Apps and trackers are supposed to collect data and make us healthier. But there's still a long way to go, says Dominik Böhler, Professor of Management in Digital Health. The developments will not only change the fitness industry, but also the role of trainers and medical professionals.
How much digitization in our healthcare system is needed to tackle the next pandemic in a relaxed manner?
That would have to be a quantum leap. What we have now learned during the pandemic: Even if I get relevant, meaningful, and valid data, the interpretation of that data is still a socio-political issue. I can understand the same graph in different ways. I think this is where we need an update to get the data faster and more reliably. And then there needs to be communication that takes society along as well.
You are currently researching health insurance companies in the context of business models. What are the most exciting findings?
Up to now, the healthcare system has primarily reimbursed drugs or medical devices. Once they are approved, they don't change. But suddenly algorithms and artificial intelligence come along with products that can change constantly. We ask ourselves how these services can be remunerated. We also try to find out, how we can set incentives for healthcare professionals. For Example: How can physicians contribute to collecting and curating data? Because at first, not doctors, but algorithms benefit from high-quality data. Even in the future, when medical data will only be provided in part from trackers. The doctor will likely continue to ensure the quality of the data for a long time.
In Germany, medical prescription apps have been available since October 2020. 25 apps have been approved so far and they have been prescribed 40,000 times. In this evolving space, what role will fitness apps have?
It will be difficult to approve fitness apps on prescription with a health claim. We have to differentiate: What promise does the app deliver to me? As long as an app aims to improve personal performance, it's not a health app doctors can prescribe. It's subject to co-payments. On the other hand, those fitness apps and trackers generate a lot of data or biomarkers that can also provide information to the medical community.
Dominik Böhler: The Startup Professor
Dominik, a business economist and information systems specialist, is a Professor of Management in Digital Health at the Technical University of Deggendorf. Previously, he spent seven years at the Center for Innovation and Business Creation at TUM helping young startups update the healthcare system with their business models. With Digital Health, he wants to make medicine better and more accessible.
(🤝 Meet Dominik at Linkedin)
When will the data generated from fitness apps be "medical grade"?
When I make a medical diagnosis, I have to be able to trust the quality of the data. For fitness apps, this means: How meaningful is the collected data? What can I really use it for, and how much context information would I need to be able to use? In other words: How much tracking do I allow trackers and apps to do so they can better assess how I'm doing?
Will health insurers soon pay for fitness mirrors or wearables?
In some cases, the insured already gets reimbursed for gym memberships or certain other preventive care apps. That's to support preventive health care.
You say: In tomorrow's healthcare system, regulated and unregulated spheres will meet and mix. Can you explain that?
There will be companies that operate in both the regulated sphere and the unregulated sphere like Apple does today. They have approved the Apple Watch as a medical device. Yet Apple is primarily a manufacturer of consumer products. Apple knows what products consumers use and how they use them. The traditional medical device manufacturer, on the other hand, thinks about diseases and about evidence. The question of whether the consumer wants and needs the product is usually only asked in the second step. But patients differ in terms of social milieu, and age groups and thus have different needs. In the future, those fields will merge. We will be able to use non-medical data to better define customer groups. Medical device manufacturers will partner or have a product portfolio that includes FDA-approved as well as non-approved products.
So in the future, all the measured values collected for various purposes will flow together in a kind of health cockpit?
That is realistic. From my point of view, the key question is what I want as a patient and what I want as a person. After all, the more preventive care data we collect, the less strongly I am as a patient - but as a private person. But when does the patient journey start? If I want to, I'm a patient every day. Whether I want to be is another question.
In the future, will researchers, doctors, and pharmacists also work with data collected in gyms?
Why not? If it helps decision-making and if the patient wants it. There are already patients who go to the doctor with the data from the fitness trainer. This mixes preventive care and diagnosis. When I analyze more data, I work more with probabilities on whether a diagnosis could occur. In the healthcare system, patients need to be able to assess and understand this risk. At some point, too much information is too much.
How does this change the role of physicians?
In the future, patients will be managers of their own health. The physician is the management consultant who helps reduce complexity and offer more educated insights. From my perspective, he could be something like a strategy consultant for the patient journey.
How could gym operators contribute to a digitized healthcare system?
Collaboration between gyms and medical professionals is conceivable. A fitness chain could build a strategic IT department and offer more than just tracking its customers' fitness levels. They could take health data and analyze it from that perspective. Do I need to go to the doctor's office for a stress EKG, or can I do it on the side of the treadmill at the gym? If necessary, the gym could advise visitors to go to the doctor. At the gym, I have relatively good contextual control. If I'm on the treadmill, there will be fewer variables skew the results than when I run in the wild.
So the gym could be the first level of prevention?
It could be, in theory. But I can make people feel insecure by misdiagnosing and that's no fun. Health is more than fitness, tracking, and performance enhancement. The idea may or may not work.
More great content on digital health
... said Jeff Rogers, Global Research Leader and Distinguished Research Scientist at IBM, at FitTech Summit V: Tech or Die! at 8th and 9th November 2021 on the internet (🤝 Meet Jeff at Linkedin). It's still a long way to go until data provided by wearables will actually bring a broad impact on society's health, Jeff explained.
Where might the journey of digital health lead?
We may soon be able to just type in certain symptoms and, with the help of artificial intelligence, a diagnosis will be made - and in a more structured way than "Dr. Google." With a better way of processing data using artificial intelligence, I can improve the search process. Also, not every doctor has a comprehensive picture of every situation. Doctors also google, they just say that very rarely.