Digital Health Technologies

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Contents

Introduction

Digital health technologies refers to "the use of information technology/electronic communication tools, services, and processes to deliver health care services or to facilitate better health.” [1] These tools have the potential to improve healthcare professionals’ ability to accurately diagnose and treat diseases and to enhance the overall delivery of healthcare. These technologies use computing platforms, connectivity, software, and sensors for health care and related uses. [2] Essentially, digital health is the intersection between IT and healthcare, and is changing the way that medicine is practiced. [1]

Digital Healthcare Umbrella

Digital healthcare is a broad, and multidisciplinary concept that encompasses various concepts pertaining to information technology and healthcare. [3] Telehealth, telemedicine, and telepharmacy are all areas that can be categorized under this umbrella.

Telehealth

Telehealth is the “use of electronic information and telecommunication technologies to support long-distance clinical health care, patient professional health-related education, public health and administration.” [4] Telehealth technologies include mHealth, video conferencing, remote patient monitoring, and store and forward.

mHealth

mHealth, short for “mobile health”, refers to the “healthcare applications and programs that patients use on their smartphones, tablets, or laptops.” [4] mHealth applications allow patients to track health measurements, share information with health care providers, set medication and appointment reminders, and communicate with providers online. [4] mHealth applications examples include asthma and diabetes management tools, weight loss management tools, and smoking cessation apps.

mHealth in Maternal Care and Childcare

Due Date Plus App[5]

In particular, mHealth is changing the landscape of maternal and child health. According to a WHO report, over 800 women pass away daily from preventable causes related to labour and pregnancy around the world. 99% of these women are from developing nations. By using mHealth applications, family members and doctors will be able to monitor pregnant women and prevent deaths. [6]


Wyoming Medicaid did a study that measured engagement levels and post-birth outcomes for patients who used a mHealth app called, “Due Date Plus.” [4] This mobile app provides a platform for women to record pregnancy milestones, access medical services, and find symptom-related information. The study found that women who used this app had an increased compliance with prenatal care and a decreased occurrence of babies born with low birth weights. [4]

Video Conferencing

Health care providers are overcoming the barrier of distance by utilizing real-time video communication platforms to diagnose and treat patients remotely. [4] Specifically, this technology has been used to treat inmates, military personnel, and patients located in rural locations.

Treatment of Prison Inmates

Diagnosing Prison Inmates Remotely[7]

The South Carolina Department of Corrections and the Medical University of South Carolina are using video scopes and high-resolution cameras to diagnose and treat inmates remotely. [4] They are also conducting online appointments using video and audio communication platforms to reduce prisoner transportation costs and to increase safety by keeping inmates in and providers out of correctional facilities. [4]

Treatment of Military Personnel

With the use of video conferencing technology, physicians who are deployed with soldiers are able to treat and assess patients who are stationed at different deployment zones. In addition, video conferencing allows for soldiers who are stationed abroad to be treated by physicians who are stationed in their home country. [8]

Remote Patient Monitoring (RPM)

Remote Patient Monitoring (RPM) involves the “reporting, collection, transmission, and evaluation of patient health data through electronic devices such as wearables, mobile devices, smartphone apps, and internet-enabled computers.” [4] RPM technologies such as wearables and other electronic monitoring devices are used to collect and transfer health data such as vital sign data including blood pressures, cardiac stats, oxygen levels, and respiratory rates to the physician or health care provider. [4] According to the Center for Technology and Aging, patients who participated in RPM were less likely to have hospital stays, incurred fewer emergency and urgent-care visits, and were able to better manage their symptoms. [4] They also reported increased physical stamina levels as well as greater overall satisfaction and emotional well-being. [4] Chronic conditions can also be more readily and efficiently managed, resulting in higher quality care and outcomes as well as reduced costs.

RPM Cycle

RPM Cycle[4]

The RPM cycle consists of 5 steps: collect, transmit, evaluate, notify, and intervene. For example, if a cardiologist is treating a patient using a blood pressure monitor, then the following 5 steps can be followed as part of the treatment process. [4]

  • Collect: The patient puts on the arm cuff and the blood pressure monitor collects their blood pressure data
  • Transmit: The data is transmitted to the cardiologist
  • Evaluate: The cardiologist receives and reviews the data for any abnormal patterns
  • Notify: The cardiologist notifies the patient if there are any issues with the blood pressure data
  • Intervene: If there were issues found, the cardiologist creates a treatment plan [4]

Kardia Band and Apple Watch

​​
Kardia Band for Apple Watch[9]

An example of a RPM technology is the Kardia Band and Apple Watch partnership. AliveCor is a medical device and artificial intelligence company that sells electrocardiogram (EKG/ECG) hardware and software for consumer mobile devices. [10] AliveCor introduced the first medical-grade EKG brand for the Apple Watch called the Kardia Band, along with a new app for smartphones. The Kardia Band for Apple Watch allows users to discreetly capture their EKG at any time. [10]Users can record a single-lead EKG by touching the Kardia Band’s integrated sensor that communicates with the Watch app, Kardia by AliveCor. The Atrial Fibrillation (AF) detector uses Kardia's automated analysis process algorithm to detect the presence of AF in an EKG, which is the most common problem with the rate or rhythm of the heartbeat (cardiac arrhythmia) and a leading cause of stroke. [10]The Kardia Band also includes a normal detector, which detects if your heart rate and rhythm are normal, and an unreadable detector, which prompts you to retake an EKG to ensure that physicians and health care providers receive the highest quality recordings. [10] Users can also record voice memos on their Apple Watch to send to the healthcare professional along with the EKG. This ensures that health care professionals are receiving the full picture of what was happening at the time of recording. The chief executive officer of AliveCor, Vic Gundotra, says that the “Kardia Band for Apple Watch represents both the future of proactive heart health and the introduction of the wearable medtech category.” [10] The Kardia Band for Apple Watch will allow caregivers and individuals to take on a more active role in managing their health.[10]

Store and Forward

Store and forward telehealth refers to “the capture, storage, and transmission of patient health information for asynchronous healthcare delivery using data storage and transmission technology.” [4] Some examples of store and forward include:

  • Teleradiology: A specialist radiologist or physician reviews x-rays taken at a remote location or after hours.
  • Teledermatology: Having the digital images of a patient’s skin condition sent by a general practitioner to a dermatologist for diagnosis and treatment advice.
  • Consultation: A junior doctor taking and sending images of a patient’s wound to their consultant for advice.
  • Retinal Screening: Diabetic retinopathy is an eye disease that causes high blood sugar. A technician can take images of patients' eyes with this disease to send to an opthamologist for review. [4]

Telehealth Services and Applications

Telehealth technologies can be used to address issues such as physician/specialist scarcity, be used for education and training, increase patient and provider engagement and communication, and manage chronic diseases. However, there are issues that telehealth technologies face such as the issues with self diagnosis, privacy, and mental health.

Primary Care Physician Shortages and Specialist Scarcities

Telehealth technologies provide patients at smaller, less-resourced hospitals to see specialists who work at larger regional facilities.[4] For example, those living in rural communities or underserved urban areas can communicate with specialists via videoconferencing, without having to travel outside of their communities. [4]

Education and Training

Several organizations are providing healthcare education using digital telehealth technologies. For example, Harvard’s Safety, Quality, Informatics and Leadership (SQIL) program uses these technologies to take a blended learning approach. [4] SQIL uses on-demand content combined with in-person training to create a medical education model that uses “information technology, data, and a culture of continuous improvement to enable healthcare organizations to evolve into true learning." [4] Physicians are also using online and mobile platforms to meet their Continuing Medical Education (CME) and Maintenance of Certification (MOC) requirements, and to prepare for Board Exams. [4]

Telehealth and Patient Engagement

Telehealth technologies such as health management apps for mobile devices are encouraging patients to manage chronic conditions, lose weight, increase physical activity levels, and to gain emotional support. [4] For example, diabetes patients are using carbohydrate tracking apps and glucose monitoring devices to manage their blood sugar measurements. Other patients are communicating with their healthcare providers and scheduling appointments through secure online communication portals. They are also accessing health education content via smartphones and computers and are also using wearables and monitoring systems to gain knowledge about their sleep patterns, vital signs, and activity levels. [4]

Telehealth and Provider Communication

A significant telehealth development is the increased communication via digital and telecommunications platforms among care providers. [4] Telehealth technologies allow health care providers to share information and collaborate in the treatment of their patients. In a situation where a family physician has to consult a specialist for a patient specific condition, there would typically be an added link of communication required into the timeline. Now with telehealth, the doctors can have virtual consultations through video conferencing and online messaging platforms through which they can share patient records, notes, and results to analyze. [11] Through this virtual communication, it saves time in between setting up appointments to reach and meet specialists, and in turn, reduces costs and time for possible transportation required in urgent scenarios. [12] Health care providers are also utilizing telehealth platforms to consult with specialists and other providers to increase access for their patients in low provider availability areas. [4]

Efficiency and Cost Savings

There are hidden costs to healthcare such as taking time away from work, travel expenses and child-care costs when having to attend a physician’s appointment in person. Telehealth reduces these costs by allowing patients to meet with their health care provider in the comfort of their home or in a location that is more convenient for them. It also allows health care providers to see more patients. [4] From the perspective of healthcare providers and doctors, digital health technology also brings many potential benefits. Aside from the aforementioned communication and convenience benefits that it enables, there are also other benefits that encourage doctors to take advantage of digital health technologies. In terms of time management, the adoption of this technology has the power to reduce workload, stress, and opportunity costs for doctors.

Workload and Stress Reduction

With the self-care and self-management devices and platforms that patients can use with digital health technology, some of the time and efforts for doctors can be freed up and used as down-time. Many doctors are reported to be extremely overworked, with many reporting that they work almost 50 hours a week, not yet including extra on-call hours.[13] A poor work-life balance and workplace environment dissatisfaction can lead to high stress levels and eventual burn-out for doctors.[13] This is detrimental and concerning to their well-being and also for patients, as doctors are professionals who interact with and impact so many others. The digital movement will hopefully help reduce the workload and stress for doctors.

Opportunity Costs Reduction

As the self-monitoring tools can be self-managed by patients, this also allows more time and efforts of doctors to be utilized in other aspects of healthcare. This enables more opportunities for doctors to focus on training, research, and helping more patients. This yields net benefits for healthcare providers.

Management of Chronic Diseases

Monitoring patients in between appointments and reducing wait times are crucial elements in treating acute conditions before they turn into chronic diseases. Chronic diseases are a heavy burden for the Canadian healthcare system. The Chronic Disease Prevention Alliance of Canada reports that chronic diseases cost the Canadian economy “$190 billion annually, with $122 billion in indirect income and productivity losses, and $68 billion in direct healthcare costs.” [14] As life expectancy increases, these diseases are expected to become more prevalent and lead to longer wait times, especially in hospitals. Proactive care through telehealth can reduce unnecessary medical appointments and the economic burden of chronic diseases while also keeping the patient at home longer and reducing readmittance rates [14]

Telehealth Limitations and Concerns

While there are a lot of benefits of telehealth, there are some limitations and concerns. To start, it is not possible to do every type of visit remotely. Patients would still have to see their doctor face to face for procedures such as imaging tests and blood work, as well as for diagnoses that require a hands-on approach. [15] To continue, telehealth technologies pose a risk to the security of a patients’ health information. These privacy risks involve a lack of control over the collection, use, and sharing of the data that is transmitted across these platforms. For example, home telehealth devices and sensors that are used to detect falls may collect other personal data such as details of substance abuse or periods that the house is unoccupied. [16] Similarly, health apps may share sensitive data such as location and sensor data with advertisers and other third parties. The use of telehealth technologies has also brought issues regarding self diagnosis to light. When individuals start to feel the onset of symptoms, they tend to turn to online sources to diagnose their symptoms. There are over 10,000 diseases in the world, so symptoms from one condition will likely overlap with symptoms from other conditions. This results in individuals usually overestimating or underestimating their symptoms. Therefore, telehealth tools may not be effective since they often involve self monitoring. For instance, the Kardia Band for Apple Watch allows users to record voice memos on their Apple Watch to send to the healthcare professional along with the EKG. [4] With this technology, there is a risk that individuals might exaggerate their symptoms based on facts found online. Or, they might underestimate their symptoms and shrug off vital signs. Both of these scenarios could have negative health consequences for the individual. To continue, telehealth may have a negative impact on a patients' mental health. For highly social individuals, these clinical approaches may be a nightmare since they are unable to interact with their health care professionals in person.

Adoption Barriers for Healthcare Providers

There are a few barriers of adoption that may cause friction for the implementation of digital technology for healthcare providers. These include the traditional systems used in hospitals and the possible resistance from doctors.

Traditional Systems in Hospitals

In today's age, many doctors still spend significant time handling and processing physical paperwork through old-school medical data systems.[17] Healthcare is one of the industries that has lagged behind due to the older traditional systems that they have been accustomed to for decades.[18] Additionally, many hospitals have adopted more traditional electronic interfaces, which may be quite costly to replace at a mass scale.[19]

Resistance from Doctors

Digital technology forms that are newer and more innovative may be difficult to fully implement and there may also be a steep learning curve involved for doctors to adopt such technology.[20] For doctors who are older and nearing retirement, there may be some resistance to their willingness to learn and adapt, and the degree to which their knowledge on operating the technology may vary.[20] For healthcare providers and hospitals who choose to adopt digital healthcare technologies, a well-thought-out implementation plan that includes transitional phases are crucial to a succesful adoption.

Telemedicine

Oxford defines telemedicine as “the remote diagnosis and treatment of patients by means of telecommunications technology.” [4] Telehealth and telemedicine are sometimes used interchangeably, but in practice, are different. Telemedicine is a subset of telehealth that refers solely to the "provision of health care services and education over a distance, through the use of telecommunications technology." [4] Telemedicine technology is usually used for follow-up visits, management of chronic conditions, medication management, specialist consultation and other clinical services that are conducted remotely using secure video and audio connections. On the other hand, telehealth is a blanket term that covers "all components of healthcare and the healthcare system conducted through telecommunications technology." [4]

Examples of Telemedicine

Some examples of telemedicine include:

A radiologist interprets images remotely] [4]
  • Teleradiology: A radiologist reads and interprets imaging results for a patient in a different country whose hospital does not have a radiologist. [21]
  • Urgent care consultation: A physician can conduct an urgent care consultation via video conferencing for patients with non-life threatening conditions. [21]
  • Providing care for the Inuit people : Indigenous people, such as the Inuit, have an average life expectancy that is 11 years lower than the rest of Canadians. [21] Along with different social factors, a low population density within a wide and remote territorial region have contributed to this inequality in health status. [21] Remote northern Canadian communities usually have community health clinics where nurses work under the guidance of off-site family physicians located in regional health centers. Physicians will visit remote clinics occasionally, but the system mainly relies on air transport for accessing specialists. With telemedicine technology, patients will be able to see specialists remotely and have access to medical expertise, without having to leave their community. [21]

Benefits of Telemedicine

There are various benefits to telemedicine, both for the patient and for the healthcare provider.

Patient Side

  • Access to specialists: Patients who require the care of a specialist often have long commute times to the specialist’s office. Telemedicine makes it possible for patients to leverage the expertise of specialists from the comfort of their own home. [22]
  • Less chance of catching a new illness: At a doctor’s office, patients are at an increased risk of catching new viruses, as there are patients with a variety of symptoms and illnesses in the waiting room. With telemedicine, patients are able to stay home and get the care that they need, without being exposed to other potential pathogens. It also ensures that the patient does not spread their illness to other patients. [22]
  • Less time in the waiting room: Through video conferencing technology, patients will not have to spend time in the waiting room. Instead, they will be able to log on to their virtual appointment at a designated time and date at a location that is convenient to them. [22]
  • Better health: Telemedicine allows patients to see their doctors more often, without the challenges of a long commute or wait time. Therefore, patients will be able to better manage their health through frequent communication with their health care providers. [22]

Healthcare Provider Side

  • Reduced overhead expenses: Healthcare providers who offer telemedicine services may incur fewer overhead expenses. For example, they might be able to reduce the number of front desk staff needed or can invest in an office space with fewer exam rooms. [23]
  • Additional revenue stream: By using telemedicine, healthcare providers may see an increase in revenues. Telemedicine can reduce the lag time between patients, which allows the healthcare provider to see more patients, and generate additional revenue. [23]
  • Reduced exposure to illness and infection: As health care providers are seeing patients remotely, they are not at a risk of contracting any illnesses that the patient may carry. [23]

Challenges of Telemedicine

Having the Right Training and Knowledge

One challenge is ensuring that physicians have the right training and knowledge to provide patient consultations through telemedicine. Physicians must ensure that they follow all ethical and legal requirements to obtain consent from their patients, and go beyond the usual consent required for an in person appointment. [24] Physicians must ensure that their identities, locations, and licensure status is known and accepted by the patient, and to be able to verify the patient’s identity. If other healthcare providers are present in the appointment, their identities must be disclosed and approved by the patient. All information discussed must also be documented in the patient’s record. [24]

The Lack of Human Touch

A doctor delivers a diagnosis via a robot[25]

When a doctor at the Kaiser Permanente Medical Center in Fremont California delivered the news to a patient they were dying via a video technology robot, this sparked a debate on the importance of preserving the human presence in medicine and how to safeguard compassion in the telemedicine era. [26] The medical industry has seen great development with the help of technology. However, human interaction and touch is an instrumental part of the healthcare experience that cannot be provided with telemedicine. Touch allows humans to form personal connections with one another and promotes trust and healing. Researchers have published many studies over the past decade that show:

  • Showing compassion through comforting touch can reduce pain after surgery, improve survival rates, and boost the immune system [27]
  • When physicians are empathetic, patients have significantly better outcomes and an increased level of patient satisfaction and compliance [27]
  • Holding a patient’s hand can reduce cortisol levels caused by stress hormones [27]

Therefore, it is important that healthcare professionals find ways to combine telemedicine technology with the power of touch in order to improve patient care experiences, care and outcomes.

Preserving Human Touch

Once we have acknowledged the shortcomings of the lack of human touch in digital healthcare, our team also considered ways to preserve it. The aspects mentionned earlier are important to retain: physical touch, compassion, and empathy. [27] When giving news to patients, unlike in the robot example, the phrasing and toning of the doctor’s words can provide compassion and make a big difference in the patients’ outcomes. The empathy and doctors’ understanding of the patients’ condition can help ease and comfort the patient and increase patient satisfaction. [27] The physical human touch aspect is something robots can never replace, as it addresses the emotional needs of patients. [27] For healthcare providers considering adopting digital health technologies into their processes, they must not forget about the human touch aspect that grounds healthcare and makes it human. Treatment methods that incorporate both technology and human doctors working together are the key to success.

Telepharmacy

Telepharmacy is “the use of telecommunication technology by pharmacists to oversee aspects of pharmacy operations or provide patient care service.” [1] It is considered a subset of telehealth and telemedicine activities focused on pharmacy activities such as medication management, dispensing, and patient care. [1]

Inpatient Telepharmacy Remote Order-Entry Review

Inpatient (a patient who stays at the hospital during treatment) remote order-entry review is the process of having a pharmacist at a remote location review medication orders prior to the medications being administered by local pharmacy and nursing staff at a hospital. This allows medication reviews to happen in real-time 24 hours a day and can help reduce the workload of the inpatient pharmacy staff. Remote pharmacists are able to provide 24/7 coverage or can fill in during peak hours to supplement and strengthen the inpatient pharmacy. [28]

Inpatient Telepharmacy Review of Discharge Medications

During the inpatient hospital discharge process, the pharmacist in a remote location will review all anticipated discharge medications. They will compare the discharge medications with the patient’s electronic medical record. [28] They will then review all discharge medications by telephone with the patient and answer any questions that they might have. In this call, they will also identify any potential issues that could lead to the patient’s readmission. In order to ensure medication compliance, the pharmacist will call the patient 48 hours after discharge to ensure that the patient:

  • Has taken the proper dosage of all prescribed discharge medications
  • Understands all medications and treatment plans
  • Understands which medical reasons could lead to readmission [28]

The telepharmaicist will also schedule any follow-up calls and send any important information discussed during the call to the patient’s health care provider. [28]

Remote Dispensing

​​
Remote Dispensing[29]
"Remote dispensing, which is also refered to as retail/outpatient/discharge dispensing is when a traditional brick and mortar pharmacy is staffed by pharmacy technicians and supervised by a licensed pharmacist at a remote location." [28] The remote pharmacist is responsible for overseeing the pharmacy technicians, reviewing all prescriptions, and performing all the regular duties of a staff pharmacist in a traditional pharmacy. Remote dispensing benefits rural areas as the cost of a pharmacist can be split across several pharmacies in the same area. [28]

IV Admixture

IV admixture is the process of mixing medication into an IV solution bag that is 50 ml or greater. [28] Through remote viewing using telepharmacy, pharmacists can review and approve the IV mixture without having to put on protective equipment and approve the IV mixture in person. This allows the remotely located supervising pharmacist the opportunity to participate more in other clinical activities and in additional revenue producing activities. [28]

Remote Counselling

Remote counselling refers to a pharmacist counselling patients about their medications using video conferencing technology. [28] This can also include specialized counselling about medical conditions such as diabetes, hypertension, heart disease and HIV/AIDS. Patients who are being discharged from the hospital can also be counselled regarding their newly prescribed and continuing discharge medications via remote counselling. [28]

Misconceptions about Telepharmacy

Misconception 1: Telepharmacy Poses Health Risks

Many individuals are under the impression that telepharmacy is dangerous. However, a NDSU Telepharmacy study which studied telepharmacy in the state of North Dakota, shows that telepharmacy had a lower dispensing error rate then the national average for community pharmacies.[28] Pharmacy technicians are also continually supervised by a licensed pharmacist, and prescription medications are reviewed by pharmacists before reaching the patient. Specialized video and audio equipment that is approved by the health insurance and portability and accountability act in the USA, allows for the entire prescription process to be verified and supervised. [28]

Misconception 2: Telepharmacy Reduces Pharmacist and Pharmacy Technician Jobs

There is an increased demand for pharmacists to supervise all aspects of a pharmacy technician’s practice. The NDSU study on the safety of telepharmacy found that the use of telepharmacy created between eighty and one hundred new pharmacy jobs which in turn resulted in over twenty-six million dollars in economic development on the local and state levels in the USA.[28]

Misconception 3: Telepharmarcies Lead to Pharmacies Closures in Underserved Areas

According to a University of Chicago study in the city of Chicago’s south and west side, approximately one million people in low-income communities lived in “urban pharmacy deserts” without access to a pharmacy. [28] Telepharmacy has allowed pharmacies to open up in these “pharmacy deserts” where a pharmacist can supervise many pharmacy technicians in different pharmacy locations simultaneously.[28]

Misconception 4: Telepharmacy Enables Drug Theft and Diversion

In the United States, there are many state and federal regulations in place to ensure that telepharmacies have a lower risk of narcotics diversion than traditional pharmacies. Many states require that pharmacy technicians be certified in telepharmacy or have extensive experience working in telepharmacy. It is also often required that the Pharmacist in Charge (PIC) of a telepharmacy visit the telepharmacy facility in person weekly or monthly to examine and verify all orders and to examine all inventories of controlled substances.[28] Many telepharmacies also have lower inventory stocks and are able to choose what medications are dispensed. In some cases, telepharmacies are restricted from stocking or dispensing narcotics. Therefore, they are less likely to be subjected to robberies and internal theft. Also, telepharmacies are continuously monitored by high technology HD video cameras and audio surveillance as an additional deterrent to drug diversion or theft. [28]

Misconception 5: Telepharmacy is still in its Experimental Phases

The use of telepharmacy in the United States began in 2001 North Dakota. The United States Navy began using Telepharmacy in 2006 and currently uses telepharmacy in over 100 Pharmacy locations globally. Twenty three states now allow telepharmacy, with the number increasing in the United States daily. [28]

Misconception 6: Telepharmacy is Ineffective for Chronic Medical Conditions

Telepharmacy was found to help diabetics administer their medications, lose weight, lower HbA1C levels and lower low density lipoproteins. [28] In a study published by the North Carolina Medical Journal, they found that 92% of patients were very satisfied with their telepharmacy care with 83% indicating that telepharmacy helped them obtain the care they required. [28] The study compared 90 patients in rural areas receiving telepharmacy to 262 patients seen in person. They found that patients who were treated with telepharmacy had similar improvement in glycemic control to those patients who were treated in person at a university hospital internal medicine clinic. [28]

Medical Monitoring Devices and Wearables

There are a number of personal wearable devices that patients can use on their bodies to self-monitor and track their health condition. They are useful in providing patient health data and promoting the self-management of health conditions. With the integration of software on wearable devices in conjunction with software on smart devices, wearables can provide instant feedback, track paterns, show progress, and even share information with healthcare providers. A few types of wearables include blood pressure monitors, heart rate monitors, and smartwatches.

Blood Pressure Monitors

Functionality

Home blood pressure monitor[30]

Blood pressure monitors are devices that wraps around a patient’s bicep area on their bodies, and usually has a digital LCD or LED screen to display to the patient its readings of blood pressure and blood pressure changes throughout a specific period of time.[31] It records a log of measurements over time by measuring the amount of force being exerted onto the walls of a patients’ blood vessels while the flood flows through their veins in given time fractions.[32] It measures both systolic and diastolic numbers in time intervals.[32] Systolic blood pressure measures the pressure in a patient's arteries when their heart beats.[33] Diastolic blood pressure measures the pressure in a patient's arteries when their heart rests between beats.[33]

At Home vs At Doctor's

Blood pressure monitors at home measure in an oscillometric method, while blood pressure monitors at the doctor's office measure by auscultation.[34] By using stethoscopes, doctors are listening to heartbeat sounds to measure blood pressure against the chest by ear, through auscultation.[35] At home, digital blood pressure monitors track the vibration of blood travelling through a patients’ arteries.[34] In terms of the comparison between the two, many of the home monitors are made to be clinically accurate at a standard level, showing just minor information reading differences between the two.

Heart Rate Monitors

Functionality

Heart rate monitors are personal monitoring devices that measure and display electrical signals from a patients’ heart to show real-time readings of heart rate and patterns. They are generally used to gather heart rate data for patients who have heart conditions or for individuals who perform physical exercise.

Forms

They typically come in the form of a wristwatch device or a chest device. A wrist device wraps one’s wrist where a watch would normally be found, and a chest device wraps around the user's body and chest area. The data captured by the heart rate monitor contains raw information about the patient's heart rate and is then transmitted to a smart device with software to be analyzed and interpreted to present more comprehensive information.[36] Most devices show accurate information in real-time.

Smartwatches

Heart rate monitor on Apple Watch and iPhone[37]

Smartwatches such as Apple Watches that feature built-in heart rate monitors use an optical sensor that uses photoplethysmography to flash green LED lights and photodiodes to detect blood flow in veins throughout specific time intervals.[38] This enables background passive heart rate monitoring. Smartwatches are programmed to learn patients’ idle heart rate, thus notifying them when their heart rate shows signs of variability.[38] It scans for unusually high or low heart rates in the background to deliver notifications to the patients. It also checks for irregular rhythms and skipped heartbeats.[38] The electrocardiogram provides interpretations of cardiac rhythms and other systems to give suggestions and prompts users to call emergency services.[38] Newer versions of smartwatches also have fall detection, which helps notify emergency contacts if a patient is unresponsive after a fall.[39]

Software

Software is essential as wearable devices must be paired to a platform to let users access a more holistic view of their health data. This can be software on a mobile or desktop device. To tie this back to telehealth and the RPM cycle, the information captured from the wearable devices can be transmitted to software which can then be sent to major health institutions to physicians, who can examine the information with their professional expertise on a higher level and give medical advice. Furthermore, with mediums such as video conferencing and internet messaging, communication about medical advice and conditions based on the patients data can be facilitated. This renders a contactless and seamless digital health experience.

Breakthrough Digital Technology Forms

There are a few different forms of innovative digital technology that further expands the research and development for the healthcare provider. These include augmented reality, virtual reality, artificial intelligence, and organ printing in healthcare.

Augmented Reality

Definition and Functionality

Augmented reality is an interactive experience that inserts virtual information into the real-world in real-time, which allows for users to not lose touch of reality, but rather view both at the same time, enhancing their perception of reality.[40] It can span across multiple human senses, including visual and audio senses.[40]

Consumer Use Cases

AED4EU defibrillator application[41]

An interesting implication is an AR application that shows the nearest defibrillator based on the user’s location. The AED4EU app, created by a developer from the Netherlands, utilizes the camera and location from a user’s smartphone to show the precise location of nearby accessible defibrillators.[42] It would be useful in common populous areas such as large shopping centers or busy downtown streets. The AR camera can also be used to help doctors explain to patients their health conditions.[42] Studies show that around 65% of people are visual learners, so for patients who may be confused and concerned about their bodies, this provides a comprehensive and visual way to understand a complex condition.[43]

Nurse Use Cases

AR used for vein scanning[44]

A daily use case of AR can be used to help nurses find veins when drawing blood for patients to reduce the chances of missing.[45] This can be accomplished by using a laser-based scanner in a portable device to view a virtual real-time image of veins underneath patients' skin.[46] This can be used as an aid in both training and in practice.

Game Use Cases

Games on mobile platforms such as Pokemon Go can utilize the camera and AR features in smartphones to provide a novel and entertaining way to motivate users to exercise and conduct daily activities.[47] Through these interactive games, the experience can be developed to tailor activity to each user according to their goals and physical abilities. Developers can also add in fun reward and bonus elements to provide instant gratification to users, fulfilling their sense of accomplishment. Pokemon Go was a widespread success due to their existing fanbase, but other developers can be creative in gamifying various graphical scenarios to peak the interest of users. The power of AR in this use case is really endless and up to the developers.

Surgical Use Cases

AR used for tumor visualization[48]

AR can assist surgeons and dentists alike during operations. It can help surgeons during operations to locate tumors in real-time by inserting information into what they see in reality.[42] Dentists can utilize the same method to build retainers and caps for teeth.[49] There are countless ways in which AR can be used to aid with medical procedures and training.

Visually Impaired Use Cases

AR used for the visually impaired[50]

A meaningful implication of AR is that it can assist the visually impaired by enhancing the appearance of everyday objects and familiar faces to help patients recognize loved ones, find household objects, and navigate environments around them.[51] This is possible through emphasizing certain shapes or colors through a set of eyewear customized for various patients, depending on their specific condition. [52]

Challenges and Limitations

Despite all the benefits and possible use cases augmented reality brings to the healthcare sector, there are some challenges and limitations that must be factored in. The main challenges in AR adoption are the technical barriers and the costs. [53] As many hospitals and healthcare providers may not yet be equipped with the digital skills to execute this type of breakthrough technology, there may be high initial start-up costs. The institution must evaluate the costs and benefits of this innovation before adopting it at a full scale. [53] Most of these use cases also have a heavy reliance on the developers who create the AR applications and software, as well as the ongoing support they must provide to update and maintain the software.

Virtual Reality

Definition and Functionality

Virtual reality provides a computer-generated simulation that users can use to immerse into an artificial three-dimensional environment, using a headset device that they look into.[54] A common addition is a hand controller that uses sensors to track hand movement. There are also other sensors to track body movement. With the help of technology to trigger multiple human senses, including visual, audio, and touch, it can create an artifical world that can feel quite real.[55] It differs from augmented reality, as it creates a fully immersive experience rather than enhancing the real world with visual overlays.[55]

Surgical Training Use Cases

VR used for surgery training[56]

VR can be used to help with surgical procedure training. During operations that are life-threatening and time sensitive, it is difficult to facilitate on-the-job training as surgeons in training may become an obstacle to operating surgeons. Surgeons can use VR cameras to record their point of view in first person, which can then be streamed at any later time by surgeons in training to immerse themselves into operations without getting in the way.[56]

Physical Therapy Use Cases

VR used for physical therapy[57]

VR can also benefit patients recovering from strokes or other types of physical injuries in physical therapy recovery use cases.[58] It can be added to the rehabilitation procedure to make the exercise experience more engaging and motivating for patients through showcasing graphics and games through the headset.[59]

Limitations

There are also some challenges and limitations of applying virtual reality to the healthcare industry. One of the primary challenges goes back to the human touch aspect, as immersing oneself into a fully virtual experience reduces the level of face-to-face interactions. [60] There are also safety concerns that must be precisely addressed when developers create VR software for medical purposes, as it is notably different from VR software created for entertainment and recreational purposes.[60] It must be prescribed appropriately by certified medical experts, as there may be side effects including sickness and addiction that may arise if not used properly. [60]

Artificial Intelligence

Definition and Functionality

Artificial intelligence in healthcare is the use of deep machine learning algorithms to analyze complex medical data and generate conclusions.[61]

Diagnosis Use Cases

AI can be used to help doctors diagnose patients with various health conditions. AI software can be programmed to recognize symptoms of certain diseases in patients’ medical data.[62] It can help with the early prediction, treatment, and management of various types of diseases.[62]

IBM Watson Example

Background and Context

In 2011, IBM Watson Health hoped to penetrate the digital healthcare space with transformative artificial intelligence. [63] After forming partnerships with many medical institutions and pharmaceutical firms, they took a marketing heavy approach, announcing bold claims and headlines.[63] On paper, their technology would allow for the facilitation of medical data to improve medical processes and reduce costs overall. [64] The concept is that AI can enable medical experts to make better decisions based on data, leading to more patients cured and saved. [64]

Downfall and Failure

Unfortunately, what led IBM Watson Health to their downfall was that their product did not live up to all the hype generated by the marketing-first approach. [65] At the time, the research and technology were not yet available for IBM to deliver their product. [63] Their ideas were revolutionary, but their underdelivered product and implementation compared to their overpromises were what led them to their eventual failure.

Lessons Learned

A decade later, the necessary resources have emerged to implement AI in healthcare efficiently. [63] There are some important lessons that other medical firms can learn from the IBM Watson Health story. AI in healthcare does not only involve computers and technologies, but the human aspect also remains and is critical. AI does not replace the years of studying and practicing doctors spend, instead, it empowers doctors. Technology can often be intimidating and seen as a barrier; therefore, firms must focus on reducing the barriers of adoption through comprehensive education and training. [63] Doctors must learn to trust and confide in the technology and work hand in hand with it for a successful implementation.

Organ Printing

Definition and Process

Printed artificial heart[66]

Organ printing is a new type of healthcare technology still in its development phase. Researchers have been working on it for the past few years, but it is still being researched as of 2021.[67] The concept is similar to 3D printing; a computer model is transmitted to a printer that converts plastic to mold an artificially printed organ.[68] There has yet to be a fully functional and transplantable human organ printed to date, but there has been major progress achieved by scientists.[67] There are a multitude of possible benefits and use cases that it may enable in the future. Organ printing uses a material that is a biocompatible plastic, which serves as the skeleton and housing for each organ.[69] Patients’ cells are seeded and grown into the skeleton in an incubation chamber for a period of time.[69] Through this seeding process, the organ is customized for compatibility reasons to each patient.[69]

Organ Transplants

The current organ donation and transplant process includes long, and sometimes hopeless waitlists for compatible organ donors to become available.[70] The arrival of organ printing technology can eliminate this shortage and compatibility would be ensured by the seeding process.[70]

Pharmaceutical Research and Medical Training

Printed organs used for research[71]

If printed organs can feature a high level of complex detail and contain high resemblance to a real human organ, it will enable high quality research and training for scientists and doctors to be conducted without relying on real organs.[72]

Ethical and Legal Issues

Upon talking about the benefits that bioprinting can enable, there are also ethical and legal considerations that must be addressed. First, since this breakthrough technology is new and still in research, there are significant costs associated with the process since it requires time, skill, and customization for compatibility.[73] Researchers and healthcare providers must develop a process with reasonable costs and time required so that patients in all income brackets can have equal access to treatment. [73] Second, there is also the concern of this technology being misused in the wrong hands. For example, if athletes use bioprinting to enhance their bodies in an unnatural way to increase their speed and strength, is that considered cheating and unjust on the competitive level? [73] Or, what if individuals printed organs and sold them on the black market? [74] Bioprinting and organ printing must be regulated by a governing to ensure printed organs are handled ethically and professionally.

The Growing Popularity of Digital Healthcare

Digital healthcare has been around for decades, but has yet to be adopted into regular use by health care systems around the world. In the last few years, there is an increasing interest in pursuing digital health strategies in various places. There are three key drivers to this interest.

The first is the aging population and global shortage of healthcare professionals. The World Health Organization has projected that there will be a global shortage of 18 million health workers by 2030 while more people will get old and require long-term medical care. [75] Countries believe one way to mitigate this shortage is to increase the productivity of the existing health workforce by strategies involving digital healthcare.

The second reason is the increasing consumer demand. A 2018 survey by Ipsos conducted in 27 countries found that while just one in ten respondents had used telemedicine, more than four in ten would try it if it was available. [76] Consumers welcome the convenient and time-saving online setting of digital healthcare. They are interested in receiving non-urgent medical services online, such as routine medical consultations and prescription of medicine.

Lastly, the third reason is the COVID-19 pandemic, which affected the global healthcare system. The deadly pandemic had caused millions of deaths. It triggered a global shortage of healthcare services, and more importantly, it encouraged the need for a remote healthcare system that can prevent in-person interaction to stop further transmission of the disease. It is evident that COVID-19 has increased global demand, usage, and attention to digital healthcare. As digital healthcare is a big and growing market with huge values and financial gains, many companies are interested in developing digital healthcare services hoping they can earn a fortune from it. Therefore, the development of digital healthcare all around the world has accelerated.

2020 Digital Healthcare Valuation[77]


Predicted Growth of Digital Health Market[78]

Digital Healthcare in Canada

Canada was an early pioneer in the development of virtual care through the work of Dr. Maxwell who used telephone technology to provide virtual consultations to remote sites across the country in the 1970s. [79] However, Canada has since been surpassed by other countries in the uptake of digital healthcare.

According to the Canadian Medical Association 2019 survey, there is a huge gap between consumer demand and the availability of digital healthcare services. For example, 41% of Canadians would like to have video visits with their health care provider but just 4% of family doctors offer this option. It shows that Canadians are facing a huge shortage of digital healthcare services. [80] There are three reasons to explain this shortage.

Complicated Billing Mechanisms

The current billing regulations in health insurance plans is the largest barrier to the widespread adoption of digital healthcare in Canada. This is because the regulation stated that doctors must either personally carry out or have direct supervision over any act or procedure for it to be billable to the territorial insurance plan. As a result, the Canadian healthcare payment systems are still based on face-to-face encounters between the patient and doctor. Although some provinces do provide payment for telemedicine when both doctor and patient are in a designated telemedicine facility within the same province [81], doctors are still unwilling to provide digital healthcare services as they are discouraged by the complicated billing process required by the Canadian government. Some provinces even create harsh laws that further reduce the incentive for doctors to provide digital health services. For example, BC limits the use of the GP Email/Text/Telephone Medical Advice Relay Incentive Fee to 200 services per doctor per year while Alberta limits the use of its doctor-to-patient secure electronic communication fee code to 14 claims per doctor per week. [80]

Complicated Licensure Requirements

The second barrier that caused the slow-growing development of digital healthcare in Canada is the complicated licensure requirements. Generally, doctors must be licensed in every province where they provide traditional medical care unless they are uniformed doctors serving in the Canadian military. [80] Each of the medical regulatory bodies in Canada also have some form of standard or policy on licensure requirements for doctor providing digital healthcare services. For example, Saskatchewan offers a specific telemedicine license while New Brunswick enables physicians from other jurisdictions to provide telemedicine services to its residents through a telemedicine regulation. [81] The 2019 CMA Health Summit Statistics further explains the difficulty for doctors to provide digital healthcare. [80] Most doctors state that the process of getting licensure in other territories is too complicated, long, and expensive. They simply don’t want to waste time and money to get another license. They also don’t want to go through all the trouble to learn different regulations and bear the legal risk. The variability in licensure requirements for doctors providing cross-boundary digital healthcare eventually discourages them to provide digital healthcare services in Canada.

Obstacles for Cross-jurisdictional Licensure[80]

Lack of Connectivity

Digital healthcare is an interconnective process that requires the cooperation and sharing of data between different functions. It is essential to have digital connectivity across all points of the health care system to support virtual care. However, the 2018 survey of Canadian adults showed low levels of connectivity between patients and doctors. For example, only 22% of respondents could currently access their medical records and only 17% could make an appointment online and 10% could send a digital message to the doctor. [80] The lack of connectivity eventually makes it difficult for Canadian communities to support the operation of digital healthcare.

Public-Private Mix Efforts for Promoting Digital Healthcare

Despite digital healthcare being not widely available in Canada, the Canadian community made collective efforts to promote digital healthcare.

Reformation of Billing Mechanisms

A fee-for-service payment method had been proposed to reform the Canadian medical billing model. It calls for a clinical review to assess the need for doctor contact on an evidence-informed basis with a pricing review that considers the relative effort and payment for virtual care. Alternative payment models such as bundled payment and capitation were also proposed, hoping to simplify the billing and insurance process and encourage patients and doctors to use or provide digital healthcare. [80] In March 2019, Telus Health successfully partnered with Babylon to launch an app that enables residents of BC to have smartphone video consultations with a doctor, which will be covered by the Medical Services Plan.These reforms collectively encouraged the development of digital healthcare in Canada.

Babylon Healthcare App[82]

Reformation of Licensure Requirements

The Federation of Medical Regulatory Authorities of Canada is currently working on three initiatives to facilitate cross-jurisdictional licensure for digital healthcare purposes. It includes allowing duly licensed doctors to use their license in any province or territory, to speed up the license issuance process to doctors who hold full registration in another province as well as enabling doctors to work for a maximum number of days in another jurisdiction on the basis of licensure in their “home” jurisdiction. [83] Although these initiatives are not yet legally ruled, such initiatives had attracted government attention to reconsider the unification and simplification of licensure requirements across Canada.

Enhancement of Connectivity

The Canadian Economic Strategy Tables has called for setting up national digital health guidance on privacy, data governance, sharing, and security frameworks to reduce the barriers to the connectivity of healthcare digital systems. The Canada Health Infoway launched an initiative to expand the access of Canadian’s health information. This involved the development of the ACCESS Gateway, a platform that will enable connectivity across electronic medical and health records and the health services that Canadians use. [80] Their efforts had succeeded to enhance connectivity and supported the development of digital healthcare in Canada.

Controversies and Limitations of Digital Healthcare

There are three major controversies regarding the usage of digital healthcare. The first is the privacy concern. The operation of digital healthcare depends on data sharing between hospitals, patients, and doctors. Without sufficient data, doctors cannot provide suitable treatment to their patients. However, the transmission of patient data between the private and public sectors creates opportunities for data leakage as it is difficult to control and identify the person who can access the data as well as to ensure that service providers can keep data secure. [84]

At the same time, the qualification of digital healthcare services is also being considered. Digital healthcare can be conducted between territories and even across different countries. With different healthcare standards and regulations among territories and countries, it is difficult to ensure the qualifications of the service provider as well as difficult to check and prove whether the treatment offered by the unknown doctor fits the medical standards.

Lastly, the cross boundaries digital healthcare services also create legal concerns in which there is no unified law to decide who is responsible for any mistreatment. For example, it is difficult to determine whether the web service providers are legally responsible for the mistreatment of their contracted doctors, or the doctors themselves. As a result, patients are lack of confident about using digital healthcare services provided by private businesses currently.

The above controversies also reveal the major limitation of digital healthcare which is the lack of unified governance. There is no law, regulation, or governance body available globally to monitor the digital healthcare industry. [85] Both private and public organizations are freely contracting with medical professionals claiming that they are able to provide qualified medical services. Patients also have trouble in seeking legal help and claiming compensation regarding mistreatment and data leakage due to the absence of laws to protect their interests. It is also impossible for law enforcement to punish wrongdoers when they are located overseas. As a result, there is an urgent need for a strong legal and regulatory base to protect consumer rights and prevent wrongful acts associated with the rapid development of digital healthcare globally.

Digital healthcare has another limitation, which is that there is no unified patient database. Private digital healthcare providers cannot access patients’ health records from public hospitals to support their diagnoses. Patients’ health records also cannot be shared between medical institutions among countries. It causes difficulty for digital healthcare providers to accurately evaluate patients’ health conditions and offer suitable treatment accordingly. At the same time, the current digital healthcare services are only capable of conducting basic monitoring and consultations but are unable to perform surgery and examination in a remote setting. These are the issues that both digital healthcare providers and governments need to solve in order to enhance the services provided.

Barriers of Digital Healthcare around the World

Despite digital healthcare being a promising and demanding business, businesses and hospitals are still hesitant to develop and promote digital healthcare. The Economist has explained the major barriers that hinder the development of digital healthcare in different regions. [86] The rating of barriers includes regulation difficulty, ethical concerns, lack of investment, and technology limitation as demonstrated below.

Asia

The ethical and regulation limitations make it difficult for companies to enter and do business in Asia.[86] Asian governments consider a country-wide digital healthcare system as a tool for social control and monitoring citizens’ mobility. They do so by recording citizen’s visits to the hospital as well as their treatment routine. It is also compulsory for citizens to register their personal information in order to use the services. [87] Digital healthcare system has been proven to be effective in monitoring citizen’s mobility. However, due to the sensitive issue of data collection and sharing, those governments only empower specific companies to provide comprehensive digital healthcare while most private businesses are only qualified to provide basic health consultation such as how to keep fit or how to plan a healthy diet which is irrelevant to major digital healthcare services like medicine distribution and hospital referrals. [88] As a result, it is difficult for businesses to fully integrate into the digital healthcare market of Asia.

Europe

In Europe where the issue of digital healthcare is overseen by the European Union, the difficulty of regulation is the main barrier to promote digital healthcare. [86] There is no unified regulation and governance body regarding digital healthcare among the European countries. It is because the member countries of the European Union (EU) are not interested in collaboration and invest in digital healthcare. Especially when the UK left the EU, it shows that the union of the EU is unstable. The lack of enforcement power makes it impossible for the EU to settle the value conflict between countries and force its member countries to follow an unified law. The difficulty of regulation eventually leads to an insecure environment for cross-boundary business that digital healthcare providers are hesitant to conduct data sharing and provide services across the European countries.

America

The high investment cost with the uncertain return of investment is the biggest barrier to promote digital healthcare in America. [86] It is costly to build a standardized digital healthcare system and database in America as America is a multi-provinces and territories county with different legal and local infrastructure. The digital healthcare market in America is like a wild west with limited government support in regulation. Companies can foresee challenges on privacy and data sharing in America and they have difficulty minimizing their risk as there is no universal regulation and governance body available that provides clear guidance of how businesses should behave. The high uncertainty makes companies hesitate to expand their business in America.

South Africa and the Middle East

There are no major barriers as well as no restrictions on data collection and sharing in South Africa and the Middle East. Those countries are looking for foreign investments and they are welcoming companies to provide investment and technology to help them settle a national digital healthcare system. [86]

Future of Digital Healthcare

There are two major predictions on where new digital healthcare services will be created in cooperation with new technologies. First, when combining AI with digital healthcare, it is expected that AI can replace doctors in analyzing medical records, design treatment plans for minor diseases, and assign medicine remotely. Second, when combining VR and AR technologies with digital healthcare, it is expected that VR and AR can simulate different sickness and body situations that allows hospital and medical school to train doctors remotely with lower costs as they don’t need to buy corpses, which is very expensive and limited in the market to let doctors practice their skills. [89] At the same time, with the help of VR and AR, doctors can also perform surgery and body examination remotely which benefits patients from a remote location. With reference to the breakthrough of digital healthcare technology, Deloitte[90] had pictured the future of digital healthcare in which all data and applications will work together to help consumers make real-time decisions about preventing illness and staying healthy longer. In this future, consumers will willingly share their data because they trust the system and know they will get value back through early detection, diagnosis and continued wellness. Patients will also know their costs when considering treatment options, and researchers will be able to quickly identify which therapies work for which people.

Our Thoughts

We believe the best outcome of digital healthcare is where a standardized governance body and legislation are created to regulate digital healthcare providers in the global community. Such enforcement power will allow governments to prevent and address possible wrongdoings within and across countries, ensuring the safety of patients. For example, governments can request digital healthcare providers to enhance the transparency of data sharing and documentation in order to reduce customer’s privacy concerns. In addition, quality checks can be required to ensure the qualification of contract doctors to provide medical services.

On the other hand, this standardized governance system will become a clear guideline on how digital healthcare providers should operate, allowing businesses to reduce legal risk and uncertainty. Thus, the system can support and encourage more businesses to develop digital healthcare globally. More importantly, the COVID-19 pandemic has proven that all countries are in danger of the same disease due to globalization. It is important to assist developing countries in adopting digital healthcare in order to create better data sharing and to monitor the transmission of diseases. The digital healthcare system will be an effective tool to alert and prevent future outbreak of global pandemics.

COVID-19 is a strong case to encourage the internationalization of medicine and health care, and yet the will of the global community to make this happen doesn't seem to be there right now. By reviewing the prior empirical study and academic literature, we are able to identify that political struggle is the main barrier to cooperation between countries. Due to the differences in political ideologies and prolonged conflict between political parties, there is a tense relationship within and between countries. Countries have different diplomatic policies with the succession of new political leaders, and will get distracted by internal political conflicts, which reduces their incentive to deal with global affairs. Externally, countries are valuing their individual gains more than mutual benefits. When global cooperation contradicts their self-interest, countries will either object to the proposal or withdraw from the union. UK Brexit is a good example to demonstrate the weak cooperative power in the existing global union. There is simply no way to foster long-term global cooperation if countries refuse to give up a proportion of self-interest and seek manual gains. With the increasing suffering and financial loss from the pandemic that eventually outweighs the cost of global cooperation, we expect that the global community will recognize the need to create a standardized digital healthcare system with an unified regulation and governance body.

Upon considering different forms of digital healthcare technology and their benefits, use cases, and limitations, our team has formed a prediction on what a future world may look. Our team believes that the future outlook on digital healthcare is not a battle between technology and humans, but rather, they will work together as strong complements to provide improved healthcare processes for communities.

Authors

Lisa Nguyen Karina Lui TuenYeung Ha
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

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