How will the field of digital health evolve in the next 5 years?
By Emma Norris, on 4 February 2019
By Olga Perski, Claire Garnett & Susan Michie – University College London, UK
The Society of Behavioural Medicine’s Digital Health Council aims to inform and prepare the society’s broader membership for the evolution of the digital health field. In this service, the Council contacted relevant stakeholders, including academics working at the intersection of behavioural science and technology, to get their perspective on how the field of digital health might evolve in the next 5 years.
We were asked to respond to the below interview questions, which will be compiled into a report that will be presented at the Society of Behavioural Medicine’s Annual Conference in March 2019. In our responses, we drew on our collective experiences in addition to points raised at the recent Richard & Hinda Rosenthal Symposium, titled ‘Behaviour change to improve health for all’, co-hosted by the US National Academy of Medicine and the UK Academy of Medical Sciences in January 2019.
- When thinking about the next 5 years, what do you think will be most important for digital health? [this can be broad, as it applies to technology, legislation, etc.]. Why?
A priority in the next 5 years is the development of regulatory frameworks for digital technologies that take evidence of engagement, effectiveness and cost-effectiveness into consideration, with a view to consolidating international standards. Further down the line, this will ensure that only user-centred and effective digital health technologies are integrated into routine healthcare practice, without invoking opportunity costs. As many users access digital health technologies outside formal healthcare routes (e.g. via commercial app stores), it will also be important to further develop public health assessment frameworks and repositories (e.g. the National Health Service’s Apps Library, which will help users select tools that are secure and evidence-based.
A second priority will be to advance our data analytic methods to address scientifically important questions using the large amounts of relatively unstructured temporal and spatial data collected from wearables, physiological measures, smartphone apps and environmental sensors. This will also help detect situations in which people could benefit from behaviour change support, which will inform the development of just-in-time, adaptive interventions that require less deliberate engagement on the part of the user.
- When thinking about the next 5 years, which technology capabilities do you think will bring more promise for digital health? Why?
The deployment of machine learning and artificial intelligence systems (including artificial neural networks) will help advance the digital health field, as this will provide support for more rapid synthesis of available research (including high-quality research published via non-traditional platforms, such as F1000Research; to address the big question of what behaviour change interventions work, how well, for whom, in what settings, for what behaviours, compared with what and why (e.g. The Human Behaviour-Change Project). The digital world is rapidly changing, and the development of effective interventions requires considerable time and resources; it is therefore not feasible to undertake this process from scratch for all present and future technologies, populations and settings. The use of artificial intelligence to make sense of available data will help to identify key characteristics of complex interventions that drive effectiveness.
- How do you see the digital health field evolving in the next 5 years?
In the next 5 years, we will see more academic-industry partnerships and novel funding schemes for research aimed at advancing scientific knowledge. New funding structures and business models will encourage partnerships that are sustainable and focused on delivering effective and equitable digital behaviour change interventions. We will also see more user-led research initiatives with diverse online communities being actively involved in setting the research agenda. We hope there will be more multidisciplinary teams with behavioural scientists playing an important role in providing theory, methods and evidence relevant to understanding behaviour change.
- What do you think behavioural scientists can do to be more prepared to work with digital health in the next 5 years? [this can be broad, as it applies to training, partnerships, etc.]
Behavioural scientists should seek out and create training opportunities to help build capacity to deploy, critically interrogate and interpret results from novel evaluation methods that account for iterative design and testing cycles, including working with large, complex data sets. Behavioural scientists should also focus on advancing theories of behaviour change over time, within individuals as well as within tailored groups and general populations, acknowledging that many theories of behaviour change reflect group differences informed by data collected in cross-sectional designs. Understanding the dynamic nature of behaviour change and developing and implementing appropriate methods to analyse this will help drive scientific innovation across academia, industry and clinical practice.
- What is the role that behavioural scientists will play in digital health in the next 5 years?
Behavioural scientists will increasingly find themselves in interdisciplinary projects, adopting learning from and influencing developments across a range of scientific fields. This will be facilitated by the development of shared vocabularies and conceptual frameworks. Behavioural scientists should further hone their skills in mixed methods research, as the integration of users’ subjective experiences and views with objective measures of diverse behaviours will add significantly to the skills of computer scientists and other stakeholders and collaborators. The development of dynamic theories of behaviour change by behavioural scientists will be able to inform intervention development in a way that is likely to make them more effective.
- How do you see technology supporting behaviour science in the next 5 years?
Recent technologically-enabled data collection methods (e.g. Ecological Momentary Assessments or location estimation via smartphones or wearable devices) will inform the development of dynamic theories of behaviour change, allowing current theories to be tested and refined, and new ones to be developed. In contrast to our current, static theories, these dynamic models will take account of feedback loops, emergence and adaptation.
- Would your answers to these questions differ? If so, how?
Dr. Olga Perski’s research is cross-disciplinary in scope, drawing on theories and methodologies from behavioural science, computer science and human-computer interaction to develop and evaluate digital behaviour change interventions for smoking cessation and alcohol reduction. Specifically, her doctoral work was focused on the conceptualisation, measurement and promotion of ‘engagement’ with digital behaviour change interventions: @OlgaPerski firstname.lastname@example.org
Dr Claire Garnett’s research interests include health behaviours, behaviour change interventions, development and evaluation of digital interventions, excessive alcohol consumption as a behaviour change target. Her PhD thesis focused on the development and evaluation of a theory- and evidence-based smartphone application to reduce excessive alcohol consumption (‘Drink Less’): @ClaireVGarnett email@example.com
Professor Susan Michie is Professor of Health Psychology and Director of the Centre for Behaviour Change at UCL. Susan’s research focuses on developing the science of behaviour change interventions and applying behavioural science to interventions. She works with a wide range of disciplines, practitioners and policy-makers and holds grants from a large number of organisations including the Wellcome Trust, National Institute of Health Research, Economic and Social Research Council and Cancer Research UK: @SusanMichie firstname.lastname@example.org