Digital Health

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Digital Healthcare is the combination of technology and traditional healthcare. Considered to be a broad, multidisciplinary concept , digital health applies digital transformation to the healthcare field by incorporating software, hardware, communication, and digital services to the healthcare field [1] With the use of all the underlying technology available under the umbrella term "Digital Health" such as Health Analytics, Internet of Medical things, Telemedicine, Telehealth, Health Information Technology, Mobile Health, etc, this technology helps medical and health professionals manage illnesses and health risks in patients and promote wellness [2]


Brief history

Early examples of Digital health can be traced back to 1897, where the one of the first uses of telemedicine was documented by Adam Darkins and Margaret Cary in their book "Telemedicine and Telehealth:Principles, Policies, Performances and Pitfalls [3]. Their account contains information on how a telephone consultaion with a physician was held to bypass catching prevalent a croup infection at the time

With healthcare technology advancements in the 20th century such as the introduction of various imaging techniques combined with the inductions of various professional medical associations led to the vocalization of topics such as the transition from traditional healthcare methods to advanced technology driven substitutes[4].

The 21st century has seen the biggest strides in the growth of digital health technology, numerous exemplary use cases and device augmentations to support better healthcare[5]. With the inventions of devices and mediums such as the WellDoc in 2005 and Fitbit in 2007, healthcare saw a major turn to being independent and patient/consumer oriented for the convinience of individuals in mind. [6]..

Functions of Digital Health

Digital health has numerous functions, but the major objectives being driven by digital health are[7]:

To improve the quality of outcomes of care and service and reduce costs

To improve population health by making medicine more personalized

To improve the patient experience by improving access

To improve the experience for the healthcare provider by reducing inefficiencies

To digitize traditional health systems and modernize the process and points of interaction

Selected technologies in Digital Health

Digital health has a broad scope when we try to categorize the variety of interaction points people can access it with. The list includes numerous fors of wearable technology, mobile health solutions, telehealth, health information technology, clinical solutions, blockchain technology, information of medical things, and telemedicine [8].

Our article will explore three of such categories in depth: Internet of Medical Things, Telemedicine, and the technological innovations in clinical and diagnostic settings.

Internet of medical things (IOMT)

The internet of medical things or IOTM for short, is an integral part of digital health. The continued development of smart sensors, smart devices, advanced communication protocols such as bluetooth and wireless internet have made it possible to interconnect a myriad of "medical things" and monitor all sorts of bio-medical signals. This not only helps in the observation of our vital and biological statistics but also aids in the diagnosis of diseases in patients without any traditional human intervention[9]. [10].

Remote health monitoring though IOMT

One of the key use cases of IOMT is to use smart devices to remotely and continuously monitor the health of patients while still allowing them to carry out regular tasks and that too without a hospital setting[11].

Oxymeter connected to an android phone
Using devices such as smartwatches, digital weight scales, wireless oxymeters etc, vital patient information such as heart rate, blood pressure, blood oxygen levels, glucose levels, and stress levels can be transmitted from the device sensor itself to a central decision support system in the device, or a portable patient monitoring unit (PPMU) stationed at a seperate location such as one's home and the hopsital. This enables the the medical professional to monitor such signs, look into previous records and measure any irrational behaviour all from their computer or smart device without the patient even visiting a hospital setting. This also lowers hospital bed occupancy costs, visitation costs, and presents a more accurate trend line for accute diagnosis.[12]. .

Typically, the data gathered through the device is transmitted through networks such as wi-fi, ethernet, or cellular networks for long range and bluetooth foor short and immediate distances. [13]. .

Heart disease management

A remote cardiac monitoring device
Remotely monitoring the heart is considered a crucial part of remote health. Traditionaly, electrocardiograms (ECG's) are used to monitor heart beats and its rhythm using elctrodes connected to a large machine that measures these signals in a hospital setting. With current technological advancements, portable ECG machines in the form of wireless nodes can transmit heart data wirelessly to android or ios based devices such as mobile phones for the consumer to quickly view their own vital signs. the data is stored in applications with the patient's other medical data and can be remotely seen by their medical providor for easy access and management [14].

Brain and neurological disease management

Wearable EEG device examples
Apllicable for patients suffering from illnesses such as epilepsy, alzheimer's, dementia etc, IOMT bases neurological monitoring devices such as the remote EEG montor can be used to monitor the brain waves and any electrical activity happening in the brain to sunderstand signs of irregularity and aid in the research of such diseases. Found in many shapes and forms such as headbands, sensors embedded in the devices function through contact based, like the galvanic skin response sensors, or contact less methods such as using motion detecting cameras to accurately identify behavioural and gestural changes in patients, especially those suffering from neuro-degenerative diseases. The continuous monitoring of electrical signals in the brain can be transmitted to the patient's family or healthcare providers for monitoring and management. Devices such as these can help to catch erratic behaviour early on and get the patient to a stable state quicker or even avoid them altogether[15].

Diabetes and blood sugar management

Continuous glucose monitor connected to a smartphone application
Patients who suffer from diabetic problems need to frequently check their blood glucose levels to make sure their sugar intake is kept in check and their glucose levels are under control[16]. There are currently many devices that patients can easily use to measure and manually check their glucose measurements at home or at a pharmacy, however they do not provide real-time monitoring of sugar levels. Using IOMT, specifically by using implantable continuous glucose monitoring machines (CGM) or other comparable sensors, companies such as eversense are able to provide automatic and constant glucose monitoring services for everyone. These devices can stay on the patient's body and stay in place for 7-180 days without needing replacement. The sensors are wirelessly connected to smart phones and other personal devices and keep uploading blood glucose levels at regular intervals. Though application, the patient can receive warnings and reminder whenever their glucose levels are not within regulated or pre-set levels[17].

Fall detection in the elderly

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Each year, 36 million falls are reported each year, out of which 3 million cause injury and 32,000 are responsible for deaths[18]. Coutries such as the United States categorize falls as one of the leading causes of death in older adults, making it a public health concern among the aging population[19].

There are many devices in the market that use IOTM technology to help the elderly quickly respond to falls and be safe. Personal wristbands embedded with accelorometers, gyroscopes, and vibration sensors can be worn by individuals, which can accurately determine if the wearer has fallen or lost balance. During such occasions when the device registers a fall, a central system akin to a home alarm system is alerted of the fall, which contacts emergency helath authorities, a family member, or the police that a medical emergency has taken place. Compared to instances where the fallen person is rendered unconscious oe unable to move, the mortality rate is drastically reduced as emergency attention is promptly able to arrive due to the alert[20].

Mobile health

Personal health technology in action
Mobile health is in fact quite well established among the general population due to the influence of smartphones and smart accessories in our day-to-day life. Devices such as smartphones, wearable technology such as smartwatches, smart t-shirts, pedometers, pacemakers, TENS units, and any IOMT device that supports mobile health and independant tracking of health data qualifies as a part of mobile health[21]. [22]. These devices are innovative as they facilitate the monitoring of vital sign management, track medication control, generate accurate trend lines of vital records[23].

In accordance to Moore's law, as thecnology keeps on advancing, the price of said technology will become more affordable[24]. Smart watches that cost upwards of $300 in 2014 now cosst 1/10th of the price and actually provide more health monitoring functions than its predecessors. This combined with more upgraded communication standards have made it possible for us to enjoy mobile health tracking more easily and cost efficiently[25].


Telemedicine, sometimes referred to as Telehealth, is when patients receive medical treatment without having to visit their doctor's office. Telemedicine can done using a phone, cellphone, tablet or computer. Telemedicine can be done in one of multiple different ways. Patients can:

  • Talk to their doctor live over the phone or a video chat application.
  • Send and receive messages from their health provider using secure messaging, emailing and secure file exchange.
  • Use remote monitoring so health care practitioners can check on patients at home. Using a monitoring system to check a patients vital signs is an example of this. [26]

A brief history of telemedicine

Telemedicine has been around for longer than many may think. It was first used many years ago when people first started developing new technologies to communicate over long distances.

  1. The first incidences. When telegraphs were created in the 1840s, communicating over long distances became possible. The first major incidence of telemedicine occurred in the American Civil war in the 1860s. The Union Army used the telegraph to communicate casualty reports, coordinate patient transport, and request medical supplies.[27]
  2. The Telephone. The patenting of the telephone by Alexander Graham Bell in 1876 brought forward a new era of communication for people. This allowed doctors to cut down on unnecessary office visits by doing phone appointments. This was documented as early as 1879.[28]
  3. Radio Communications. Radio communications was a developing technology during the early 1900s. One of the first instances of telemedicine being used through radio communications happened in Australia in 1928, when Reverend John Flynn founded the Aerial Medical Service (AMS). They used telegraph, radio and airplanes to administer treatment to rural areas in Australia. This was documented as the first incident in any country where an organization used telecommunications technology to deliver healthcare to remote areas.[29]
  4. The television makes face-to-face communication possible. In 1964, upon receiving a grant from the U.S. National Institute for Mental Health (NMH), the Nebraska Psychiatric Institute implemented a two-way closed-circuit Television link between the Institute itself and Norfolk State Hospital about 112 miles away. The link was used for education and consultations between specialists and general practitioners.[30]
  5. Today. Telehealth in todays day and age is much faster and much easier to access than it was in past years. The Covid-19 pandemic has accelerated the use of such technologies within our society and has created a demand for telemedicine like never seen before. Patients now can use their cellphones, tablets or computers to access healthcare at the push of a button. There are also new technologies in development that will be used in the near future to make telemedicine much more comprehensive and substitutable for a real in-person doctor's visit. Some of these technologies will be discussed below.

Telemedicine today

  • Zoom. In 2020, Zoom went from just another video-conferencing platform to an essential service that many began using to do work from home and other things remotely. This was also one of the main applications that health care practitioners would use to talk to patients who could not come to in-person doctor's visits. Zoom for Healthcare is a comprehensive platform that is optimized to help healthcare practitioners connect with patients and provide more accessible, personalized healthcare experiences.[31]
    A doctor's appointment in a virtual setting
  • Telehealth organizations. Companies such as Teladoc, MeMD, HealthTap and many more provide their clients with access to doctors around the world whenever they need medical attention. These companies usually have apps which come with video-conferencing options so that patients can use them for their telemedicine appointments. These types of apps will prove to be useful as doctor shortages may make it harder to have a consistent family doctor who can keep up with your health records in the future.

New telemedicine technologies

  • H3 Health Cube. The Unidoc H3 Health Cube, is a standalone remote health clinic, that enables a real-time, remote doctor visit which contains essential diagnostic tools as well as a full video-conferencing setup. With this health cube, patients can go through full consultations as if they are in a physician's office. This type of technology may become common in the near future, as those who are more vulnerable will be able to avoid contact and still safely receive medical attention outside of their doctor's office.[33]
    H3 Health cube
  • Dr. Clobo Camera. The Doctor Clobo Camera is a special connected camera which can take pictures of hard to reach areas on the body such as inside the mouth, ears, nose, hair and skin. This camera connects to an app which sends the high-resolution pictures to a doctor who will analyze them and consult with the patient afterwards. This camera is an innovation which helps patients at home deal with the minor checkups that doctors normally do in the office. This can reduce doctor's visits by a lot and would potentially save time and money as well. [35]

Discussions on telemedicine

During the digital health presentation in Drew Parker's Summer of 2022 466 course, the class was asked if they think that people will continue to visit their doctor as telemedicine continues to advance. Some liked the idea of telemedicine, and one actually used it a fair amount, but the majority of students stated that they would still prefer to visit the doctor even with the advancing state of telemedicine technologies. The reasons cited in favour of in-person visits were based around the fact that doctor visits are much more hands-on and the doctor can actually test and see what is going on with them. Drew brought up the point that it is not easy to give up going to see a doctor who has become more than just a doctor, but a friend, and how that sort of connection and thorough treatment cannot be replaced using web-based telemedicine. Most people, especially those of older generations, have grown up with family doctors, and only switch doctors in certain circumstances. This connection is very valuable to many people, as not having that type of connection can change the way that a person views medicine and doctors altogether. Also, most people do not trust telemedicine technologies enough yet to give up going to the doctor altogether. In a 2021 poll by NPR and multiple other organizations, it was found that 42% of people used telemedicine. Of those people, 64% would have preferred to visit a nurse or doctor in person.[36] This shows that people are still not fully sold on telemedicine as a complete substitute yet, as it is yet to be able to deliver the same quality of examination that an in-person examination can deliver, in the eyes of many people. However, as new telemedicine technologies such as the H3 Cube continue to be developed and improved, there is a good chance that people's viewpoints will eventually change, as time passes.

Innovations in diagnostic technology

Traditional diagnostic process

There are five main processes in traditional diagnostic. The first step is clinical history and interview. So the patient will come to the doctor when they experience a health problem, and the doctor will acquire their clinical history and conduct the interview with the patient. Next, the doctor may do a hands-on observational examination of the patient, which is called physical exam, this exam can help the doctor figure out the next steps. Then, the patient may need diagnostic tests. This is a critical feature of standard medical practice, it can help the doctor identify a condition before its clinically apparent. And then it should be the medical imaging. It includes medical technology such as X-Ray, CT, and MRI, which play a critical role in diagnosing. The development of medical imaging has improved the doctor’s ability to detect, diagnose, and treatment, it can also help the patient avoid invasive procedures. And the last step is referral and consultation. In this process, both doctor and patient can consult with other experts through a formal or informal way. This procedure's purpose is to have a second opinion from other experts for an unsure condition. [37]

Current challenges

Diagnosis has important implications for patient care, research, and policy, so it’s the most crucial part of healthcare, when a diagnosis is accurate, a patient has the best opportunity for a positive health outcome, and public health decisions are often influenced by diagnostic information, so in order to improve the accuracy, we need to know about its current challenges.

1. Clinical history & interview: a.Ineffective communication b.Obtaining history can be challenge (memory loss, health problems limit communication) c.Time Pressure (Interview)

2. Medical imaging a.Perceptual or cognitive errors made by radiologists b.Incomplete or incorrect patient information c.Insufficient patient information sharing

3. Diagnostic testing a.Selecting the appropriate diagnostic testing b.Operating parameters (false positive/false negative result) [38]

Today's diagnostic innovations

Microsoft cognitive services

The mission of this AI service is to give the user’s app a human side. It includes 6 aspects:

1. Vision Identify and analyze content within images and videos

2. Speech Improve customer experiences with Cognitive Service for Speech

3. Language Understand conversations and unstructured text with Cognitive Service for Language

4. Decision Make smarter decisions faster

5. Search Autosuggest, image search, news search, video search, web search, entity wearch

6. labs Apply advanced coding and language models to a variety of use cases [39]

Selected use case

A famous use case is Pneumonia classification. Pneumonia is the main cause of child death in the world. From 1000 children born alive, 12-20 children will die from pneumonia before their 5th birthday. The dataset here is chest x-ray for both pneumonia and normal images. Scientists collected more than 5 thousand chest x-ray images from the public, and then machine learning and image cognition can help the computer give out the diagnostic results. The benefits of this use case are: save lives with highly precise automated diagnosis and reduce the risk of human misdiagnosis. And here is the sample interface, it’s really easy to use, and we can see that the doctor only needs to upload the medical image, and then the computer can show the prediction.

Chest x-ray sample for our use case


TCR-Antigen map

The Antigen Map is the complete mapping of which T-cells bind to which antigens. If we knew nature’s map, we could read the story about what your T-cells are currently targeting or have targeted in the past. Although the scale of the complete map is enormous, using a combination of high-throughput sequencing, functional assays, and cloud-scale machine learning, we are learning to decode that map for disease-specific antigens. As this map comes into focus, we will unlock a new approach to diagnosing disease based on reading your immune system. [41]

T-cells and their story

The human immune system is an astonishing diagnostic system, continuously adapting itself to detect any signal of disease in the body, the state of the immune system tells a story about virtually everything affecting a person’s health, so if we can read this story, then we can have an accurate diagnose. And the “story” is hidden t-cells in our blood. After the patient's TCR be sequenced from their individual sample, and then compare with the database, if the sample’s sequence matches a specific case, then the doctor can take the diagnosis immediately. And the disease-specific signatures may be used by doctors and researchers to improve disease diagnosis, treatment, and vaccines. [42]

Some Applications:


Ovarian cancer

Autoimmune disease: Type I diabetes

Celiac disease

Crohn's disease

Infectious disease:


Lyme Disease

Other diseases

Other diseases with an unmet need for a blood-based diagnostic [43]

Technology innovation in disease surveillance

Disease surveillance

Traditional disease surveillance has been a key ingredient in any public health portfolio for many decades.

Disease surveillance is widely recognized as one of the most important tools to assess, predict, and mitigate infectious disease outbreaks.

Traditional disease surveillance is based on data collected by health institutions, and the data typically consists of information such as morbidity and mortality data, laboratory reports, individual case reports, field investigations, surveys, and demographic data. They are generally collected by physicians, public health laboratories, hospitals, and other health providers and institutions. [44]

How blockchain technology works in digital health

Blockchain technology and digital health

Blockchain is a distributed system for recording and storing transaction records.

Blockchain is a shared, immutable record of peer-to-peer transactions built from linked transaction blocks and stored in a digital ledger

Blockchain relies on established cryptographic techniques to allow each participant in a network to interact (e.g. store, exchange, and view information), without preexisting trust between the parties. In a blockchain system, there is no central authority; instead, transaction records are stored and distributed across all network participants. [45]

Re-imagining the possibilities & challenges

Some possibilities that exist and can be engaged with the use of blockchain technology:

  • Transforming the future of healthcare delivery
  • Accelerating clinical research and scientific innovation
  • Engaging underserved citizens [46]

Factoring Education in Digital Health

There is a marked shortage of doctors in BC, with almost one million residents that don't have a primary care physician.[47] This has been a long standing issue in BC and it's only set to get worse as the average age family medicine doctor if 49.[48] There are various potential causes for this issue. The payment structure by which family medicine doctors are compensated generally doesn't reflect the amount of work they are expected to do. There is only one medical school in BC (UBC) that offers 288 seats each intake.
Picture of UBC's medical school

Medical school tends to have very high tuition costs, with only 288 seats being offered each intake and the payment structure not compensating family medicine doctors appropriately new graduates are less likely to choose family medicine. According to the Canadian Medical Association the percentage of medical graduates choosing family medicine fell from 38.5% to 31.8%.[48] Digital health can be used to help with some of these issues. For instance medical schools could start offering non practical components of their curriculum, online via Zoom to keep costs down. Telemedicine could be used to provide better access for patients to doctors without the need for the doctor to set-up a clinic with high operating costs. Telemedicine and more sophisticated diagnosis tools will help decrease the workload on doctors and ensure a better quality of health for the patients. Education in digital health also refers to individuals that may not be comfortable using all the new tools that are available to them. The elderly population for example make up a significant portion of at-risk patients and they may no know how to properly use telemedicine.

More medical schools

Political parties are making the expansion of he medical program a key issue in their campaigns. In late 2020 the provincial NDP party proposed creating a new medical school in SFU's Surrey campus.[49]Having more medical school will help with the shortage of doctors, but there are still root causes that need to be addressed. eLearning could play a key part in making education more accessible by having more reasonable costs for new graduates. Research suggests that to have there is still a lot of work that needs to be done to implement eLearning with cost benefits and advantages over traditional instruction.[50] However with the right implementation of online and practical aspects new students entering school could see a reduction in their tuition fees. Making medical education more accessible will encourage more potential students to apply and assist in dealing with the shortage of primary care physicians.

Changes in the curriculum

According to research the curriculum in medical schools will also see a drastic change in the future. Students will spend more time on their specific specialization, the amount of time it takes to graduate would decrease and students will spend more time on practical application rather than theory.[51] With the advent of new technologies such as AI, remote health monitoring and telehealth it is imperative the curriculum keeps with changes. Schools need to ensure a digital literacy component is available for students to keep with the technological innovations in the healthcare field.

Ensuring accessibility

Telemedicine may change the way patient-doctor communication is conducted in the future. A significant portion of at-risk patients however, may not be comfortable using all of the tools that are provided to them. [52] Training and support are crucial in ensuring patients know and are comfortable using tools that they are provided. There should be a program that contributes to digital literacy and helps patients become more accustomed to telehealth or remote health monitoring. As digital health continues it is imperative that patients and physicians are able to keep up with the changes to ensure the highest quality of communication between the two parties.

Overlying challenges of digital and remote health

While the benefits and conveniences of remote health systems and mobile health tracking is quite substantial, there are some stern challenges present as well. Interconnected devices, specially in a hospital environment means data can flow seamlessly and quickly. However, due to security weaknesses, hackers can target and attack any connected device to gain access to the entire system channel for any neferious purposes. There are also clear privacy concerns when using applications that keep personal medical data. Nowadays, many ad agencies and data harvesting companies can gain access to a persons medical information from their smartphone if the user is not cautious. Once stolen, this data can be sold in the black market and dark web for high profits and cause other personal information to be stolen through the data leak.

To combat many of such risks, it is very important to make the older generation more digitally literate and make them ready to fully adopt such medical services without the risk of losing private information. Hospitals and clinics must also take digital security seriously and gain professional help when designing or implementing network wide software implementations. The service must keep patient security in mind and in priority.

Some final thoughts

Digital health is an amazing thing. The digital transformation of health care is changing how health care is delivered to us[53]. The fact that we are at an age where someone's blood sugar can be measured continuously, wirelessly, needle-free, and be automatically tracked in a easy to use interface on our smartphones available for us and our doctor's to analyze is... pretty amazing.

While the technologies of digital health were developing at a considerable pace, the COVID-19 pandemic accelerated the progress in implementing many aspects of remote health management. A record number of doctors, medical clinics, hospitals, and health practioners embraced using zoom and other telemedicne platforms to see patients. The inherent success that followed made remote apppointments a staple in our lives and a supplementary method for doctor's visits.

Yes, like many other forms of emerging technology, the umbrella under digital health sufferes from various drawbacks. From inefficient achitecture design to privacy risks to user acceptance and education, there are many reasons though which the usage of digital health services can be seen in a negative limelight and portrayed as a work in progress[54].

But, so what, I dare say. Yes it is a work-in-progress, but it also is such an amazing thing to look forward to!

The advances in digital and mobile health have led to more interconnected patient-doctor relationships where patients can get better and more suitable treatments based on the best of data, that too when they are sitting on their front porch. Now this is futuristic and exciting. Is it not ?


Anubhav Bhopla Anoop Bassi Chenyang Sun Mohammed Shahrukh Islam
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada


  48. 48.0 48.1
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