363-1130-00L  Digital Health

SemesterSpring Semester 2022
LecturersT. Kowatsch
Periodicityyearly recurring course
Language of instructionEnglish

AbstractToday, we face the challenge of non-communicable diseases. Personal coaching approaches are neither scalable nor financially sustainable. The question arises therefore to which degree digital health interventions are appropriate to address this challenge. In this lecture, students will learn about the assessment of digital health interventions.
ObjectiveCan medical Alexas make us more healthy? (The New York Times, April 2021), Wearables as a tool for measuring therapeutic adherence in behavioral health (npj Digital Medicine, May 2021), Improving community healthcare screenings with smartphone‐based AI technologies (The Lancet Digital Health, May 2021), Predictive analytics and tailored interventions improve clinical outcomes (npj Digital Medicine, June 2021), H1 2021 secured $14.7B in digital health funding, already surpassing all of 2020ʹs funding (Rock Health, 2021)

What are the implications and rationale behind the recent developments in the field of digital health?

Digital Health is the use of information and communication technology for the prevention, management and treatment of diseases. It covers topics such as digital health interventions, digital biomarker research, digital coaches and healthcare chatbots, telemedicine, mobile and wearable computing, self-tracking, personalised medicine, connected health, smart homes or smart cars.

In the 20th century, healthcare systems specialised in acute care. In the 21st century, we now face the challenge of dealing with the specific characteristics of chronic conditions. These are now responsible for around 70% of all deaths worldwide and 85% of all deaths in Europe and are associated with an estimated economic loss of $7 trillion between 2011 and 2025. Chronic diseases require an intervention paradigm that focuses on prevention and lifestyle change. Lifestyle (e.g., diet, physical activity, tobacco, or alcohol consumption) can reduce the risk of suffering from a chronic condition or, if already present, can reduce its burden. However, a lifestyle change is only implemented by a fraction of those affected, partly because of missing or inadequate interventions or health literacy, partly due to socio‐cultural influences. Individual personal coaching of these individuals is neither scalable nor financially sustainable.

Against this background, the question arises of how digital health interventions (DHIs) can allow medical doctors and other caregivers to scale and tailor long‐term treatments to individuals in need at sustainable costs. At the intersection of information systems research, computer science, behavioural medicine, and health economics, this lecture has the objective to help students and upcoming healthcare executives interested in the multi‐disciplinary field of digital health to better understand the design and assessment of DHIs.

After the course, students will be able to...

1. know design and assessment frameworks for DHIs
2. assess DHIs
3. discuss the advantages and disadvantages of DHIs
4. propose a DHI incl. business model that addresses an unmet need of existing DHIs
ContentTo reach the learning objectives, the following topics are covered:

1. Overview of design and assessment frameworks
2. Preparation of DHIs
3. Optimization of DHIs
4. Evaluation of DHIs

The lecture is structured in two parts and follows the concept of a hybrid treatment consisting of live sessions and complementary online lessons. In the first part, participants will learn and discuss the learning topics. Complementary learning material (e.g., video and audio clips), multiple-choice questions and exercises are provided online.

In the second part, participants work in teams and will use their knowledge from the first part of the lecture to critically assess DHIs, identify unmet needs and propose a DHI incl. a business model that addresses the unmet need. Each team will then present and discuss their findings with their fellow students who will provide peer-reviews. Additional online coaching sessions are offered to support the teams with the preparation of their presentations.
Literature1. Cohen AB Dorsey ER Mathews SC et al. (2020) A digital health industry cohort across the health continuum Nature Digital Medicine 3(68), 10.1038/s41746‐020‐0276‐9
2. Collins LM (2018) Optimization of Behavioral, Biobehavioral, and Biomedical Interventions: The Multiphase Optimization Strategy (MOST) New York: Springer, 10.1007/978-3-319-72206-1
3. Coravos A. Khozin S. and K. D. Mandl (2019) Developing and Adopting Safe and Effective Digital Biomarkers to Improve Patient Outcomes Nature Digital Medicine 2 Paper 14, 10.1038/s41746‐019‐0090‐4
4. Fleisch E Franz C Herrmann A (2021) The Digital Pill: What Everyone Should Know about the Future of Our Healthcare System, Emerald Publishing: Bingley,UK, 10.1108/9781787566750
5. Katz DL Frates EP Bonnet JP Gupta SK Vartiainen E and Carmona RH (2018) Lifestyle as Medicine: The Case for a True Health Initiative American Journal of Health Promotion 32(6), 1452-1458, 10.1177/0890117117705949
6. Kvedar, JC, Fogel AL, Elenko E and Zohar D (2016) Digital medicine’s march on chronic disease Nature Biotechnology 34(3), 239-246, 10.1038/nbt.3495
7. Kowatsch T Otto L Harperink S Cotti A Schlieter H (2019) A Design and Evaluation Framework for Digital Health Interventions it ‐ Information Technology 61(5‐6), 253‐263, 10.1515/itit‐2019‐0019
8. Kowatsch T Fleisch E (2021) Digital Health Interventions, in: Gassmann O Ferrandina F (eds): Connected Business: Creating Value in the Networked Economy, Springer: Berlin, 10.1007/978-3-030-76897-3_4
9. Kowatsch T Schachner T Harperink S et al (2021) Conversational Agents as Mediating Social Actors in Chronic Disease Management Involving Health Care Professionals, Patients, and Family Members: Multisite Single-Arm Feasibility Study, Journal of Medical Internet Research (JMIR) 23(2):e25060 10.2196/25060
10. Kowatsch T Lohse KM Erb V et al (2021) Hybrid Ubiquitous Coaching With a Novel Combination of Mobile and Holographic Conversational Agents Targeting Adherence to Home Exercises: 4 Design and Evaluation Studies, Journal of Medical Internet Research (JMIR) 23(2):e23612, 10.2196/23612
11. Nahum‐Shani I Smith SN Spring BJ Collins LM Witkiewitz K Tewari A Murphy SA (2018) Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support Annals of Behavioral Medicine 52 (6), 446‐462, 10.1007/s12160-016-9830-8
12. Sim, I. (2019) Mobile Devices and Health The New England Journal of Medicine, 381(10), 956‐ 968, 10.1056/NEJMra1806949
Subject-specific CompetenciesConcepts and Theoriesassessed
Techniques and Technologiesassessed
Method-specific CompetenciesAnalytical Competenciesassessed
Media and Digital Technologiesassessed
Project Managementassessed
Social CompetenciesCommunicationassessed
Cooperation and Teamworkassessed
Customer Orientationassessed
Leadership and Responsibilityassessed
Self-presentation and Social Influence fostered
Sensitivity to Diversityassessed
Personal CompetenciesAdaptability and Flexibilityassessed
Creative Thinkingassessed
Critical Thinkingassessed
Integrity and Work Ethicsassessed
Self-awareness and Self-reflection fostered
Self-direction and Self-management assessed