Moderator’s note: I'm excited to introduce Research in Action followers to the new Digital Health Initiative at CIRP@CHOP. This new line of research at CIRP is led by Linda Fleisher, PhD, MPH, who has had almost 30 years of experience in health education, health communications, public health program evaluation, and the development and evaluation of health interventions, including web-enabled interventions.Today we feature a Q&A with Dr. Fleisher to introduce her vision for the initiative and look forward to her future blog entries.
Q: Many people think digital health is using apps on a tablet to lose weight or plan a fitness routine. How do you define digital health?
A: If you look in Wikipedia you will find a laundry list of definitions that includes a wide range of elements -- wireless devices; hardware sensors and software sensing technologies; microprocessors and integrated circuits; the Internet; social networking; mobile/cellular networks and body area networks; Health IT (aka health information technology); genomics; and personal genetic information. There are also many terms that are often used to describe digital health, such as mHealth (aka mobile health); Wireless Health; Health 2.0; and eHealth. So, you can see it’s much broader than apps that you might download on your smartphone. For us at CIRP, we are focusing on developing interventions and evaluation approaches that rely on technologies, such as smartphones, the Internet, and social networking, to educate consumers and improve their health. We know our research efforts will evolve and expand to stay abreast of this dynamic field.
Q: What are the key issues in digital health, and how do you think they can be addressed?
A: This is such an emerging and innovative area and every day there is something new. From my perspective, one key issue is about quality -- how to ensure that these technologies are designed based on solid scientific evidence and that they are evaluated to make sure they improve health. A tremendous amount of research has been conducted over the past 30 to 40 years regarding a wide range of health behaviors and health topics. For example, we may now understand how to help people quit smoking, but is this body of knowledge being used as a basis for the app or digital health tools? And remember, many of these apps aren’t developed in research organizations, but rather by industry and marketing departments, and they may not be aware of these research findings or how to build an evidence-based app. While the initial business aims for an app might be different, an app developer should consider health outcomes. It’s more than if someone likes it or will buy it; it’s conducting a rigorous evaluation to know if the digital health tool actually works to change behavior and improve health outcomes.
Q: Where do you think the field of digital health is headed?
A: Digital health is going to become more and more sophisticated and will be part of everyday life. I can see providers and payors recommending specific apps as part of treatment plans or health behavior programs. Knowing which ones to recommend will be an important part of the process. I also see consumers becoming much more discerning and wanting to know which mHealth apps are effective. As more personal data are available from all of these different sources, we also will be able to tailor and personalize these mHealth apps.
Q: Evidence-based health communication has been your area of study for many years. What brought you to CIRP?
A: I started my career as a health educator, designing programs and research to improve health. I have worked in the field of cancer – across the continuum of prevention to survivorship – for many years and have been particularly interested in empowering patients and consumers to take control of their health. Most recently, I have been conducting research in understanding how people use digital health tools, and we are now doing similar research here at the Center. My work has spanned different health issues and populations, and I am truly excited to learn from my new colleagues and leverage my expertise in pediatric injury prevention.
Q: What sets CIRP’s Digital Health Initiative apart from other organizations doing similar work?
A: The mission of the Center is to translate research into action, and I think this sets us apart. We are interested in not just improving the quality of our own digital health tools, but also in taking this knowledge to create technologies and approaches for anyone working in the digital health space. We want to be able to help evaluate the effectiveness and use of their digital health tools.
Q: Have you and your team published or presented any recent research in this area?
A: Over the last few years, I published and presented my research in a variety of journals and settings focusing on designing evidence-based digital health tools, evaluating how these tools are utilized in the real world, and how effective they are in changing behavior. I have been fortunate to work with many colleagues and staff to conduct this research and look forward to continuing to share our experiences both in scientific venues and in the popular press. It is important to share our findings with consumers and the communities that work with us too so that they can integrate these findings into their practice.