Digital Health Project Course, Fall Semester 2021, ETH Zurich
Can 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 on how to develop evidence-based digital health interventions (DHIs) that 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 need, design, implementation, and assessment of DHIs.
After the course, students will be able to…
- understand the importance of DHIs for the management of chronic conditions
- discuss the opportunities and challenges related to DHIs
- better understand the design, implementation and evaluation of smartphone‐based and chatbot‐delivered DHIs
To reach the learning objectives, students will work on the following topics:
1. Motivation for Digital Health
- The rise of chronic diseases in developed countries
- Lifestyle as medicine and prevention of chronic diseases
2. Design of a Digital Health Intervention (DHI)
- Overview of design frameworks for health interventions
- Development of a conceptual model for a DHI
- Implementation of a smartphone‐based and chatbot‐delivered DHI
3. Evaluation of DHIs
- Overview of evaluation methods and evaluation criteria for DHIs
- Evaluation of a smartphone‐based and chatbot‐delivered DHI
The lecture is structured in two parts and follows the concept of a hybrid therapy consisting of online sessions and complementary online lessons. In the first part, students will learn and discuss the topics of the three learning modules in weekly on-site sessions. Complementary learning material (e.g., video clips), multiple‐choice questions, and exercises are provided via the online learning platform.
In the second part, students work in teams and will use their knowledge from the first part of the lecture to develop a smartphone-based and chatbot-delivered health intervention with MobileCoach (www.mobile-coach.eu), an open‐source software platform for digital interventions and ecological momentary assessments. Each team will then present and discuss their resulting digital health intervention and evaluation results with their fellow students who will provide peer reviews. Additional online coaching sessions are offered to support the teams with the design and evaluation of their digital health intervention, and with the preparation of their presentations.
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Michie, S., L. Yardley, R. West, K. Patrick and F. Greaves (2017) Developing an Evaluating Digital Interventions to Promote Behaviour Change in Health and Health Care: Recommendations Resulting From an International Workshop Journal of Medical Internet Research 19(6):e232, 10.2196/jmir.7126
- 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
The mandatory material will be provided via the online learning platform.
Students should be interested in the multi‐disciplinary field of Digital Health at the intersection of health economics, information systems research, computer science, and behavioral medicine. Attendance of the Digital Health course (offered at ETH in the spring semester or at the University of St.Gallen in the fall semester) is advantageous but not required. Please note that you need a smartphone with either iOS 12 (or higher) or Android Version 8 (or higher) to test the digital health interventions of the course participants.
If you have any further questions regarding Digital Health Project, then please contact David Cleres.