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What’s Needed to Scale Digital Health Initiatives?

What’s Needed to Scale Digital Health Initiatives?

Digital health is gaining steam, but the successes have been limited to small patient groups and studies. Can digital health products get to the next level and impact wide swaths of the population?

Digital health efforts to give patients, clinicians, and caregivers more tools to better manage a disease are paying off. There are numerous examples of apps and connected products that have helped patients with diabetes, Parkinson’s disease, Crohn’s disease, and more.

Still, these successes are isolated, meaning most patients with chronic diseases do not yet enjoy better health as a result of digital health. Extending those benefits to more patients on a widespread basis is the next step for digital health adoption, Ashish Atreja, chief innovation and engagement officer in medicine at the Icahn School of Medicine at Mount Sinai, told an audience at the FT Digital Health Summit USA in New York City earlier this month.

“What’s going to happen in the next five years is the scalability of that [those success stories] . . . We have to take all this innovation that’s happening . . . we have to find signals which are really evidence-based, prescribe it to the patients at the point of care, and then we’ll start seeing the transformation happening at scale,” Atreja said.

Atreja was part of a panel discussing digital health. Here are a few of the steps he and his fellow panelists said are necessary to bring the pluses of digital health to many more people:

Single Out the Digital Tools with Evidence

Health systems are getting proactive about pinpointing useful apps that show evidence of benefits and are adopted by patients. Atreja noted that patients at Mount Sinai are often prescribed a digital health tool—an app, survey, care regimen, or telemedicine opportunity—in addition to a drug prescription. Then, their use of that tool can be tracked to determine adoption rates and whether it provides a benefit.

Leave Some of the Details to the Patient-Consumers

Patients are likely to prefer different features, formats, and reminders, said Deneen Vojta, executive vice president of Research and Development at UnitedHealth Group. Giving patients a choice in how they want to interact with a digital health tool is key to increasing use.

Nelia Padilla, vice president in Consulting Services at QuintilesIMS, echoed that, pointing out that being able to personalize how they receive feedback and decide what sort of triggers work best for them is important for patient adoption.

Give Important, Actionable Data to the Right Person

Data fatigue is a real problem and is a barrier to better care, according to Atreja. It’s important that the data points that are meaningful and can be acted on be shared with the person or team that can take that action.

For instance, while data on HbA1c levels may be best shared with a physician, data showing a lack of proper nutrition may mean that patient needs help affording healthy foods. That data might be best shared with a case manager or a social worker, who can help direct a patient to the proper resources for groceries and healthy meal planning.

“As health systems, we don’t have capacity to ingest all of this innovation happening,” Atreja said. “We don’t have workflows—who’s going to consume the data to be able to create action . . .”

Ask the Patient

Thompson is a patient advisor at Memorial Sloan Kettering who, in addition to learning more about the hospital’s point of view, is in the unique position of having deep experience with digital health as both a patient and a digital health technology vendor. She pointed out how vital it is to bring patients into the conversation early.

“I was Patient 1 on a pilot [study] and it took a company 19 sign-offs to get all the permissions necessary to operate in that environment,” Thompson said. “That’s a very high barrier that as a startup founder before I was a patient, I had no idea what was going on behind the scenes. I think involving the patient early on to find a solution, not a technology, is a good strategy.”

She added that another important issue is being straightforward with every stakeholder. “Also, transparency so everyone understands where the barriers are. If you can get as many no’s as possible from many sides, then you know where the barriers lie.”

Don’t Overwhelm the Patient

While apps have been adopted at high rates in specific instances, managing chronic diseases may require a different approach, Atreja said. “We have found very high adoption in limited scenarios like procedures or major surgeries [or a] cancer journey, in some regards. But something that is ongoing, like hypertension—you don’t require an app for hypertension, necessarily,” he said. “You just need to know five things you need to do, and maybe some regular way of checking your blood pressure. So we call it mini-apps or micro-apps, which get the job done.”

In some cases, digital health can achieve what a doctor can’t. Thompson explained, “I’m not the best patient. Sometimes I forget my medication, I skip a scan sometimes, I skip appointments for myriad reasons. But I’m more likely to admit that to my app than to my physician. I have a relationship with my physician and I don’t want her to be upset with me. It’s just a reality.”

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