Recommendations for Successful Development and Implementation of Digital Health Technology Tools

Abstract

Digital health technology tools (DHTTs) have the potential to transform health care delivery by enabling new forms of participatory and personalized care that fit into patients' daily lives. However, realizing this potential requires careful navigation of numerous challenges. This viewpoint presents the authors' experiences and perspectives on the development and implementation of DHTTs, addressing both established practices and controversial topics. This article offers a practical guide organized into 10 recommendations derived from a multidisciplinary lecture series and associated workshop discussions on "Digital Health and Digital Biomarkers" held at the University of Luxembourg in 2023-2024. Key messages include the need to understand specific health care challenges, form interdisciplinary teams, incorporate patient feedback, select appropriate measurement technologies, ensure data integration and interoperability, apply advanced data science techniques, use scalable designs and open standards, comply with regulatory requirements, and maintain continuous evaluation and improvement. While the guide highlights essential practices, it also addresses contentious issues such as balancing innovation with regulatory compliance, addressing ethical concerns in artificial intelligence adoption, managing privacy versus the need for comprehensive data integration and open science, and managing the financial sustainability of DHTTs. The authors argue that digital health's greatest potential lies in its ability to provide participatory and personalized care, but this requires a delicate balance between technological advances and ethical, legal, and social implications. Overall, this workshop-derived viewpoint aims to help health care professionals, engineers, developers, and researchers not only adopt best practices but also address and resolve the controversial aspects inherent in the development of DHTTs.

Keywords: application; data interoperability; data privacy; digital health; electronic health record; health care technology; health monitoring; interdisciplinary collaboration; mobile health; real-time; recommendations; regulatory compliance; technology; telehealth; user engagement; user-centered design; wearable.

Figure 1.. Generic workflow for the development of digital health technology tools (DHTTs). This figure illustrates common key steps in DHTT development, directly reflecting the 10 recommendations presented in this paper. The workflow is organized into 3 main phases: planning, development, and sustainability. Each numbered step corresponds to a specific recommendation and is accompanied by letter codes indicating the stakeholders directly involved in the project—P: patients and advocacy groups; H: health care providers; R: researchers; D: developers and engineers; M: project managers; B: regulatory bodies and policymakers. The workflow progresses from left to right, with arrows indicating the primary flow between phases. The green dashed arrow represents the continuous evaluation and improvement process (recommendation 10) that spans all phases, emphasizing the iterative nature of DHTT development. We note that this figure presents a simplified, generic workflow, and specific DHTT projects may often have additional subphases or phases beyond this basic scheme, depending on the requirements, complexity, and scope of the digital health solution being developed. The actual workflow may be more complex and iterative, with potential variations for different types of DHTTs and organizational contexts.

Figure 2.. Interdisciplinary team structure and direct stakeholder involvement for digital health technology tool (DHTT) development. This figure illustrates a typical composition of an interdisciplinary team for DHTT development, as outlined in recommendation 3. Interactions are highlighted by the gray dotted lines. The core development team (blue) consists of project managers, researchers, engineers, software developers, and user interface and user experience (UI/UX) designers. Key stakeholders who are directly involved in the project design (shown in pink), including patients, caregivers, health care providers, policymakers, and regulatory bodies, are shown interacting with the core team. These interactions emphasize the importance of diverse perspectives and collaborative input throughout the DHTT development process.

Figure 3.. Digital health technology tool (DHTT) ethical framework. Four interconnected pillars—safety, privacy, responsible artificial intelligence (AI), and equity—provide critical considerations for ethical DHTT development, including risk-benefit analysis, data protection, algorithmic assessment, and health care disparity measures.