My CPhA Digital Health Conference takeaways

Recently I attended the inaugural Digital Health Conference by California Pharmacists Association. I learned so much that I want to share my takeaways. And this happens to be my first LinkedIn article! (This is about a 5-min read, not including hyperlinks). The photo above is me posing with Dr. Parisa Vatanka, a champion of digital health and a dynamic leader of our profession.

In my career thus far I have been fortunate to see firsthand how digital health tools can help improve the efficiency of healthcare delivery and people’s healthcare experience. I also have been learning a lot from entrepreneurs (including my old CEO, whose fast and entertaining book Where Does It Hurt?: An Entrepreneur’s Guide to Fixing Health Care encapsulates both the vision and reality of disruptor startups taking on the massive and Byzantine U.S. healthcare realm), as well as organizations that are passionate about digital health.

Despite my voracious learning, I still had a few missing pieces: how can pharmacists – experts in disease management and drug therapy – integrate digital health into our work? When I first heart about CPhA’s inaugural digital health conference, I knew that I had to come! And it was absolutely worth it.

The California Pharmacists Association has always been ahead of the curve on innovations and this conference is no exception (AMCP, ISPOR, and other pharmacy organizations are also doing GREAT thing in anticipation of an explosion of growth in digital therapeutics).

The meeting started off with a great message from speakers. An interesting point was shared: Who are rushing to enter the healthcare space? Investors and tech companies. The digital age has ushered in an unprecedented growth and development of technologies that can improve people's living conditions, environment, and work. It's widely recognized that changes have been slow to emerge in the healthcare sector due to the sheer size and complexity of existing infrastructures and business models. Although the decks are stacked against healthcare disruptors, they recognize that there is a huge need to create a better healthcare experience and remove inefficiencies/barriers from everything people do in healthcare: how personal health information is stored and transformed into insights, how people access medications, and how pharmacists can be a part of the healthcare revolution which had been forecasted by the New York Times in the last decade.

Digital health tech comes in all types (e.g. wearable tech, cloud computing, AI, etc.). Large health organizations are leveraging machine learning and predictive analytics to predict medication issues requiring pharmacist-driven interventions. These technologies also have a place in payer organizations, hospitals, and specialty pharmacy vendors to improve efficiency of workflows (e.g. real-time benefit verification that will surface details of prescription benefit/cost/other requirements at the point of prescribing. This can help address the challenges of rising drug costs, and other barriers to medication access/adherence).

More gadgets are being designed to improve individuals' experience interacting with medications and healthcare services. Smart inhalers, insulin pens, pills with sensors, continuous glucose monitoring devices, and electrocardiogram from handheld smartphones are some examples that aim to improve medication adherence, and make disease management/health monitoring more interactive for patients (Here's a thought: does quantifiable health equal better outcomes? Apple Watch developers and athletes wearing smart clothing seem to think so). Providers will be able to better assess and monitor patients’ health conditions with continuous real-time health data generated by devices outside of clinic visits.

These made me think of the seizure-alerting watch that can notify others when a seizure occurs, and provide data for doctors and pharmacists to evaluate the effectiveness of antiepileptic medications.

The U.S. healthcare system continues to lag behind other countries in health care quality, cost control, and patient outcomes. Our healthcare system is solidly based on the acute care model, or “sick care” model. The sick care model is highly siloed and healthcare delivery is inefficient. Most of the standards for health care from 1910 no longer apply to our current situation going into 2020. We need to abandon the antiquated "sick care" model and start caring for people via the "health care" model before they become sick and sicker. A “health care” model is characterized by patients who are engaged in their health care, technology that connects information and insights, and tools/incentives that promote better health outcomes.

The future of digital health is pretty exciting considering that 10,000 people will age into the Medicare system daily, and this group is highly tech-savvy! A CEO of a startup also shared with me that Medicaid enrollees have a high penetration of mobile phones. Technology integration of health and social services can help address social determinants of health, which account for up to 80% of a health outcome.

Reimbursement is a top issue for digital health companies (also a hot subject among payers). Digital health devices have the potential to help patients reach outcomes that are more like clinical trial results (a new medication will only work if patients take them) (some stakeholders are also coming up with innovative programs and digital health formularies).

An important personal takeaway was that digital health has a big opportunity to make health care equitable for all people by building in accessibility features. Smart AI assistants have made it possible to set voice medication reminders, but what if you can’t hear it? What if you can’t use voice to interact with it? The concept of universal/inclusive design will make digital health products accessible to all people with a wide range of abilities and other characteristics.

In addition to making digital tech user-friendly, who are well-equipped to translate patient-reported outcomes collected through digital tech into clinical insights? Pharmacists (do you see your doctor as often as your pharmacist?) None other than pharmacists know best about all the medications and supplements you are taking. And pharmacists are often the first point of contact when people have problems with their therapies (for those who have pharmacists in their families, chances are you have texted them in the middle of the night about the 10 different oral, injectable, and topical medications on your nightstand).

So what’s the role of pharmacists in the era of digital health? We’re now in the 4th industrial revolution where artificial intelligence and big data are shaping the future of work for all professions. As practitioners, pharmacists play a critical role between tech developers and scientists. Digital health needs pharmacists’ patient care experience and clinical insights to help incorporate evidence-based medicine and offer the best user experience. Our current medical/pharmacy education must redesign curriculums to prepare future practitioners for work beyond the fill and beyond medication adherence. Practicing professionals should continue to build new skillsets and put themselves out there.

Overall it was a truly inspiring and eye-opening conference. It's clearer than ever that pharmacists have a unique role in this growing field! I’m looking forward to seeing what digital health will bring to the healthcare profession, and how pharmacists will leverage their expertise to make healthcare better for all. Another important message is to be involved in our profession at the national level, state, and regional levels!

#digitalhealth #WeAreCPhA #DHTrendsetters