Why Physicians are Needed in Digital Health

I hear from physicians on a daily basis who have left or who are thinking about leaving clinical practice and would like to enter the digital health sector. I will not discuss all the things one needs to consider when leaving practice. What I will discuss is the digital health landscape and opportunities within it for physicians.

Digital health encompasses a wide array of opportunities. One area is health information technology. One need not have a degree or training in computer programming in order to enter this field. However, a background in informatics (a newly designated specialty of the American board of Medical Specialties), electronic health records, and for some jobs, business, would be necessary. Another is the commercial side of digital health technologies.

Chief medical information officer and chief knowledge officer. The CMIO has been a job in existence for a while, but is rising to a level of preeminence, given the rapid adoption of EHRs in hospitals and other health care facilities. The scope of the job varies widely, according to the needs of the institution. The job used to entail being a champion of IT to other physicians, selling them on the merits of EHRs. Today, it entails developing strategic business plans for IT, alignment of clinical system capabilities with organizational needs, and ensuring that they are consistent with global trends in medicine, informatics and information technology. The job of chief knowledge officer is different from the CMIO is a new concept. It is one which utilizes informatics and applies it to clinical and financial objectives of the institution. Tying practice to regulatory mandates which may affect reimbursement would fall under the job description. For example, using informatics to identify patients at high risk for readmission and changing workflow and clinical practice to decrease and track endpoints might be a project that falls under the CKO. These jobs are in great demand now.

Digital health industry consultant. Some digital health tech companies are started by physicians out of an entrepreneurial spirit. Some are started out of a clinical problem that can best be met with digital technology (this might involve diagnostic or therapeutic tools, workflow assistance, or communications). However, some companies are started by entrepreneurs with limited or no clinical background. The product might have sound technical design, the clinical need is correctly identified, but clinical knowledge gaps might create barriers to implementation or marketing. Some technologies might ultimately benefit from clinical trials, whether the purpose is FDA approval, reimbursement by government or private payers, or for comparative marketing purposes. Physicians well-versed in this arena would be invaluable in guiding the company through such a process. Failure to consider clinical perspective input may have dire consequences for a fledging technology. Investment by these companies in reasonably priced advisors is a wise business decision. Knowing the clinical landscape and where the opportunities are for digital health might be easier for a physician. Physicians are hired as industry analysts, recruiters, and company executives. There will be these needs to cover the digital health arena as well.

The digital health care consultant. I submit that one day there might be a medical specialty in clinical digital health (digital health specialist). Much like the orthopedic surgeon recommends a physician skilled in physical medicine and rehabilitation for the post-surgical patient, a clinician might recommend a digital health specialist to prescribe personalized digital health technologies for the patient with chronic diseases. Clinicians will be utilizing digital health tools as an integral part of practice. However, knowing which tools to use in specific clinical circumstances might not be easily discernible. It would be the digital health professional who might determine, in concert with the clinician (perhaps via virtual consultation), which technologies the patient’s profile would best benefit from. ACOs might be a great setting where the digital health consultant is most useful in designing digital programs to improve patient outcomes.

As a physician who left practice because of my interest and experience in digital health, I am excited for the prospect of the above possibilities for others.