Technology is changing and evolving constantly. The same is true for technology as it relates to healthcare and is known as “digital health”.

What is digital health, and how does it play a role in nursing?

The Food and Drug Administration gives digital health a broad definition – saying its scope includes categories including mobile health (mHealth), health information technology (IT), wearable devices, and telehealth/telemedicine.

Health informatics is also considered digital health. Informatics is the science and practice of design, and use of information and information technology to support human health, so the two concepts go hand-in-hand.

Blaine Reeder, PhD, is a former CU Nursing faculty member and now works at the University of Missouri

The relationship between digital health and informatics was the topic of a virtual presentation by Blaine Reeder, PhD, at the University of Colorado College of Nursing at Anschutz Medical Campus.  Dr. Reeder is a former CU Nursing faculty member and is now an Associate Professor at the University of Missouri.

Barriers to Digital Health Research

Using digital health tools can be critical for a PhD student or nurse scientist.

“As a junior researcher, you might be asking how do I use something with has a sensor or some device that might give me useful information,” Reeder says. “You might be thinking you want to use a tablet-based app or you want to develop one. You might hear from a company that has a digital intervention tool, but it could take hundreds of thousands or millions of dollars and years of testing before you can use it, and that will likely be beyond your research resources.”

That’s only one barrier nurse scientists may find when using digital health in research. Reeder listed four main barriers:

• Rapid pace of technology and the slow pace of research
• Lack of persistent support for technologies that are known to work
  • Cost infeasibility
  • Inconsistent funding
• Lack of unified, investigator-controlled research support
  • Lack of integrated technology management
  • Lack of collection, access, and control from disparate data sources
  • Lack of support resources
• Undesirable outcomes
  • Wasted time and research funding
  • Perpetuation of health deficits and inequalities

Researchers can overcome these barriers with planning from the earliest stages of research using “translation by design”, a term that Reeder coined a few years ago to describe his research approach. Translation by design is an iterative approach to creating digital health solutions tailored to the specific needs of individuals and populations that account for cost-feasibility, translation, and sustainability of research in real-world settings.

“If something (like a sensor or app) ends up costing $5,000, it doesn’t matter if we can demonstrate that it can help lower-income adults stay in their homes. They won’t have access to it,” Reeder says. “The focus of translation by design is how do we get to something that’s cost-feasible that supports work processes for things like care coordination or individual self-management.”

Translation by design also focuses on using a progression of study types from informatics, with each study type focusing on the type of question one can ask at different stages of research. These types include studies like needs assessments, lab function tests, and usability tests all the way through pragmatic trials that address the original motivating question.

“Some of the questions from these study types will have to be revisited as research progresses to show effectiveness and adaptability of digital health solutions, support new business models for sustainability, and ultimately overcome known and emergent barriers I’ve talked about,” he says.

The Future of Digital Health

Reeder says he prefers to use the term digital health when talking about sensor-based technology and research because the technology is evolving and converging together.

Ultimately, he believes eventually digital health will simply become health as sensor-based devices and information captured by them are everywhere.

“Digital health is what I use now for the umbrella term I used to call smart home research or mobile health research’,” he says. “All of these things associated with digital health will be embedded in the health and wellness experience of everyone’s everyday life and how they interact with the healthcare system.”