To the Editor:
Pooja Chandrashekar promotes “A Digital Health Preclinical Requirement for Medical Students” in her Letter to the Editor.1
The recent COVID-19 pandemic illuminates the value of being able to provide care remotely and has catalyzed the deployment of digital tools at an unprecedented pace. That said, Chandrashekar’s opening and sweeping assumption that “digital health is gaining momentum within clinical practice but remains poorly understood by many physicians” might be more accurately rephrased. The term “digital health” has become more popular as new, patient-facing technologies are offered up—frequently outside of clinical practice—but remains poorly understood by all sorts of people. Like innovation, disruption, and artificial intelligence, “digital health” invites allure and misunderstanding. The ambiguity of “digital health” can be confusing to precisely trained clinicians and frankly, to anyone who grew up learning that a cornerstone of health care involves “the laying on of hands.” That said, there are also billions of patients and physicians accustomed to digital solutions helping them in all other aspects of life, so the notion of having health-related data and tools at their fingertips makes sense.
Apps, digital platforms, and wearables are ubiquitous. Most digital health innovations and the startups that created them will die, but a few will survive, nudging health care toward a more easily accessible, patient-centered experience, until they are replaced by new versions or something better. In the places where technologies shine, care is enhanced—patients are empowered to be healthier. Doctors are well advised to consider new digital tools with humility and a trained eye.
The Mayo Clinic Alix School of Medicine has, for years, incorporated digital health and related emerging technologies into its (required) preclinical course. It is likely that other schools will do the same, and hopefully, those that have not yet, will. Medical schools should confirm that preclinical requirements are (1) foundationally relevant, independent of a student’s chosen future professional path; (2) durable, still useful after training; and (3) positioned appropriately in the preclinical years.
Knowing which digital tools truly lead to better health is a first step in determining what should be poured into the foundation of every doctor’s education. The trick is extracting from what it seems today like we should teach, those lessons which tomorrow, we will be glad we did.
David Rosenman, MD, MBA
Preclinical course director, Mayo Clinic Alix School of Medicine, Rochester, Minnesota; firstname.lastname@example.org; ORCID: https://orcid.org/0000-0002-5924-0776.
Wendy Sue Swanson, MD, MBE
Former chief of digital innovation, Digital Health, Seattle Children’s Hospital, Seattle, Washington; email@example.com.
1. Chandrashekar P. A digital health preclinical requirement for medical students. Acad Med. 2019;94:749.