The first ever cardiac conference in digital health - ESC Digital Summit 2019 - is set for 5 and 6 October at the Creative Hub in Tallinn, Estonia.
The event brings together core groups that are at the forefront of the digital health transformation. Patient groups, healthcare professionals, technology developers, policymakers, regulators, and reimbursement officers will take a deep dive into pressing issues, such as cybersecurity and how to evaluate whether a technology is beneficial.
"Rarely do health professionals get involved in this debate," said Professor Martin Cowie, Chair of the ESC's Digital Health Committee. "Too often the conversations are only within one stakeholder group."
Cardiovascular medicine is on the cutting edge of the digital health field because there are so many different things to measure. Technology is getting better and better at measuring electrocardiograms (ECGs), blood pressure, blood sugar, and so on. People are monitoring themselves and using algorithms or artificial intelligence (AI) to help them make the best choices."
Professor Martin Cowie, Chair of ESC's Digital Health Committee
"Will artificial intelligence replace human intelligence?" is one congress debate. In Prof Cowie's view, AI will amplify human intelligence. "Central to the conference is stripping away the hype without being cynical. Healthcare professionals will see the possibilities while developers will gain insights into regulatory requirements and clinicians' need for good evidence before backing a new approach," he said.
Collecting evidence for reimbursement authorities and regulators is challenging in the digital world where technologies change quickly. The congress will explore how much proof is sufficient. "We can't wait five years for a huge clunky randomised trial, so there must be other methods of assessment," said Prof Cowie. "We do need validation that a technology is not just new, it's better."
This comes to the fore in the congress debate "Wearables and mobile apps: precision medicine or the emperor's new clothes?". Prof Cowie noted that these technologies produce a "tsunami of data" - but are people healthier as a result? "In theory they look great - personalised, continuous, in real time. But if we are going to restructure teams to look at streams of information, even with AI in the background, we need to be sure it will improve outcome. Monitoring can also be counterproductive if it leads to anxiety," he said.
A more nuanced approach is needed for wearables and apps, said Prof Cowie. Fitness trackers may help some people, but not others. Monitoring vital signs might be useful for a short period, rather than lifelong. "We will find a role for these technologies, but we should avoid uncritical acceptance that every wearable will improve health or make people feel better," he said.
Cybersecurity is another hot topic to be scrutinised during the meeting. "There are a huge range of attitudes to data security. Some tech companies seem rather lax, European policymakers are tightening the rules and delivering fines, and citizens sit somewhere in between," he said.
Estonia is a leader on interoperability, meaning how novel technologies integrate with existing systems. Delegates will hear how to develop an interoperable digital health ecosystem. And as a signal of the country's interest in digital health, the Estonian Prime Minister is set to attend the opening session.
Stay tuned for the Technology and Innovation Pitch Presentations - a rapid fire of ideas and concepts across all fields of cardiology. "These will be stress tested by the event's varied audience," said Prof Cowie.