What attracted you to cardiology and especially Digital Health?
In Germany, we had the civil service, which I conducted in Freiburg Heart Center. I was there to develop three-dimensional reconstructions of coronary vessels and developed, with my colleagues and mentor Jens Peterson, several software applications to connect hospitals. We even developed our own picture archiving and communication system. It was a great time (around 1997), very productive, and it gave me first-hand insights into cardiology and Digital Health.
As a cardiologist and specialist in cardiomyopathies how do you integrate Digital Health in your work? And how do you envision this evolving in the future?
We see the deficits in current hospitals in connecting information and using it most effectively. Especially in the work-up for cardiomyopathies, you generate up to a gigabyte of data from for instance four-dimensional echo, MRI, and genotyping. Yet, their use is often limited to some extracted parameters. Some 8 years ago, we started a project scheme for Digital Health studies in our institute, including partnerships with leading partners in academics and industry. Currently, for instance, we are conducting a randomized trial together with Apple Inc. to evaluate lifestyle interventions and smart devices in dilated cardiomyopathy patients. Another approach is to predict distinct parameters using artificial intelligence (AI) models we have developed which will undergo prospective validation.
As you mention, Digital Health involves many partners. How do you cooperate with the industry and help develop new technologies?
We have development programmes both with start-ups as well as big tech companies like Apple Inc. They know how to bring technology to the people and how to create digital platforms. I also like the spirit in many of these companies. Looking at our interaction, I am often surprised how sensitive and respectful they approach a clinical problem. For me, this interaction is a real game changer in the field.
How do you think that technology can change the patient and the doctors’ experience?
Machine learning is incredibly powerful in integrating complex data. In the near future, I hope the manual integration of data is hugely supported by algorithms, to allow more focus on the patient. I also think that care will benefit in regard to quality, consistency, and prognostic impact when we use the technologies that are often already normal in our leisure time, but elusive at clinical work.
Which problems did you encounter when integrating new technologies in your hospital? And how did you overcome these?
Our hospital started a new process for user-centred ideas and projects. You formally apply for it and of course need to convince a lot of people. You should try to start with low-hanging fruits and small improvements to overcome the initial hurdles and then scale up.
Which innovations do you foresee in the future changing cardiology?
For me, the stethoscope will fade away. Do understand me correctly. I don’t hate my stethoscope, but in the near future it is like playing an old shellac plate—it is fun and sentimental. Instead there will be other tools, AI enhanced, mobile, patient, and doctor friendly that provide higher diagnostic accuracy.
You are also known for your extensive genetic research. How do you see machine learning and artificial intelligence changing this work?
Genetics is cool! There is plenty of data that needs to be processed. Additionally, we have the evolution of our genome that is not completely understood. Machine learning can jump in and link evolution, genomes and disease. The community only has started in exploring the potential, but I think it is tremendous!
Although Digital Health is gaining more attention, which problems do we still need to overcome?
Changing things can be difficult—and especially our safety thinking in the hospital seems to contradict brave decision to cut analogue ties and move forward. We need pioneers and Digital Health expert centres in each country that provide blueprints for a successful transformation. In Germany, I try to impact on this development with a great team in our eCardiology division in the German Cardiac Society.
Which concerns do you have regarding Digital Health?
You can find in each aspect something negative or dangerous. Digital Health will not solve all problems of medicine. We definitely need to use the power of Digital Health for prevention and not make fully automated disease treatment machines and forget the former.
Conflict of interest: There are no conflict of interest.
Professor Benjamin Meder, MD, Deputy Director of the Center for Cardiology, Angiology and Pulmonology and Chair of the Institute for Cardiomyopathies Heidelberg talks to CardioPulse Digital about his vision for Digital Health and the ways to implement it. He is cardiologist by training but has a long track-record in experimental and translational research. He is Deputy Director of the Centre for Cardiology, Angiology and Pulmonology and group leader for Molecular Genetics and Translational Biotechnology. He is also heading the Institute for Cardiomyopathies Heidelberg, which is a precision medicine unit dedicated to heart muscle disorders and was recently selected for the Professorship ‘Precision Digital Health’. He has published numerous high-ranked studies on precision medicine and is involved in several large-scale national and international networks on this topic. From 2018 to 2021, he was visiting Associate Professor of Genetics at Stanford University, one of the world’s leading universities, to conduct research in the fields of precision medicine and advanced genetic technologies. Using his strong background in technology, he has strongly embarked on computational sciences and artificial intelligence to propel the translation of novel concepts towards more efficient treatments of patients.