The Ethics of Digital Health: Balancing Convenience and Patient Safety

In the wake of the pandemic and growing concern over global health issues associated with aging, mortality, child illness, epidemics, and more, digital healthcare has evolved to take center stage. Information technology was always a vital part of the healthcare industry. However, with the advancement in the field, the digital healthcare industry is witnessing endless possibilities for transforming healthcare services. The COVID-19 pandemic has fueled this transformation, with increased demand for contactless symptom checks, remote consultation, remote patient monitoring, and more.

In recent times, digital health has utilized AI and data obtained from secure sources to provide patient-focused care and assist with prevention strategies. AI and Machine Learning led to the unforeseen growth of the digital health sector with innovations like ingestible sensors, robotic caretakers, apps to monitor patients remotely, and more. As per Precedence Research, with more upcoming innovations, the digital health market will witness a CAGR of 19.4% from 2023-2032 and is expected to reach $1,694.21 billion in 2032.

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However, digitization of healthcare also demands enhancing patient security while providing convenient healthcare services. Data security and privacy of patient information is becoming more and more vulnerable due to data breaches and cyberattacks. Hence, while addressing patient concerns, robust cybersecurity measures need to be in place to balance convenience and security in the digital health sector.

Convenience vs. Patient Safety: Ethical Considerations

As we explore the vulnerability of the digital health sector to data theft and system breaches, one question arises. Although technological evolution has transformed the healthcare industry and improved patient convenience with services like mobile health applications, cloud-based management, and more, how is this happening without undermining the security of healthcare data? With the increased use of digital space to provide convenient healthcare, patient data privacy remains at stake.

While patients desire convenient methods to access healthcare benefits, they still are skeptical about how their data might be used, how it can negatively impact their insurance and credit card access, and more. The mounting competition between convenience and privacy is currently a top priority for healthcare organizations.

As such, the ethical considerations in providing digital healthcare, namely autonomy, justice, beneficence, and non-maleficence, have taken predominance to balance these values.

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Autonomy

Autonomy in digital health refers to a person’s own will and right to make choices about their healthcare. Obliging to the principle of autonomy, the physician discloses crucial information about the benefits and risks of engaging in digital health methods, which are essential for the patient to understand and willfully consent to the treatment procedures.

Digitization in healthcare has encouraged the free flow of communication between patients and doctors, enabling patients to be more active regarding diagnosis and treatment plans. Unlike the existing process, patients are more engaged in discussions with their caregivers, facilitating a more collaborative approach toward health management. Their self-efficacy and autonomy over their choices are visible through the increased use of wearable fitness technology like smartwatches which help them monitor their sleep cycles, heart rate, and more.

Moreover, patients are provided adequate information about the collection of their data and how organizations will preserve and utilize this data, giving due regard to their privacy and security.

Justice

Another pillar of medical ethics is justice, which refers to fair and equitable healthcare resources for all. Ethical considerations in digital health arise when there is a question of accessibility.

Availing of digital health resources depends on certain factors like affordability and availability of technological equipment or the needs of a certain section of people. For instance, people dealing with rare disorders, aging citizens, or homeless people can have little to no benefits from digital health services. Hence it is crucial to incorporate fair access while planning and implementing digital tools in the healthcare sector.

However, it can sometimes go beyond affordability and get impacted by an individual’s ability to deal with digital healthcare tools. If a section of the population is unable to use healthcare technologies resulting from digital illiteracy, it can trigger an unjust healthcare design.

But digital health facilities have also empowered some people who otherwise cannot benefit from conventional healthcare due to geographical or physical constraints. In this regard, digitization in healthcare facilitates fair access to health resources and improves the efficiency of medical services with due consideration of patient privacy.

Beneficence

Another core ethic of medical practice is beneficence which drives healthcare workers to act in the best interest of the patients. Like conventional healthcare practice, it is a crucial part of decision-making in digital healthcare, which requires physicians to consider all the risks and benefits of a treatment plan before proceeding with it through digital mediums.

With the healthcare sector seeing dramatic transformation with the increased usage of healthcare information technology (HIT) and consumer health informatics technology (CHIT), and more, it is playing a crucial role in empowering patients to manage their health. Moreover, it is also decreasing the patient’s dependency on professional caregivers, improving access to medical resources, and enabling the patients to remain and heal in their homes rather than staying in an institution. All of these are beneficent outcomes of digitization in healthcare which also involves caution and careful consideration of patient information.

Non-Maleficence

Physicians are bound by the principle of non-maleficence, which requires them to avoid causing harm to their patients, both physically and emotionally. They must take great care to weigh the benefits and drawbacks before making any decisions. While the advancement in digital health technologies has enabled healthcare professionals to provide efficient and effective medical care, it also has the potential to adversely affect patients with the disclosure of sensitive data, incorrect computerized diagnoses, and more.

As such, clear communication is a priority in digital mediums to enable patients to take charge of their health and make informed decisions. Maintaining the privacy of the patients with careful handling of their health information and considering the cost-effectiveness of digital health tools also hold significance in implementing the non-maleficence principle.

The principle of non-maleficence also holds particular significance in pediatric care, as children have unique physiological, developmental, and psychological needs.

What are some of the Examples of Digital Health Technologies

There are numerous technologies within the realm of digital health that can be used to improve healthcare services. These include both software and hardware tools and services, such as:

Telemedicine

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It refers to the remote delivery of healthcare services via digital mediums and can be used for multiple purposes, including consultation, diagnosis, patient monitoring, and more. Telemedicine has enabled people living in remote areas to access effective healthcare services, which otherwise was impossible.

People now consult physicians via video or phone calls and text messages, which has improved the convenience for both patients and physicians. It is much more cost effective than traditional healthcare, and using advanced AI and machine learning tools provides improved care to patients.

This also creates a lot of opportunities for marketers looking to sell telemedicine-related products/services to physicians. With digitization and telemedicine really picking up, marketers can increase conversion rates, should they have the right contacts.

However, telehealth comes with challenges, such as a lack of in-person communication necessary for building trust and accurate diagnosis of a patient’s condition. Moreover, appropriate telecommunication infrastructure is also crucial to the proper implementation of this technology.

E-Prescribing

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E-prescribing is a type of electronic health record and refers to offering medical prescriptions through digital channels. It is capable of reducing prescribing errors and increasing efficiency and timeliness. Furthermore, it can help improve patient-prescriber communication with the clear transmission of information.

The integration of e-prescribing systems with patient record systems can enhance the efficiency and quality of prescribing in healthcare. By utilizing AI-enabled applications, prescribers can identify prescription errors, consider alternative medications, and detect potential drug interactions that may pose a risk to patients.

Electronic Medical Records (EMRs)

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These are transformed versions of traditional on-paper records that document patient information. Electronic medical records offer multiple benefits as compared to traditional methods, such as,

• Tracking vital patient information like medication history, allergies, test results, etc.
• Better communication between patients and caregivers
• Improved medication prescription safety and accuracy.

Having information on the ready helps healthcare providers to provide better care and timely service. With all the crucial patient information stored in one place, doctors and other healthcare professionals can make informed decisions at each step.

Additionally, EMRs are cost-effective, as they eliminate the need to take the same test multiple times. They also enable the seamless sharing of information to help healthcare professionals coordinate their services for the patients.

mHealth or Mobile Health

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Mobile health covers a wide range of mobile software and equipment under its umbrella, used for providing healthcare services and information. It includes

• mobile applications that help patients track their health data
• devices that help healthcare professionals monitor their patients remotely, and more.

People are using smartphones and tablets on a large scale for various purposes like scheduling appointments, managing prescription refills, and leveraging disease management programs. Moreover, devices like smartwatches help observe vital parameters like heart rhythms, temperature, etc.

All the data collected by these wearables and hand held devices is constantly monitored for disease treatment interventions, and alert one about their personalized health promotion.

Additionally, mobile health technology also provides easy access to healthcare facilities for people residing in underserved areas. They also help boost healthy habits in individuals by providing real-time feedback on their health status.

Telemental health

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It is a way of delivering mental healthcare through digital mediums. Telemental health technology can help tackle a wide range of mental conditions like depression, anxiety, substance abuse, and more.

As compared to traditional therapy, telemental health offers more benefits like ease of communication and accessibility. It is much more economical as it reduces the cost of in-person consultations, travel, and other costs associated with it. Moreover, telemental health takes care of patient privacy and anonymity, which is a vital advantage.

The advancement in AI/machine learning tools has boosted the growth of telemental health with more accurate diagnosis and treatment planning methods that cater to the patient’s unique needs.

Case studies of digital health technologies

All over the world, healthcare systems struggle with providing affordable services, equitable access to healthcare, consistent outcomes, and meeting the needs of an ever-growing population.

Digital health technologies help overcome these challenges by

• Supporting the health goals of a country’s population
• Improving consumer experience
• Providing insights into health conditions for better diagnosis and care
• And more

There are a lot of global case studies that support these advantages offered by digital health technologies, for example, Chile used AccuHealth for remote monitoring of chronic illnesses.

In fact, chronic diseases are one of the primary causes of death around the globe. For instance, in the United States, 66% of healthcare expenditure goes into providing medical care to patients struggling with chronic conditions, whereas Chile has around 5 million people dealing with chronic ailments.

To deal with this challenge, healthcare systems in Chile are seeking help from AccuHealth to identify patients with long-term conditions who can benefit from their health-training programs. With this AI remote monitoring technology, health coaches can easily monitor high-risk patients and reach out to them within a few hours of an abnormal biometric reading.

The AccuHealth kit is a collection of sensors and tablets that help patients with biometric monitoring, including blood pressure, blood sugar levels, and other parameters. This kit can be tailored for various diseases like diabetes, hypertension, and more. To analyze the impact of the technology, AccuHealth led a study on 4000 diabetic patients and tested their A1C levels and blood pressure at regular intervals. The results displayed a 1.5-point decrease in A1C after six months, which as per AccuHealth, directly translates into a 20–40% reduction in health complications for chronic patients.

AccuHealth is an example of how digital health solutions can help patients manage their conditions conveniently and how healthcare providers can leverage AI-generated insights to provide timely care to patients, adhering to the principle of beneficence.

Wrapping Up

Digital health technologies are establishing the future of healthcare that makes the most of Health Information Technology to provide high-quality care to patients. The multi-faceted benefits of healthcare technologies, including improved organizational systems and behavioral patterns and optimization of treatment processes, can help healthcare systems worldwide to provide cost-effective care to the growing population.

With more and more technology integration making its way into the healthcare industry, technology companies can develop and market personalized products/services to fill specific pain points.

However, every technological implementation should be preceded by thoughtful, ethical considerations of autonomy, justice, beneficence, and non-maleficence to balance patient safety and convenience. Informed consent from patients and careful handling of critical patient information should be the priority of healthcare providers in the rapidly advancing digital health sector.