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  Today in Health it. This story is a book recommendation, the Digital Reconstruction of Healthcare by Paul Serreto and John Halamka. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current and engaged.

My company is Health Lyrics. I provide executive coaching and advisory services for health leaders around technology and it. If you wanna learn more, check out health lyrics.com. Here's today's story. There are moments in history when technology policy and urgency to change converge. This is one of those moments that's an opening quote from a book I received this week and read this week.

Great book, the Digital Reconstruction of Healthcare, and it's worth a look for you. Lots of information in here that will help you to frame the future of digital health. In your organization has research, has frameworks, talking points. Let me, let me just give you a taste of what's in here. Here's a chapter summary.

Chapter one is digital reconstruction necessary. Chapter two, the merits and limitations of telemedicine, hospital at home, and remote patient monitoring, which gives you an indication. One of the things I really like about this. It presents all angles of this, the arguments for the arguments against the studies for and the studies against.

So it's a pretty balanced approach to it. Uh, third chapter, digital Assault on COVID-19. Number four, entering the age of big data and AI assisted medicine. Number five, exploring the AI ML toolbox, which is an explanation of the main terms and technologies. In machine learning and artificial intelligence in common language.

Uh, if you get the book for no other reason, get it for that chapter. It's a great chapter. Number six, the transformative impact of conversational technology. Seven, securing the future of digital health, and eight, the digital reconstruction of global health. I like the book also because it's, uh, it's about 130 pages, so it was not too hard to get through, and it has just so much in there for you.

So let me, . Let me pull out some of the highlights from this to, uh, get you started. Let's start with chapter one, and Chapter one gets broken down into a couple areas, reviewing the evidence on effectiveness. Episodic medical care often falls short, diagnostic errors, inadequate infrastructure, digital health during a time of crisis.

Okay, so you think, oh, this is great. Then you go on. One of the largest analysis of digital health companies, on the other hand, concluded that their services have yet to provide a substantial impact on disease burden or cost in the US healthcare system, among patients with high burden, expensive medical conditions.

Yet the picture, he goes back and forth with some supportive studies and some that show the gaps that still exist in our approach to digital medicine. The thing I love about this is. There are conclusions in here as well that are gonna help you. So in controlled trials that examine the effectiveness of treatment protocols for treating cardiovascular disease, for instance, a trial may conclude that a drug or lifestyle intervention is ineffective across the entire patient population, but that does not rule out its value in certain subgroups.

Similarly, when reviewing telemedicine services, it is tempting to lump all services together or to treat different patient cohorts as one homogenous group, but it's far more likely that the benefits are harm caused by telemedicine Varies depending on the type of disorder being treated, the severity of the disease, the communication tools being employed, the type of teleservices, asynchronous, or synchronous.

The state law governing the patient clinician interaction and whether services offered directly to the patient or to other clinicians as a teleconsultation. So you get the picture, there's, there's a lot of strong conclusions made, but there's a good balance to the book. I go on the episodic medical care and I, I like the, the work here that they've done on remote patient monitoring is really good.

He says, uh, no responsible practitioner would conclude a diabetic patient is in good metabolic control based on a single blood glucose reading. And that's really true, and that's one of the foundations for a strong remote patient monitoring program that is going to bring in information and start to create a more comprehensive view, more of a whole person view of the medical condition that's going on.

The same report found that diagnostic mishaps contribute to about one in 10 patient deaths, and it goes on to talk about how AI and machine learning and the various technologies associated with that, uh, are going to . Be able to come alongside doctors and provide more context to them before they make, uh, those kinds of diagnosis.

So that gives you a taste of that first chapter. The merits and limitations of telemedicine and hospital at home and remote patient monitoring is probably the one you're gonna get the most out of the chapter you're gonna get the most out of, to be honest with you. It, it talks about telemedicine's dynamic growth, what's gonna hold it back.

These are important topics. We cover this on the show pretty often. One survey found that 69% of consumers want their healthcare providers to offer more telemedicine services as an alternative to in-person visits. Once the pandemic is over. In addition, about one third of the consumers don't feel safe going to the hospital.

Since the pandemic began. It's likely that fear will have a long shelf life. That's probably true. It goes on to talk about the different telemedicine choices that you're going to make. It examines the scientific evidence, which is always helpful. He actually goes into the various different programs that are out there as well.

He doesn't only talk about the Mayo program, he talks about Mount Sinai. He talks about Partners, healthcare and others, and what their programs are doing. . I say he, but I mean they obviously, here's a stat that I found really interesting. University of Wisconsin and University of Pennsylvania found that E-visit actually increased the number of office visits by 6%.

The conclusion was based on the analysis of a dataset of several hospitals, medical centers, and medical practices. In over 2.5 million primary care visits. Similarly, a Rand Corporation study reviewed insurance claims data from about 300,000 patients over a three year period, and found that about 12% of the telehealth visits had replaced regular medical visits.

But 88% represented new utilization. The results suggest that increased convenience may tap into unmet demand for healthcare and new utilization may increase overall healthcare spending. So it it's those kinds of nuggets that I've really appreciated from this book. And as I mentioned before, one of the, one of the chapters I really appreciate is the exploring the AI ML toolbox, which is an ex explanation of the main terms in common language.

It breaks down the various aspects of machine learning and artificial intelligence talks about a. Supervised learning and subdivided into classification of regression and, and unsupervised learning. And reinforced learning Talks about artificial neural networks, random forest modeling. You get the picture.

I mean, gradient boosting goes into a lot of different terms that we really need to know as we're getting further, further along in this journey. And really understand how each one of those things gets applied to healthcare. Really good book if you're in Health it, and especially if you're working in strategy or making the case for new digital tools and methods within your health system.

Or you just want to understand the key drivers and the obstacles for digital health. All right. That's all for today. If you know of someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com, or wherever you listen to podcasts. Apple, Google Overcast, Spotify, Stitcher.

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