7 Questions: Digital healthcare & technology

pharmaphorum spoke to digital health strategist and influencer Denise Silber about how and where technology is, and will be, affecting the healthcare environment.

What is your involvement in digital healthcare/healthcare technology?

There is not one term that covers my involvement as I combine the work of a digital health strategist, communicator/evangeliser, and connector. I've been doing this in different forms since the appearance of the web 20 years ago. I come from the pre-web world of health communication and I've been bridging the gap between that world and the next one ever since.

In addition, having lived in several countries (US, Mexico, Switzerland, France), I've always approached this with an international perspective. Sir Tim Berners-Lee was an Englishman in Geneva when he created the WWW but the US quickly dominated its development and, from the beginning, I felt I had to step in and help re-translate things for those living outside the US, as was my case.

For example, my company at the time, a medical advertising agency, produced one of the earliest websites in Europe to address European and American audiences with curated healthcare links and information. I was invited to join various working groups on ethical codes in Europe and the US. I wrote the first key report for the EU in 2003 "The Case for eHealth". I became an early eHealth blogger in 2005 and was very involved in bringing Web 2.0 thinking to Europe...with concepts like participatory medicine, patient-inclusiveness, through consulting, writing, speaking, and ultimately producing bigger and bigger events.

Currently, my main activity is the organisation and curation of the annual Doctors 2.0 & You digital health event.

What problems can digital healthcare and technology address?

If we are talking about helping the greatest number of people live healthy lives, the quality of our health, beyond our own genetic make-up, is largely down to getting the right information in the right place at the right time. I am referring to information in its broadest sense. This includes data, images and video, content, reminders.

• A patient cannot be optimally diagnosed and treated with incorrect or incomplete information. Sharing of patient data is not possible without digitisation. Sharing of state-of-the-art knowledge is not possible without digitisation. Clinical computing and artificial intelligence are set to replace human searching of all possible scenarios and conditions. Large data sets become Big Data, which are analysed through algorithms.

• Preventive measures cannot be taken if people are not informed (and reminded) in appropriate, accepted ways. Tracking helps prevention take on an entirely new role (digital trackers). Also digital gamification contributes to better understanding and positive attitudes to health care.

• People are mobile, so we need mobile platforms to support mHealth conveniently.

• And, last but not least, online communities, whether specifically for health or general platforms, like FaceBook, Twitter, Google+, have proved themselves indispensable. Health is 24/7. People want and need to interact, with whom they want, when they want. The kind of support that patients and caregivers are finding online is irreplaceable. Professionals are finding professionals and, in some cases, patients and professionals are finding each other.

What problems can't be solved through digital health and technology?

Well, nothing can be 'solved' by technology alone. Technology is a facilitator. Despite technology entrepreneur Elon Musk's fears about artificial intelligence and robots, we still need humans to interact and do things. There are still no end-to-end technology solutions. Also, despite all we say, "the inequalities of access to health" cannot be solved by technology alone. For example, when you send out a no smoking message, the educated will pick it up first and to a greater proportion, no matter what the scenario.

What obstacles are there to greater/better use of technology in healthcare?

There are massive new societal issues arising from technology: questions of privacy, huge potential for eugenics, plus the costs of rethinking and revamping our ways of working. Many people, and I am one of them, think that we should build a new health system, rather than trying to fix the current one...And maybe that isn't a system at all, but a freer environment of some sort. We cannot afford to provide all of our solutions to everyone who could use them.

Do you use social media? If so, what is the secret to getting the most out of it?

I'm active on a number of platforms. You really have to curate your account, which means going to each platform several times a day, establishing sincere relationships with a certain number of followers, and sharing.

Do you own/use a 'wearable' technology?

I love knowing how many steps I've taken each day. It does have a favourable impact on how much I walk. I have found that the tool I'm most likely to use over the long run is an app on my iPhone...But that's not a definitive answer.

Outside healthcare, what digital/tech pioneers do you admire?

There are two companies I admire for the service they've brought to the individual, outside of health: Uber and airbnb. I haven't analysed how the companies are run, nor their founders. But how they have improved service to the customer for point-to-point land travel (Uber) or finding lodgings away from home (airbnb) is extraordinary. They are also masters of app building in terms of aesthetics and ease of use.

About the interviewee:

Denise Silber, founder and curator of Doctors 2.0 & You conferences, is an international digital health strategist and social media influencer. A former industry executive turned entrepreneur, Denise is a Smith College graduate and Harvard MBA. An American in Paris, Denise was named to the Legion of Honour, France's highest civil decoration, for her pioneering work in advancing eHealth around the world over nearly 20 years. Her academic publications are listed on Google Scholar.

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