teams together led by physicians to address some of the challenges in healthcare. They include engineers, integrated health systems, payers, and group purchasing organizations. Clinical validation is a central component.
Madara offered a lot more context to his digital health perspective in his talk and Q&A with the Commonwealth Club, which you can check out on YouTube.
He made some excellent points, emphasizing the need for more technology that makes the physicians’ job easier not more difficult and he wants the same for patients. There isn’t nearly enough criticism of what’s not working in digital health and that criticism should be helpful for developers and entrepreneurs as a reminder of what will make them better.
Still, his broadside at digital health and lack of specifics on what he liked beyond telemedicine left one wanting more details. Surely there must be some telemedicine approaches he likes and others he hates? It would have been useful to cite some specific examples of digital health initiatives and companies that he thinks are doing a good job.
Here’s a video of Madara’s address to the AMA:
And here’s a look at some of the reaction on Twitter:
#DigitalHealth as snake oil? Certainly there's been problems w/ #EHR's but this is too much https://t.co/LRys5DE4fE pic.twitter.com/3b4umznYSf
— Brian Ahier (@ahier) June 12, 2016
Sadly the government portion of digital health has become snake oil as a Quant now runs Medicare #AMA https://t.co/XDlKGTdqQs
— MedicalQuack (@MedicalQuack) June 12, 2016
Photo: Flickr user shortChineseguy
