NIH Record - National Institutes of Health

Duke’s Shaw Highlights Transformative Opportunities in Digital Health

A smiling Shaw stands holding a marker up to a dry-erase board.
Dr. Ryan Shaw

Dr. Ryan Shaw presented the latest edition of the NINR Director’s Lecture Series in his discussion, “Digital Health: Towards the Next Era of Health Care Delivery and Chronic Disease Management.” His lecture underscored the wide availability of digital technologies that health care providers can use to enhance patient care and manage chronic diseases.

Shaw noted that by integrating a suite of patient-generated health data from phone sensors, connected devices like smartwatches and activity trackers, in-home devices and environmental sensors—in addition to FDA-approved-devices like electrocardiograms, wireless stethoscopes and exam kits—health care providers will have a wealth of tools, technologies and software programs available to help bridge the gap between in-person clinic visits.

“Digital health allows health care providers to access their patients in their everyday environments, where health occurs,” Shaw said. “This access is especially important to complex and chronic disease management like heart disease, asthma, diabetes, cancer and mental health concerns.”

As the patient’s home becomes the care site, remote monitoring offers health care providers the ability to manage hospital at-home and virtual care programs. Shaw noted that telehealth grew in popularity and use during the Covid-19 pandemic for patient and health care provider safety, offering such conveniences as live video conferencing and remote patient monitoring as substitutes for in-person consultations.

“We were trying to prevent people from coming together because of social-distancing measures, and we observed a spike in delivering telehealth,” Shaw said. “I’ve heard from physicians all over the country that they never delivered telehealth before the pandemic, and health systems saying that they shifted their nursing workforce to deliver telehealth.”

These transformative capabilities are not without their drawbacks. Shaw noted that, while more than 85 percent of American adults have access to a smartphone, the digital health experience is not universal. Challenges like equitable access, affordability, security, privacy, technological literacy and data quality necessitate the continued evaluation of digital health capabilities to develop a robust evidence-based practice.

Looking ahead, Shaw and his team recently received an award for their NIH R01 proposal, “Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND).” EXTEND aims to address existing challenges that prevent the practical application of mobile monitoring-enabled telehealth for clinic-refractory disease. The targeted health condition is persistent, poorly controlled diabetes mellitus and comorbid hypertension, but the team plans to address this clinical problem in a manner that can be generalized to other conditions.

Shaw is an associate professor at the Duke University’s School of Nursing and School of Medicine. He is also director of the Health Innovation Lab and faculty lead of the Duke Clinical & Translational Science Institute’s Duke Mobile App Gateway digital health initiative. His research focuses on evaluating and integrating data from mobile health and novel sensing technologies into software applications that he uses to engineer models of patient care delivery.

Shaw’s lecture is available at

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