Dr. Patrice Harris sees the promise, and the peril, of digital health innovation
Photo: Oscar and Associates for HIMSS Media
There's no question that the COVID-19 pandemic has presented an opportunity for accelerated digital transformation.
The past 18 months have seen an enormous uptick in interest and use of digital health tools, including those enabling telehealth, COVID-19 testing and data sharing, contact tracing and vaccine verification passes.
But as Dr. Patrice Harris points out, not every tool is appropriate for every person, or every situation.
Innovators can and should ask themselves: "What can we do to not be a one-size-fits-all solution, but be complementary to a cadre of solutions?" said Harris, past president of the American Medical Association and cofounder and CEO of digital point-of-care platform eMed.
Harris spoke with Healthcare IT News about how the federal government and other stakeholders can support innovation, the best ways to ensure digital health tools don't exacerbate disparities, and how eMed hopes to play a role in filling the COVID-19 at-home testing gap.
Q. As someone who's been on the forefront of leadership in the healthcare industry, what are you most excited about right now in the world of digital health innovations?
A. For a long time, there has been a need to innovate. There are clearly a lot of problems in healthcare. And certainly if we look at the intersection of healthcare and innovation, there's also a lot of promise.
There's a lot of promise in early diagnostics, there's a lot of promise in mental health. I think there's a lot of promise in even public health, as we think about supporting those essential frontline health workers' ability to contact-trace.
And, of course, telehealth has been around for a while, as you know, but certainly with COVID, there's been a rapid acceleration of acceptance of care via digital health means.
There's a lot of opportunity around removing barriers. We've seen barriers at every turn both pre- and post-COVID. And there's a lot of promise in digital health and technology and virtual care, removing barriers to care.
So I see a lot of promise in the years to come.
Q. What can decisionmakers, including in the federal government, do to help support those innovations?
A. I characterize the opportunities for everyone – but certainly the federal government – as regarding funding, policy and regulation.
I am originally from West Virginia, and I went back to my hometown and traveled about an hour south, and there was not good broadband service. And so clearly, if we want to democratize healthcare, if we want to increase access, we have to make sure that everyone has that equitable opportunity to even participate in virtual care or digital health innovation. So funding is critical for broadband.
Funding is critical for innovation. HHS and CMS have the Center for Medicare and Medicaid Innovation. There's an opportunity to fund and spur innovation in the digital health world. And certainly, there are always opportunities for public-private partnerships. So that's the funding piece.
And then the policy piece – and I guess policy and regulation go hand in hand, and perhaps are opposite sides of a coin. But you know, during COVID, we saw the federal government, specifically CMS, relax some of the rules around access to services and care via telephone. We need to modernize our regulations, I think, for a future world where digital healthcare is a part of the solution.
Now, you know, I do not believe anyone is saying that there's a one-size-fits-all approach here. It's right care, right person, right time – at an affordable cost.
But certainly, I think we need to modernize regulations that support and promote further adoption of innovation and digital healthcare. And so policy and regulation go hand in hand: It's [a matter of considering] what do we need to stop? And what do we need to change? And what do we need to add?
Q. What strikes me in my reporting is how much potential these innovations have to help address the dramatic disparities in healthcare outcomes that we see in the United States. But at the same time, if someone can't access these innovations, they do not help to close that gap. How can stakeholders ensure that these digital health innovations are not widening the resource gap and are not only making options more available to people who already have means?
A. Like you asked me at the very beginning of our conversation: I'm very excited about the promise. But I'm also clear-eyed about the peril.
We need to be clear-eyed at the very beginning of the development of innovation. As we get excited about the new technology, let's have a conversation at the very beginning. Unintended consequences are consequences nonetheless. I'm sure you've reported on incidents where there have been unintended consequences around algorithms, and other issues.
Listen, you can't avoid every consequence. But to me, if you have conversations about those at the very beginning – you have conversations about the peril – you can solve for those ahead of time.
To your point, one area of the peril is further widening health inequities. And so, we have those conversations at the very beginning: Sort of think through, "OK, if we do X, what potential impact might it have on these health inequities?"
Then I think you go a long way in – not a guarantee, but certainly mitigating the widening of those gaps.
Q. Given that framework, how can we use digital health tools to address the lingering effects of COVID-19, especially considering its effect on already vulnerable groups?
A. I can tell you about one of my major worries. As you know, at the beginning of the pandemic, we saw the long lines waiting to get tested. People were waiting 10 hours, and then the test results were not readily available.
As you know, I'm the CEO and cofounder of eMed. When we saw the long lines, we began to think about this company: How can we solve this problem? As you just said, people can't afford to wait 10 hours, and no one should have to wait 10 hours in a car. So what can we do to not be a one-size-fits-all solution, but be complementary to a cadre of solutions?
We know about going to on-premises sites for care, and about care you can get virtually. But what if we even dive deeper and talk about a subsect of that virtual care, which is diagnostics and early diagnosis?
You and I know that the earlier you intervene in a disease condition, the greater there are opportunities for a cure. There will be new treatments on the horizon; there are already new treatments on the horizon. But, of course, a lot of these treatments require that early diagnosis. So that is why it's a perfect opportunity for the use of technology: diagnosing earlier, getting folks to treatment earlier.
The Biden administration has announced a major investment in testing. And that is good news. The stakes are high as we're returning to work, returning to school, it's a cold and flu season, people are traveling.
When the stakes are higher, you need some opportunity, some plan, some process in place to make sure that results are verified and – also critically important – are reported to local health authorities, who are very interested in mitigating outbreaks.
So we think that there's a right test, right place, right time, and we want to make sure that the administration gets the appropriate return on its investment to keep our country safe and moving in the right direction.