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AMA CEO: “Digital Snake Oil” Remarks Have Initiated Much-Needed Discussion

June 20, 2016
by Rajiv Leventhal
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The American Medical Association’s (AMA) CEO and executive vice president, James Madara, M.D., discussed further his recent comments about digital health products being “snake oil of the early 21st century.”

Last week, in a June 11 address to AMA’s House of Delegates at its annual meeting in Chicago, Dr. Madara, an academic pathologist by trade, used the term “digital snake oil” to begin a conversation about emerging technologies in medicine. Specifically, he said, "Today we have really remarkable tools — robotic surgery, new forms of radiation treatment, targeted biologics; and we live in a time of rapid development in the digital world — telemedicine as an example. But appearing in disguise among these positive products are other digital so-called advancements that don't have an appropriate evidence base, or just don't work that well — or actually impede care, confuse patients and waste our time. From ineffective electronic health records, to an explosion of direct-to-consumer digital health products, to apps of mixed quality — it's the digital snake oil of the early 21st century."

Not surprisingly, Madara’s comments made waves in the health IT community last week. For example, John Halamka, M.D., CIO at Boston’s Beth Israel Deaconess Medical Center, took issue with Madara’s words in a blog post where he said moving from a paper-based industry to electronic transactions, sharing data, doing population analytics, engaging patients/families has been the goal of the country’s five National Coordinators for Health IT to date. “There is no snake oil. We created the digital foundation that is a prerequisite for the next generation of tools,” Halamka said in his blog.

James Madara, M.D.

Now, in a more recent interview with AMA Wire on June 17, Madara spoke about the fallout from his remarks. “The early response has fallen into two general camps, which is exciting because it has initiated a healthy and much-needed discussion about this issue. The first camp is those who are generally comfortable with the pace of development of new technologies, the tsunami of digital tools and apps that I spoke of, and who perhaps aren’t concerned or don’t know enough about the potential health risks of what sometimes amounts to un-validated toys,” he said. The second group, Madara continued, consists of those who have said that the AMA CEO is right— “The industry is moving toward a mess where the useful tools are not clearly differentiated from the toys,” he said in the interview.

Madara added that “the term digital snake oil isn’t meant to be a criticism of any one product, rather a critique of a direct-to-consumer industry that exists today with little oversight and often questionable scientific evidence to support the claims made.” He brought up an example of a product that says it will measure your blood pressure but in the fine print indicate the product is for entertainment only, and that that the readings are not to be trusted.

When asked specifically about electronic health records (EHRs), and if they are part of what he classifies as “snake oil,” Madara said they are not; but he noted that EHRs “are symbolic of a system that is not fully functional or living up to its potential.”



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