Digital health has been with us since 2010, where does it stand today? What are the key areas of focus, and where do the opportunities lie? Demand is often driven by what people are willing to pay for, since the inception of the smartphone, consumers have had access to one form of digital health, namely apps for over a decade. In that time, senors and wearables have also become prevalent. Employers and health systems have also started to adopt these tools as part of wellness offerings or as an adjunct to clinical care.
A new paper in Nature Digital Medicine by Adam Cohen and colleagues from Johns Hopkins Hospital reviews the current landscape of digital health. From a population segmentation perspective, digital tools can address prevention, newly diagnosed disease, and chronic illness. Not surprisingly, since chronic conditions account for 75% of the cost associated with health care much of the maturing digital tools also fall into this category. Digital tools that support prevention are less present on the digital health continuum. Is digital health doomed to repeat the same development patterns that clinical care has addressed? Reimbursement is still an outstanding issue, so it is not surprising to see more tools in clinical areas where payment is more likely, and the timeline for prevention has a long horizon, which makes it challenging to demonstrate value.
The authors reviewed 1,214 companies in a digital health database, of those 702 met inclusion criteria. Almost 74% of companies were funded to build tools to support chronic condition management compared to 23% for prevention. The table below shows the clinical indications and where the digital health tool maps to the care continuum.
Of note, digital tools for prevention were most often leveraged by consumers, which indicates an unmet need in the healthcare continuum that is an area of opportunity for a more holistic view of health care to pivot away from current perceptions that it is “sick care.”
Leveraging the whole care continuum to support a more robust health system seems like a way forward. It remains to be seen if that is possible in the fragmented health care market in the USA and is undoubtedly unclear as we work through a pandemic to determine future health care needs post-COVID. Future state, clearer data use agreements, ethics, and transparency will continue to loom large as issues for consideration as we move into this next decade of digital health.
Thanks for reading – Trina
(Opinons are my own)
Cohen, A.B., Dorsey, E.R., Mathews, S.C. et al. A digital health industry cohort across the health continuum. npj Digit. Med. 3, 68 (2020). https://doi.org/10.1038/s41746-020-0276-9