From digital therapeutics to vaccines and virtual visits, health care witnessed a faster pace of innovation during the last year than previously thought possible — and that is creating a glimpse into how the future of digital health is starting to take shape.
“For many of us who have spent careers in this space, it feels like this is the moment we’ve been waiting for. It’s a little bittersweet coming with the backdrop of a tragic global pandemic and we can’t lose sight of that,” said Rajiv Kumar, MD, Science Advisory Board Member, Virgin Pulse. “But if there is a silver lining, it’s the convergence of consumerization, data liquidity, more proof of return on investment, removing regulatory hurdles and clearer pathways for reimbursement.”
Kumar moderated a Health Evolution virtual gathering, “The next stage for digitally-enabled care,” which included Sukanya Soderland, SVP & Chief Strategy Officer, Blue Cross Blue Shield of Massachusetts, Jackie Kosecoff, Managing Partner, Moriah Partners and Maryam Gholani, Chief Product Officer, Digital Innovations, Providence.
“We live in this world in health care where we have islands of innovation that show what the future might look like, and then the rest of the world, so to speak, does more high-cost bricks and mortar care,” Soderland said. “Use cases are starting to expand in terms of how digital health can be used. Care in the home and care on the go are becoming more understood.”
What the future of digital health might look like
Kumar asked the experts what they’re most excited about relative to the future of digital health.
“I’m really excited about how the Internet of Things, smart devices, smart homes. It’s going to enable us to make care available to consumers everywhere. And then I’m really excited about the kind of changes that AI and machine learning can bring into place,” Gholami said. “We’re starting with simple AI. We’re not necessarily using the latest, but I think there’s so much potential there, and I’m super excited about the combination of two.”
Kosecoff agreed that moving more care moving into the home is exciting, while Soderland added that is particularly true for enabling seniors to age in place.
“Digitalization can help solve continuity of care problems if we put our minds to doing it,” Kosecoff said. “And health care is way too expensive so to the extent that we can make it less expensive through technology: Godspeed.”
Achieving that future will require executives to lead efforts to identify digital health tools and engage consumers and patients to effectively use those technologies.
Separating signal from noise when identifying digital health tools
Innovators and tech stalwarts alike are flooding the market with new technologies, making it more difficult than ever to identify and evaluate tools and develop strategies that will demonstrably improve outcomes or deliver against financial and operational goals.
“It truly is inspiring and overwhelming at the same time,” Soderland said. “We are really trying to understand both the clinical efficacy and the statistical relevance and reliability as well as the consumer experience and consumer engagement rates, which has been a challenge for the industry to date.”
Soderland added that BCBS Massachusetts also considers how a new digital tool integrates into its own workflows, as well as the workflows of clinicians. She said the degree of time and back-end integration work with legacy systems to build a seamless experience for physicians and patients is considerable and difficult. She also pointed to the payer’s customers that require specific vendors or technologies as another factor that needs to be considered when choosing digital tools.
Kosecoff advised that when evaluating digital health products, it’s also important to consider whether it’s a new product in a new space or a new product competing with established vendors. Then she recommends dividing products by platform versus point solution, determining whether or not it actually conflicts with other digital health tools in use. A health system might offer three different apps for diabetes, hypertension and weight loss, for example, and each is likely to have features related to diet so it’s critical to ensure they are not working against each other.
“You can have the greatest cure in the world but if people don’t use it, it’s not the greatest cure in the world. So is this a sticky application? Is this something that people actually use from soup to nuts?” Kosecoff said. “Is there evidence, and I mean scientific evidence, that it’s actually making a difference? Then I ask how interdigitated a point solution is to the rest of the health system?”
Moving forward, the challenge is not just in identifying and implementing the right technologies, it’s also about ensuring beneficial tools are not overlooked or missed.
“When I miss an e-mail from someone who’s saying they are doing innovation, it’s not just that I don’t want to miss out for all the problems we are focusing on at Providence,” Gholami said. “It’s that I don’t want the health care industry to miss out on some great solution or entrepreneur.”
Addressing the consumer engagement problem
As previously noted, engaging consumers and patients with digital health tools has historically been challenging and, despite the acceleration of virtual visits and other technologies during the pandemic, that is not likely to change in the near term.
“If we’re just putting a digital interface between a clinician and patient, but everything else remains the same, that’s good and there’s some convenience there, but we are not fundamentally changing the cost equation,” Soderland said.
That said, Soderland recommends building in similar elements of community and social connection that have worked in other industries, making the technology seamless, personalizing it and embedding incentives to attract consumers.
Gholami added that consumers need a unified access point for the digital health tools and digital therapeutics. One patient, for instance, might have doctors telling her to use an app for pregnancy, another for depression, yet another for diabetes and a that patient might struggle to remember all those apps. “Give patients the unified access point,” Gholami said. “Make sure you instrument everything, collect the data, and see what consumers do.”
Kosecoff suggested that engaging with consumers begins by understanding that America is “a nation of non-compliers” and pointed to the resistance to masks even during COVID-19 as just the most recent example, adding that medications have traditionally also had lower compliance rates than would be expected.
“Then the question becomes, as the world is more technology enabled, can we use data and AI to identify people who will most likely engage with something?” Kosecoff asked. “That’s important. We need to begin to identify with consumers who are most likely to engage with us.”
From there, Kosecoff said it is critical to incorporate human elements to engage with people via a personal sense, and to remember that every encounter makes a difference and every aspect of engagement counts because one unpleasant experience can destroy a relationship permanently.
Maintaining the momentum digital health developed amid the pandemic response will require health care executives leading the way forward to work with their teams to understand to focus on the best opportunities, increase work to address consumer engagement that can make or break digital strategies and ensure that critical tools or services are not missed.
“Digital adoption now is being driven through necessity,” Kumar said. “I expect that a lot of this is going to become permanent.”