Insights

Digital Health to Take Off in 2019 – Our Predictions

Laurel Pickering, MPH
February 5, 2019

For the majority of my career I’ve been integrally involved in regional and national efforts to transform healthcare. At the Northeast Business Group on Health (NEBGH) I spent a quarter century building a coalition of healthcare leaders and stakeholders to drive excellence and value in healthcare. At Welldoc, serving as Executive Vice President of Enterprise Solutions, I’ve been on the front line of innovating with healthcare stakeholders to embrace and implement digital health therapeutics, like Welldoc’s BlueStar, into the array of technology-based products and services aiming to improve the state of healthcare delivery.

It’s with this lens and my pulse on key drivers that I, along with industry thought leaders at Welldoc and writings from other experts, predict that 2019 will be the year that digital health finally takes off. Read our 7 predictions below and find them presented as an infographic:

We’ll track and assess our predictions over 2019. We invite you to weigh in with your predictions. Also, let us know where you think our predictions are on target or off base, and why. Let’s dive in.

 

 

 

 

Prediction 1: An exponential increase in innovation and use of digital health tools and therapeutics integrated into healthcare delivery. We see several factors coalescing to make this prediction. Firstly, the developers of digital health technologies continue to push the capabilities and capacity of digital health tools. At the same time developers are keenly cognizant of the need to maximize the ease of use by consumers – a critical component for successful implementation and engagement. Secondly, research conducted with digital health tools, particularly with validated digital therapeutics, is and will continue to demonstrate their clinical and economic value. As we transition, albeit ever so slowly, towards value-based healthcare, these tools will fit more naturally into healthcare delivery. This reality will cause substantially greater demand by those who deliver, pay for and are consumers of healthcare services. That includes just about everyone!

Prediction 2: Consumers of healthcare, aka the public, are more ready than ever for the integration of digital health tools and remote healthcare delivery, but these solutions must dovetail easily with their daily life. The public is increasingly implementing technology-based solutions to conduct many aspect of their lives, from how they bank, plan travel for work and pleasure, shop for food, purchase household items and more. Healthcare delivery has been somewhat of a holdout but as the digital-native and digitally savvy consumers age1, they’re demanding that healthcare services be technology-enabled to ease and maximize access and delivery. Meet Dawn2, a valuable read focused on the customer of the future, states, “For innovators, there has never been this much opportunity…The winners will be the ones who create with the customer of the future in mind.”

Prediction 3: Digital health solutions and clinically validated digital therapeutics must have the capability and capacity to customize, personalize and disrupt life less. While digital natives (see above) are clamoring for their healthcare services, as many as possible, to be accessible virtually, they want these digital health solutions to fully consider their personal wants, needs and desires. Tech-savvy individuals, especially millennials, expect services to be personalized, on-demand, virtual, 24/7 – it’s what they’ve grown up with. They want to focus on their life and priorities and not waste time with inefficiencies of the healthcare system. Meet Dawn2 states this succinctly, “[People] increasingly expect technology to form an intelligent, adaptable ecosystem around us.” To meet this demand digital health tools must have the capabilities and capacity for each user to customize the digital tool to meet their personal needs including aspects such as set up, daily use, notifications, optimizing communication with their healthcare providers, etc. And to maximize the full potential of digital health solutions they must ease, not encumber daily healthcare decision or the care of chronic diseases, like high blood pressure or diabetes. Digital health solutions must do more, so users can do less while benefiting from the tools.

Prediction 4: Epidemic levels and cost burden of chronic health conditions force healthcare decision makers to contain costs, improve care and reverse this trend and escalate the value of digital health solutions. Forbes’ 7 Predictions for Healthcare in 2019,3 predict that, “Digital health tech for out-of-hospital incidents will grow by 30 percent to more than $25 billion.” This will be fueled by aging populations who are increasingly being diagnosed with chronic health conditions, including obesity4 and the related type 2 diabetes5, at epidemic levels globally. Optimal utilization of digital health solutions partnered with the use of lower cost virtual delivery of care have the potential to hit the quadruple aim6 home run for healthcare stakeholders – better outcomes, lower costs, improved patient experience and improved clinical experience.

Prediction 5: Transition to value-based care models will finally hit a tipping point. Yes, we’ve been hearing about the arrival and promise of value-based healthcare for years now. But healthcare prognosticators, including Forbes3, are calling 2019 “the year of value-based care.” They make three predictions: 1) Fifteen percent of global healthcare spending will be tied to value-based care models, 2) Value-based care models will be incorporated across health systems globally, and 3) Innovative private insurance models will shake up the payer industry. We at Welldoc expect all of these factors, including the hyper vigilant focus in healthcare delivery on achieving the quadruple aims, to further drive demand for validated digital health solutions with demonstrated cost savings. This, we believe will drive both value-based care and digital health solutions to hit their tipping points in 2019.

Prediction 6: Sophistication, use and integration of artificial intelligence (AI), machine learning other technology advances will push the limited of digital health solutions. Advances in technology are racing ahead at lightning speed. These advances will lead to changes in all aspects of our lives, including in healthcare delivery. Several advances hold promise for maximizing the impact of digital health solutions, particularly artificial intelligence (AI) and machine learning (ML). In Meet Dawn2 authors suggest that with the capabilities of AI, “not knowing will be unacceptable and nearly impossible.” They characterize AI as having the capacity to, “Change decision making from a personal deliberation to a collaborative and connected feedback loop.” To take this a step further, they suggest that overtime technological advances will blur the lines between our real and virtual worlds stating, “differences will be indistinquishable.” In our work at Welldoc, we see AI moving beyond a back-end tool for the healthcare enterprise to the forefront of the consumer and clinician experience. AI will have the capacity to simplify natural interactions and will enable information to be brought to users with consideration of their personal context, lifestyle and healthcare needs.7 And these tools will have to be accessible by the user and their healthcare providers from anywhere,  at any time as peoples’ lives become more “de-located and independent.”2

Prediction 7: Digital health solutions and technologies will be increasingly integrated into clinical guidelines, standards of care, and coverage guidance by global healthcare stakeholders. Regulatory organizations and agencies across the globe are working to stay ahead of advancements in digital health and healthcare delivery technologies and respond to the demands of technology developers, healthcare providers and systems, payers; and consumers. We provide a global sampling of here:

  • The U.S. FDA has developed a Digital Health Innovation Action Plan.8 Within this plan, and particularly pertinent to digital health solutions, is the FDA’s Software Precertification (Pre-Cert) Pilot Program, aimed at, “informing the development of a regulatory model to assess the safety and effectiveness of software technologies without inhibiting patient access.”9
  • In late 2018 an Evidence Standards Framework for Digital Health Technologies, was published by England’s National Health Service, the National Institute for Health and Care Excellence and three other related entities.10
  • In mid-2018 the World Health Assembly of the WHO unconditionally adopted a Digital Health Resolution11 discussed in detail in a recent Insights.
  • The American Diabetes Association’s (ADA) 2019 Standards of Medical Care12 for the first time included a new section focused on diabetes technology and specifically mentions the wider availability of telemedicine and its potential capacity to increase access to diabetes care.13 The standards includes this statement: “Technology-enabled diabetes self-management solutions improve A1C most effectively when there is two-way communication between the patient and the health care team, individualized feedback, use of patient-generated health data, and education.14
  • The U.S. Centers for Medicare and Medicaid Services (CMS), is adapting to increased demand for payment for virtual services by adding several new codes in 2019 for coverage of various aspects of Remote Patient Monitoring15 with strong support from the American Medical Association.16

There you have our 7 predictions for why digital health will take off in 2019. Let us know your predictions for digital health in 2019? Do your predictions align closely to ours or are they drastically different? Let us know by sending us an email to connect@welldoc.com. During the course of 2019 we’ll check back on our predictions and publish our findings in Insights.

References:

  1. Athena Insight: Infographic: 5 fast facts about millennial patients. https://www.athenahealth.com/insight/infographic-5-fast-facts-about-millennial-patients. (Accessed January 4, 2019.)
  2. Meet Dawn – Customer of the Future. https://lippincott.com/customer-of-the-future/meet-dawn/. (Accessed January 4, 2019.)
  3. Rege A: Forbes: 7 predictions for healthcare in 2019. https://www.beckershospitalreview.com/hospital-management-administration/forbes-7-predictions-for-healthcare-in-2019.html. (Accessed January 4, 2019.)
  4. World Health Organization: Obesity and overweight key facts. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. (Accessed January 4, 2019.)
  5. International Diabetes Federation. About diabetes facts and figures. https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html. (Accessed January 4, 2019.)
  6. Bodenheimer T, Sinsky C: From triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine. 2014;12(6):573-576. doi: 10.1370/afm.1713. http://www.annfammed.org/content/12/6/573.full.pdf+html. (Accessed January 4, 2019.)
  7. AI is the new UI: Healthcare experience above all. 2017. https://www.accenture.com/us-en/insight-digital-health-artificial-intelligence-ui. (Accessed January 4, 2019.)
  8. S. Food and Drug Administration. Digital health innovation action plan. https://www.fda.gov/medicaldevices/digitalhealth/. (Accessed January 4, 2019.)
  9. S. Food and Drug Administration. Digital health software precertification (Pre-Cert) program. https://www.fda.gov/MedicalDevices/DigitalHealth/DigitalHealthPreCertProgram/default.htm. (Accessed January 4, 2019.)
  10. National Institute for Health and Care Excellence (NICE): Evidence standards framework for digital health technologies. https://www.nice.org.uk/Media/Default/About/what-we-do/our-programmes/evidence-standards-framework/digital-evidence-standards-framework.pdf. (Accessed January 4, 2019.)
  11. World Health Organization: Digital health draft resolution. http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_ACONF1-en.pdf. (Accessed January 4, 2019.)
  12. American Diabetes Association. Standards of Medical Care in Diabetes – 2019. Diabetes Care 2019;42:(Suppl. 1):S1-S193. http://care.diabetesjournals.org/content/42/Supplement_1. (Accessed January 4, 2019.)
  13. American Diabetes Association. Patient-centered Care is the Focus and Priority of the 2019 Standards of Medical Care in Diabetes, Published Today by the American Diabetes Association. http://www.diabetes.org/newsroom/press-releases/2018/patient-centered-care-focus-of-2019-standards-of-medical-care-in-diabetes.html. (Accessed January 4, 2019.)
  14. Greenwood DA, Gee PM, Fatkin KJ, Peeples M: A systematic review of reviews evaluating technology-enabled diabetes self-management education and support. J Diabetes Sci Technol 2017;11:1015–1027. doi: 10.1177/1932296817713506 1–13.
  15. Centers for Medicare and Medicaid Services (CMS): Final policy, payment, and quality provisions changes to the medicare physician fee schedule for calendar year 2019. https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year. (Accessed January 4, 2019.)
  16. American Medical Association. AMA announces playbook to successfully adopt digital health. https://www.ama-assn.org/press-center/press-releases/ama-announces-playbook-successfully-adopt-digital-health. (Accessed January 4, 2019.)

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