Healthcare was a much anticipated topic in President Donald Trump’s State of the Union address — in fact, a Politico poll showed that 82 percent of Americans wanted to hear the president address the healthcare system over other divisive discussion points.
While he did briefly touch on some healthcare related topics, like making drugs more affordable and getting rid of the Affordable Care Act's individual mandate, those looking for a deep dive likely found themselves disappointed.
In his first State of the Union Address, Trump laid out his top priorities for the country, among which were making medication cheaper, giving veterans more choice in their healthcare and combating the opioid crisis.
The president gave few concrete details about how his administration would solve these issues, but technology could play a roll; the government has previously used digital health as a tool to address a number of these issues.
Read on for a look at how digital health could fit into the Trump administration's plans.
Veterans' health
Last night the president made it clear that veterans’ healthcare was among his priorities.
“And we are serving our brave veterans, including giving our veterans choice in their healthcare decisions,” Trump said in his speech.
In recent years the Department of Veterans' Affairs has been expanding and growing its digital health offerings. This coupled with new legislation that makes telemedicine more accessible to veterans has opened the door for veterans seeking new healthcare tools.
For instance, in January the senate passed the Veterans in E-Health and Telemedicine Support Act of 2017, bipartisan legislation aimed at expanding the VA’s telehealth programs and letting VA providers cross state lines to practice telemedicine.
Over the summer Trump and VA Secretary Dr. David Shulkin announced the roll out of a new app, called Veteran Appointment Request, which lets veterans schedule and change their appointments from their smartphone. They also launched the VA Video Connect, which had been in trials at more than 300 VA facilities before the announcement.
“Working with the Office of American Innovation and the Department of Justice, we're going to be issuing a regulation that allows our VA providers to provide telehealth services from anywhere in the country to veterans anywhere in the country, whether it's in their homes or any location,” Shulkin said in August. “We call it ‘anywhere to anywhere’ VA healthcare. That's a big deal.”
But the VA’s interest in digital health doesn’t stop at telemedicine. In November, the department rolled out a new initiative to give veterans eligible for speech or cognitive therapy access to Constant Therapy, a mobile app that provides supplemental coaching and motivations to patients.
The VA has turned to digital therapies to help treat PTSD, a condition which affects 15 percent of Vietnam veterans and 11 to 20 percent of Iraq and Afghanistan veterans, according to the VA. In December, Potentia Lab, a behavior changing technology platform, won a contract with the VA to develop its e-learning platform for veterans living with PTSD.
Last year the VA also partnered with Google and the National Alliance on Mental Illness to offer PTSD screening through the Google search engine.
Opioids
Last night, Trump reaffirmed his commitment to fighting the opioid epidemic. Transitioning from his discussion of illegal immigration and drugs crossing over the border, he noted that the administration was dedicated to helping those in need of treatment.
“In 2016, we lost 64,000 Americans to drug overdoses: 174 deaths per day. Seven per hour. We must get much tougher on drug dealers and pushers if we are going to succeed in stopping this scourge,” Trump said. “My administration is committed to fighting the drug epidemic and helping get treatment for those in need. The struggle will be long and difficult — but, as Americans always do, we will prevail.”
Though the speech did not specifically talk about treatment options, the federal government has turned to digital health in the past.
In the fall Trump declared the opioid crisis a public health emergency and pledged to allow for the expansion of telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment, according to a statement issued by the White House. However, the announcement did not include any of the specific ways that the services would be expanded.
Following this announcement, the White House released The President’s Commission on Combating Drug Addiction and the Opioid Crisis report. The report encourages more digital technologies to address the crisis. It goes on to specifically mention wearables that could automatically inject naloxone when blood oxygen levels become low, as well as apps that function as behavioral coaches.
In addition, the Department of Health and Human Services hosted a code-a-thon in December to find solutions to tackle the crisis. The HHS hosted more than 50 innovators from across the country. The competition had three categories: prevention, treatment, and usage trackers.
“We are teaching the department that there are all these people around the country that are willing to help out and it is was important for us to address this problem with humility,” Bruce Greenstein, chief technology officer at HHS, recently told MobiHealthNews. “Basically we are saying we need help and we reached out to the tech, innovation, and data community.”
Pharma and the FDA
The president put a strong emphasis on developing more affordable drugs in the future. While any actions that evolve from Trump’s pledge will primarily impact pharma, he did mention the that the FDA’s speed in approving both drugs and medical devices.
“To speed access to breakthrough cures and affordable generic drugs, last year the FDA approved more new and generic drugs and medical devices than ever before in our history,” Trump said in his speech last night.
Last year 46 original medical devices were approved by the FDA, up from 39 original devices approved in 2016.
Under FDA Commissioner Dr. Scott Gottlieb, the agency accelerated its plans for digital health regulation. Most notably the agency’s pre-certification program, which focuses on the firm and developer instead of the product. If the FDA is satisfied the firm is responsible for the safe development of a device, it won't need to regulate each product from that firm. Big names like Apple, Samsung, Fitbit, and Johnson & Johnson are all participating in the initial pilot. The agency also released a slew of draft and final guidances specifying device categories that would stay outside of the FDA's regulatory jurisdiction and, therefore, be available more quickly.
