The development of digital health technologies has and continues to involve people from diverse sectors: healthcare, telecommunications, IT, entrepreneurs, and patient advocates to name a few. The unique intersection of stakeholders in this space as well as trailblazing in the regulatory and healthcare cultural arenas brings to my mind a few points around which one might shape discussions about the digital health ecosystem.
1. ‘’Build it and they will come” doesn’t necessarily work. The adoption of technology often must be accompanied by creation of a new or alteration of existing process or workflow. Physicians are painfully experiencing this with EHRs. Remote patient monitoring is a perfect example of requiring patient management policy, personnel and workflow changes. There must be an accompanying change in the culture of healthcare as well. They must both buy into the partnership of health and disease management concept. Patients and providers need to accept technology as a positive experience. Only then will technology fit into the equation.
2. There are many customer profiles. Many digital health solutions require partnering with other companies to enhance or optimize the customer’s experience. One example would be a social media analytics company partnering with a Pharma company and/or online patient community site. Other examples would be a wearable sensor technology company partnering with a professional sports team or medical device company, or a patient portal developer partnering with a payor, provider, and/or patient. Many technologies will connect various stakeholders with the goal that shared information will benefit patients (and others) and therefore creates business relationships which would not otherwise evolve.
3. New business models are required. Heretofore, healthcare vendors are accustomed to the product development -> obtain reimbursement -> profit progression. Much of digital technology is like the old BASF commercial: “We don’t make—–, but we make it perform or look better.” Partnering with companies which have already entered the healthcare space is one way of getting on board. Partnering with companies which result in additive benefit creates more value. A value proposition might only be seen by some potential customers and not others. For example, ACOs see a visionary benefit to deeper IT and monitoring products than other providers.
4. Government mandates are both blessings and curses. Government mandates have created a huge EHR industry. Some companies invest more in their technology than others, some consider the end user more than others, and some do the bare (or less) minimum. I don’t think any industry would be proud to say that up to one-third of customers are so unsatisfied that they are switching companies within the first two years of what promised to be a long-term solution. Such is the case with EHRs. Is this a reflection of poor design, poor training, poor business planning on the part of the customer, or more than one of these? It suffices to say that mandates drive billions of dollars in sales. Regulations of mobile health apps are expected to be announced by the FDA within the next 2 months. This will provide a blueprint for development and hopefully spur investment and sales. Regulations will also (hopefully) discourage those making false claims and unreliable devices, thereby giving providers and patient/customers more faith in them, leading to increased adoption. A few more impactful technologies receiving FDA approval will lead to a change of culture to some degree, putting apps on the radar of chronic disease patients and others.
5. Success is ultimately related to a positive impact on consumers/patients. Ultimately, bells and whistles will prevail only if they result in better patient or consumer health outcomes. Certainly some technologies have already demonstrated such improvements. But they are far and few between. In addition, many technologies, by virtue of their nature or necessary partnerships, might not be able to demonstrate effects on outcomes. Other metrics will be utilized or developed to assess these technologies as they are in other sectors of society.
While this is not a ‘how to’ type of post, I meant to give an overview of commonalities and complexities of digital health development and adoption and integration. I welcome all comments.