David Shaywitz , CONTRIBUTOR : I write about entrepreneurial innovation in medicine.
Earlier this week, clinical investigator Brennan Spiegel, a gastroenterologist at Cedars-Sinai in Los Angeles, shared some of his early experiences with digital health adoption, and illustrated with specific examples some of the challenges associated with the real-world implementation of emerging technologies.
It turns out that wearables fall off or are lost, some patients don’t want to don virtual reality goggles, and putative proxies for health – like activity – may not be, depending on the circumstances (a writer turned out to be less active as her pain decreased, because she was comfortable enough to return to her craft).
None of this is especially surprising (see here and here in particular, also here and here), and in fact, seems to describe the typical adoption pattern for new technologies, as Alexis Madrigal has perhaps captured better than anyone in this Atlantic article.
Surprisingly, and somewhat disappointingly, some seem to have interpreted Spiegel’s piece as representing a failure of digital health; nothing could be further from the truth. Spiegel and his colleagues seem to me to be at the forefront of this field; they are the early adopters, the folks actually in the arena, figuring out how to use the new technology to improve the lives of patients.
While I don’t work with Spiegel in my current role (disclosure/reminder: I’m at a cloud genomics company in Mountain View, which doesn’t have any relationship with either Spiegel or Cedars-Sinai), I did in my previous role, when I led the development of an early stage GI drug. In fact, I specifically sought out Spiegel precisely because of the depth of his experience as clinical investigator — particularly in patient-reported outcome (PRO) development – as well as his commitment to scientific rigor, his obvious empathy for patients, and his appreciation for the art as well as the science of medicine. Many of these same qualities seemed apparent in his most recent article.
Exploration at the bleeding edge of technology is not for the faint of heart; it’s easy to describe theoretical benefits of a novel approach, but notoriously difficult to actually deliver them. That’s why most physicians and most hospitals choose to wait on the sidelines, letting emerging approaches mature, before eventually choosing to adopt.