The Podcast

Digital Health Canada produces a monthly podcast called Digital Health in Canada, hosted by Shelagh Maloney and Katie Bryski. It brings together leaders from across the Canadian health technology sector to explore, in the hosts’ own words, “the human side of digital health in Canada.” Episodes run about 35 minutes and are released to the public. I’ve been listening since the early episodes and encourage anyone reading this blog to do the same.

Tied to Digital Health Canada’s 50th anniversary, the podcast has adopted a consistent closing ritual. At the end of each episode, Katie asks every guest the same question: “In one word, what does digital health mean to you?”

How Others Have Answered

The answers have been thoughtful, and they follow a recognizable pattern. Guests reach for words that capture aspiration, momentum, and possibility. Enablement. Liberation. Paradigm-shift. Data. Safety.

What strikes me, listening to these answers accumulate, is that none of them actually defines ‘digital health’ as a concept. Each describes an outcome the speaker hopes to achieve, not the term itself. A term that its most passionate advocates cannot define is not a term. It is a belief system.

How I Would Answer

If Katie asked me that question, my answer would be: OXYMORON. The term ‘digital health’ does not reflect reality. It never has.

Health is analog. It is messy, non-linear, and deeply personal. It lives in the space between what a patient can articulate and what they cannot bring themselves to say. It resides in a nurse’s instinct at 3 AM, in a family’s silence in a waiting room, in a body that refuses to follow the textbook. Health is not a signal that can be sampled, compressed, and transmitted without loss. Health is irreducibly, stubbornly, defiantly human.

When we attach ‘digital’ to ‘health’ as a modifier, we are not describing health. We are describing the tools we use to manage information about health. That is a meaningful distinction, and collapsing it has consequences.

Consider the analogies we would never accept: ‘digital love,’ ‘digital grief,’ ‘digital courage.’ We would immediately recognize those as category errors because the modifier does not fit the noun. Health belongs in that same category. The moment we label it ‘digital health,’ we have subtly reframed a human condition as a technology problem.

Digital Health Origins

The term ‘digital health’ was not coined by a clinician, a patient, or a health policy researcher. Rather, it emerged from the startup investment ecosystem around 2010 to 2011. A new generation of health technology companies needed a label. The existing options did not fit: ‘Healthcare IT’ felt old-school and enterprise-heavy; ‘eHealth’ was losing momentum; ‘mHealth’ was too narrow; ‘Health 2.0’ was already fading. Borrowed loosely from Eric Topol’s writing on the digitization of medicine, ‘digital health’ filled the gap. Regrettably, it stuck.

The choice of terminology was, in other words, a marketing decision. Not a clinical one. The term was invented to describe a venture capital investment category and, from there, it migrated into conference names, government strategies, organizational titles, job descriptions, and eventually into the name of the very organization whose podcast prompted this post. A label invented by investors became the defining language of an entire sector.

I have never liked the term. Not once. Not in a boardroom, not in a strategy document, not in a conference keynote. Since my diagnosis, sitting in waiting rooms and hospital beds, that discomfort has become something far more personal. I offer that perspective as someone who has spent half his career inside the sector, who understands the work, and who believes in its importance. Being an insider is not a conflict, it is a qualification.

The Insider Problem

A term that begins as industry jargon can, over time, earn its way into common usage. ‘The Internet’ did. ‘Email’ did. The test is simple. Would your mother use it?

My mother would not. The test is not about whether the term appears in a government strategy. It is not about whether it shows up in a job title or a conference theme. The test is whether the person actually receiving care would ever reach for those words to describe their own experience.

They would not. When a term cannot be recognized by the very people it claims to serve, it has not earned its place. It is an industry using its own secret handshake and calling it a language.

Patients do not ask their doctors about digital health options. They ask how they can see their results without playing phone tag. They ask whether they can message someone when a symptom worries them at midnight. They ask whether their medication list will follow them to the specialist. These questions are not ‘digital health’ questions. Instead, they are healthcare questions that technology could help answer, if we designed for the human need rather than the industry category.

I speak from experience. Over the past four years I have spent more time in hospital than I care to recall, sat in more clinic waiting rooms than I can remember, and interacted with more nurses, physicians, and specialists than most people will encounter in a lifetime. We talked about my counts, my medications, my next scan, my recovery. We talked about my fears. Those conversations were real and they mattered. Not once did a clinician use the term ‘digital health’ in my presence. Not once did I reach for it myself. We talked about health. The word ‘digital’ never entered the room.

A Term Without a Definition

Mine is one experience. The research suggests it is not an isolated one. A 2020 paper published in Studies in Health Technology and Informatics by Fatehi, Samadbeik, and Kazemi set out to do something that should have been straightforward: define ‘digital health.’ After reviewing 1,527 records, the authors identified 95 unique definitions of the term across scholarly and general sources. Ninety-five.

A term that requires 95 definitions is not a term. It is a Rorschach test. Everyone sees in it what they brought to it.

Ninety-five definitions. The term persists anyway. It persists in job titles, in conference themes, in government strategies, in the names of associations, and yes, in the titles of podcasts. It persists because institutions are slow to abandon the vocabulary they have built their identities around, even when that vocabulary has stopped doing useful work.

Back to the One-Word Question

Every answer given by Katie’s guests describes what digital technology could become in service of health. That aspiration is genuine. Genuine aspirations deserve language that reflects reality.

‘Digital health’ does not reflect reality. For fifteen years, it has been a sector describing itself to itself, in language of its own invention, that neither patients nor most clinicians would choose. Sitting in a waiting room, those two words, pressed together, have never once captured what it actually feels like to put your life in someone else’s hands.

Some will demand an alternative before accepting the critique. That demand, while understandable, misses the point. We are not obligated to have a better answer before we are permitted to name a problem. The absence of a better term is not a defence of a bad one.

Oxymoron is offered not as a criticism of the people doing this work, many of whom I respect enormously, nor as a dismissal of the genuine progress technology has enabled in care delivery, progress from which, as a patient, I have personally benefited. Rather, the word is a provocation and an invitation: to hold the term more lightly, to drop it when talking to patients, and to design for human needs rather than industry categories.

The podcast’s own tagline quietly acknowledges the tension. ‘The human side of digital health.’ Somewhere along the way, an industry built around health felt the need to remind itself that health is human. That is not a tagline. That is a confession.

Health does not have a human side. Health, all of it, is human.

P.S.

The post was ready to publish. Then I woke up at 4 AM with a word in my head that I realized was missing. Katie’s question asks what digital health means to me. I cannot answer it as posed — the term itself stops me cold. But were she to ask what I believe technology could do in service of health, stripped of the label and the jargon, my answer would come without hesitation. HOPE.

Thanks for reading,

Mike