Recipients of AcademyHealth’s Presidential Scholarship for the AcademyHealth Institute on Advocacy and Public Policy were invited to blog about their experiences during the 2013 National Health Policy Conference. The following post is written by Reem Aly, J.D., M.H.A., a health policy associate at The Health Policy Institute of Ohio. This year’s National Health Policy Conference featured a session “How Digital Health will Impact Health Care” where three speakers gave their perspectives on the role of digital health in health care and the potential for and challenges faced by digital health. Session speakers included Don Detmer from the American College of Surgeons, Kerry McDermott from West Health Institute, and David Yakimischak of Surescripts. Robin Strongin of Amplify Public Affairs chaired the session. At the onset, Strongin acknowledged that digital health “means a lot of things to different people” and that from engaging patients in their health care to the use of electronic health records, digital health and data are key drivers of health reform. Furthermore, she stressed that while the current administration—in conjunction with the U.S. Department of Health and Human Services—was working to “liberate data” and capitalize on the potential of digital health, there were more opportunities and greater challenges for digital health in the coming years. Don Detmer reported optimistically that nationally, electronic health record (EHR) use is on the rise. With improved interest in the use of digital health for health communications and patient engagement, Detmer stated that there is opportunity for digital health to be used as an effective tool in managing health problems. He sees this more as health care moves toward universal adoption of EHRs and breakthroughs in patient interfaces. However, Detmer cautioned that there also needs to be greater interoperability of technologies. Going forward, Detmer cited a number of challenges facing digital health. He suggested that the continued lack of a universal health identifier for patients in the U.S. increases the likelihood of security issues related to digital health. Furthermore, Detmer stated that he expects increased potential for fraud and abuse with the spread of digital health and continued policy barriers to retrieving data. Kerry McDermott approached the discussion from a health care cost and cost savings perspective. Stating that the current health care payment system is unsustainable, McDermott made the case that digital health can help lower health care costs by moving patients away from high cost care settings, such as hospitals, to low cost care settings, like in home care. She stated that by enabling providers to deliver care differently, via telehealth and remote monitoring, providers could get in front of their patient’s health problems. McDermott also suggested that digital health can drive precision care through analytics and help prevent costly patient safety episodes, such as adverse events, by automating care processes and providing the ability to cross-check care. When asked about the challenges facing digital health, McDermott also identified the need for interoperability as well as the need to build an evidence base for the use of digital health. David Yakimischak discussed the unexpected consequences resulting from digital health. He reported that with the introduction of e-prescribing, 80 percent of drug prescriptions are actually dispensed and make it to the patient’s hands as opposed to only 70 percent with paper prescribing. Often, paper prescriptions never made it to the pharmacy to be dispensed, as patients are more prone to losing their prescriptions or forgetting to call them in. Yakimischak emphasized that in order for a digital health technology to thrive, there needs to be a good governance structure and an incentive model created so that outcomes desired are achieved. He suggested that for digital health to flourish in the current regulatory environment there needs to be a national infrastructure that allows room for some state-specific rulemaking. One of the primary challenges facing digital health according to Yakimischak is the misalignment of commercial and research interests. Primarily, Yakimishak stated that there is a question as to who owns health care data and to what end it can be used. Overall, the session highlighted the potential for digital health while also acknowledging a number of issues that must be addressed going forward. While the speakers shared their different perspectives, there was great consensus that aligning incentives can drive digital health to produce desired outcomes. Furthermore, all speakers acknowledged that there needs to be a focus on the creation of interoperable digital health solutions to our nation’s current health care problems.    

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