How Partnerships Between Humans and Technology Can Enhance Health Care
Rongzi Shan, BS; Shannon Wongvibulsin, BS; and Seth S. Martin, MD MHS FACC FAHA FASPC
Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Shan R, Wongvibulsin S, Martin SS. How partnerships between humans and technology can enhance health care [published online November 2, 2018]. Cardiology Consultant.
With increasing application of artificial intelligence (AI) to health care, there is often concern that AI will replace clinicians. However, rather than replacing clinical jobs, AI offers enormous potential to empower clinicians with tools to gain deeper insights into patients’ conditions and provide more effective care, optimized to the specific individual.1,2 Nevertheless, to reach this potential, it will be essential for clinicians to drive the development, validation, and implementation of new technologies.
Digital health technology can fill gaps between clinic visits for chronic conditions such as hypertension or diabetes, allowing transition from episodic to continuous care, while remaining scalable for a rapidly aging population. The current model of 15-minute appointments every 3 to 6 months leaves patients alone for months at a time without adequate self-management skills. Current digital health interventions for disease management and prevention include personalized motivational messages,3 biometric feedback, and education for health literacy.4 Industry is moving toward this trend as well, with FitBit’s recent acquisition of Twine, a personalized telehealth application that connects users with a human coach who provides tailored plans, feedback, and accountability based on data from wearable devices.5
Home monitoring may improve blood pressure control6 and decrease readmissions.7 When combining data from consumer devices with predictive analytics, remote monitoring can meaningfully enhance and expand care without burdening clinicians by alerting them only to high-risk situations that require their attention. Nevertheless, there is concern about the validity of patient-generated data8 and whether mobile medical apps are safe and effective.9 For digital health tools to improve clinical care, partnerships between clinicians and the developers of this technology is crucial.
Technology can also increase the quality of human interactions. With telemedicine, patients and clinicians can interact from the comfort of their own homes, allowing both parties to approach the encounter with increased convenience and potentially a calmer state of mind. The startup CityBlock engages low-income patients at brick-and-mortar centers, linking them to holistic resources via telehealth and a digital app. Additionally, social robots have been used as a tool to aid child life specialists in comforting hospitalized children10 or as a social lubricant to generate laughter and conversation among residents in a senior facility. Despite concerns over the isolating nature of AI, when used thoughtfully, AI clearly has the potential to enrich existing human interactions.
Overall, digital health will not replace human interaction but will instead allow clinicians to focus on what is important and empower patients to be more active in their care—a theme discussed at the Connected Health Conference and the Machine Learning for Healthcare Conference this year. To ensure technology enhances human interaction and the creativity of clinicians, we need smart designs that integrate seamlessly into patients’ lives and clinical workflows, make work more enjoyable, and avoid administrative burdens resulting from electronic health records. As with any intervention, clinicians must advocate for transparent research to validate new digital health tools before adoption. Finally, when evaluating emerging technology, we must fight for solutions that deepen therapeutic relationships while expanding access to the right care at the right time.
- Verghese A, Shah NH, Harrington RA. What this computer needs is a physician. JAMA. 2018;319(1):19-20. doi:10.1001/jama.2017.19198.
- Stead WW. Clinical implications and challenges of artificial intelligence and deep learning. JAMA. 2018;320(11):1107-1108. doi:10.1001/jama.2018.11029.
- Martin SS, Feldman DI, Blumenthal RS, et al. mActive: A randomized clinical trial of an automated mHealth intervention for physical activity promotion. J Am Heart Assoc. 2015;4(11):e002239. doi:10.1161/JAHA.115.002239.
- Magnani JW, Schlusser CL, Kimani E, Rollman BL, Paasche-Orlow MK, Bickmore TW. The atrial fibrillation health literacy information technology system: pilot assessment. JMIR Cardio. 2017;1(2):e7. doi:10.2196/cardio.8543.
- Fitbit, Inc. to acquire Twine Health [press release]. San Francisco, CA: BusinessWire; February 13, 2018. https://www.businesswire.com/news/home/20180213005548/en/. Accessed October 23, 2018.
- Margolis KL, Asche SE, Bergdall AR, et al. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial. JAMA. 2013;310(1):46-56. doi:10.1001/jama.2013.6549.
- Inglis SC, Clark RA, Dierckx R, Prieto-Merino D, Cleland JGF. Structured telephone support or non-invasive telemonitoring for patients with heart failure [published online October 31, 2015]. Cochrane Database Syst Rev. doi:10.1002/14651858.CD007228.pub3.
- West P, Van Kleek M, Giordano R, Weal M, Shadbolt N. Information quality challenges of patient-generated data in clinical practice [published online November 1, 2017]. Front Public Health. doi:10.3389/fpubh.2017.00284.
- Shuren J, Patel B, Gottlieb S. FDA regulation of mobile medical apps. JAMA. 2018;320(4):337-338. doi:10.1001/jama.2018.8832.
- Jeong S, Logan DE, Goodwin MS, et al. A social robot to mitigate stress, anxiety, and pain in hospital pediatric care [published online March 2, 2015]. Proc Tenth Annu ACM/IEEE Int Conf Human-Robot Interact Ext Abstr. doi:10.1145/2701973.2702028.