In this review paper, participants from a 2016 think tank on digital health discuss the purpose and findings of the meeting. The participants, which included academic, industry and regulatory representatives, convened to understand the current landscape of digital health technology use in health care delivery and clinical trials, identify issues and barriers to the development and adoption of these technologies, and identify potential solutions.

"These technologies could facilitate and advance more conventional randomized clinical trials (RCTs), which is particularly necessary since RCTs are becoming increasingly expensive and complex, are slow to complete and take an extensive amount of time to implement into practice," said Abhinav Sharma, MD, lead author of the review and Stanford University Advanced Heart Failure Fellow (previously a Duke Clinical Research Institute Research Fellow).


Think tank participants reported that there are several solutions that can accelerate the use of these technologies, including: developing innovation networks to rapidly test new innovations, validate findings and provide value cost-effectiveness data; collaborating with regulatory agencies to streamline development; working with professional societies to identify critical knowledge gaps that could be filled by digital health technologies; and expanding the role of public-private partnerships.

"Mobile Health Advances in Physical Activity, Fitness and Atrial Fibrillation: Moving Hearts"

Cardiovascular disease management and prevention involves a commitment to heart healthy physical activity, diet, medication adherence and self-monitoring. These daily activities are largely unmeasured, but the emergence and rapid growth of mobile devices and wearables has made continuous health monitoring a possibility and, for many patients, a reality.

Mobile health, or mHealth, is the subset of digital health that focuses on the use of mobile and wearable devices and software applications. Authors in this article provide an update on cardiovascular mHealth, with a focus on research and clinical advances in measuring and promoting physical activity and fitness plus using these same mobile devices for heart rate and rhythm monitoring, especially for atrial fibrillation.

"Only recently has the medical community started to embrace the reality that most 'health' takes place outside the hospital and clinic, namely the daily activities and clinical events that occur 'the other 362 days' per year when people are not seen by a clinician," said Michael McConnell, MD, MSEE, lead author of the review and clinical professor of cardiovascular medicine at Stanford University and head of cardiovascular health innovations at Verily Life Sciences. "Enabling patients and clinicians to leverage these technologies for proactive health care can transform cardiovascular prevention and disease management."

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