Digital health can make healthcare more open, inclusive, and patient-centred. Here’s how.

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Belén Garijo, Chair of the Executive Board and Chief Executive Officer, Merck

• Healthcare stakeholders should collaborate to build a more open, transparent network of digital health ecosystems that puts the patient at the centre of care.
• A guiding set of ethical principles can deliver safety, accountability, and transparency in capturing, owning, securing and utilizing data.
• A molecular signature of human diversity can help patients everywhere benefit from more precise, personalized treatments options.

Over the last two decades, data and digital technologies have begun to converge with medicines, devices, and diagnostics to create a new market for digital health. The Covid-19 pandemic has accelerated demand for connected drug delivery and wearable devices and apps for remote monitoring, patient engagement and adherence.

With instant access to a vast amount of healthcare information, tremendous opportunities exist to detect disease earlier, hasten the development of new treatments, and personalize them to individual patients.

Connections between people, machines and data are set to further strengthen over the next decade thanks to advances in genetic engineering, next-generation semiconductors, machine learning and human-machine interfaces like biosensors and augmentation.

Similarly, AI, IoT and machine-to-machine communications will help organizations make their clinical development and supply chain processes faster and more efficient.

This surge in data accumulation and processing power represents a transformational opportunity for patient care to become more precise, predictive, personalized, and convenient.

Over the last decade, however, healthcare information has remained largely siloed away in unstructured networks and closed ecosystems. Such closed, unconnected environments not only reduce opportunities to derive synergistic benefits across the value chain. They also harm levels of patient trust and engagement.

A survey by McKinsey of digital heath stakeholders found that success requires an integrated approach that delivers convenience and impact across the patient journey. This survey, as well another recently published by Imperial College London, identified that for data-driven healthcare to succeed, it must be built upon a platform of trust. However, most American and European patients remain unwilling to share their medical data with authorized healthcare stakeholders – especially those from the private sector.

The full potential of digital health can only be realized with an open, ethical, inclusive approach where stakeholders work together in the best interests of patients.

How to create open, transparent ecosystems that facilitate interoperability and trust

Developing secure, transparent, and integrated ecosystems require collaboration. Syntropy, a partnership between Merck and software leader, Palantir, is one such effort.

This separate entity is helping organizations unlock the potential of their health data to accelerate research and clinical outcomes that advance patient care. Importantly, Syntropy never takes ownership of the data and always transparently attributes its origin. With this framework, Syntropy is working with a range of companies, hospital networks, and research institutes to develop AI-enabled ecosystems for cancer and other therapeutic areas that solve research problems in real-time.

How to develop a code of digital ethics that can boost patient and stakeholder trust

Merck has established a Code of Digital Ethics (CoDE) to cement strong ethics around its digital health activities, a first for a large company in the healthcare industry. The CoDE, based on a decade’s worth of digital ethics learnings, governs how Merck approaches all activities relating to the development, commercialization and use of digital products and processes.

The core principles of the CoDE are autonomy, justice, beneficence, non-maleficence, and transparency. These principles ensure Merck operates in a safe, transparent, and accountable manner that benefits patients, the healthcare sector, and society at large. Other healthcare companies should consider establishing CoDEs that complement these guiding ethical principles.

How to use digital health to enable greater diversity and inclusion in clinical development

Regulatory guidelines and spirited outreach efforts are already helping achieve better ethnic and gender diversity in clinical trials. However, to truly achieve health equity, an even more inclusive approach is required. We must reduce access lag and enable precision pharmacotherapy for all patients.

Our industry today has an opportunity to build on recent breakthroughs in understanding the human genome and modern sequencing technologies to create a universal molecular signature of human diversity.

Such a signature platform will characterize variability at multiple levels that go far beyond the demographics. A range of intrinsic and extrinsic factors linked to disease can now be utilized, including omics data sourced from proteome, metabolome, transcriptome, microbiome, epigenome, radiome, genome, and exposome databases.

Integrating such a molecular signature platform with other quantitative translation tools, advanced analytics, and bioelectronics will allow our industry to help detect disease risks earlier and better predict which therapy and dosage are best for the individual patient.

Merck, often working alongside leading academic groups and AI-driven start-ups, is also accelerating its use of advanced analytics and deep learning processes to discover and develop medicines. By integrating digital tools, we can extract hidden insights from massive datasets. This helps to predict potential compounds’ properties better and create novel solutions. Digital tools and data such as omics are also helping to improve the forward and reverse translation methods used to develop precision medicines efficiently.

A safe, accountable, and collaborative environment that facilitates more open and effective ecosystems will allow our industry to transform data into actionable insights and usher in a new era of precise and personalized patient care. Industry stakeholders must come together across each of these areas to ensure that the interests of patients are placed firmly at the centre of digital health.