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Stepping Toward A Digital Approach To Chronic Disease Management

By Joao Mendes-Roter
Jun 30, 2020

There are a few industry segments that operate in the space where tech meets health. Following the Digital Therapeutics Alliance definitions, digital health is “the space at the intersection of technology and healthcare.”

Digital medicine is “the field of evidence-based digital health tools that measure and/or intervene in the service of health to support the practice of medicine broadly, including treatment, recovery, disease prevention and health promotion for individuals and across populations.”

Digital therapeutics focuses on “products (that) employ high-quality software to deliver evidence-based therapeutic interventions that prevent, manage or treat a broad spectrum of physical, mental and behavioral conditions.”

I will call these segments Digital Y.

Market Access: Requirements And Expectations

Technology is not new for healthcare. In fact, the problem was never a lack of technology, but a lack of understanding of market barriers to scale tech offering solutions.

I started my career as a market analyst, investigating how companies could add solutions to new markets in growing industries. For the past five years, I have been leading consumer health projects, both as a consultant and an operator, handling road map discussions to increase tech adoption and engagement from both the patient and the provider and having conversations with my peers in healthcare tech networks about best practices and repeated mistakes in the digital health arena.

We noted a series of unsuccessful go-to-market trials of decent technology due to lack of proven health economics (return on investment, cost savings), lack of regulation and legal momentum (clinical evidence, precedencies), and a total miscount of provider-to-patient (P2P) workflows (systems involved, liability topics, staff training).

Instead of going down the rabbit hole, let’s reanalyze the opportunity from the angle of solving market barriers. Looking at chronic disease management, a growing market with recurring high costs, the big discussions are:

• How do we balance the already sick population?

• How do we prevent the borderline population from reaching severe levels?

• How should we educate the still healthy population to follow healthy choices?

Many theories range from pure medication adherence plans to behavior modification programs, and in the end, the fact is that over 50% of patients are not taking their medications as prescribed. Further, research has shown that “Nonadherence can account for up to 50% of treatment failures, around 125,000 deaths and up to 25% of hospitalizations each year in the United States.”

Digital health can help pharma solve this.

Moving to more hybrid programs of medication adherence and behavioral modification, the challenges are larger. We want to be accurate with providing the right treatment to the right patient at the right time. We need to offer a multidisease program portfolio, including multiconnected devices with multiple healthcare services integrated — submitted with the correct health economics and clinical evidence.

A New Loop Between Market Stakeholders

Many colleagues are talking about how Covid-19 opened a window of opportunity to scale digital offerings. Indeed, while patients now expect digital interventions and communications, providers and healthcare professionals have compromised (versus the alternative of nonphysical sessions) and have become open to new technologies and ways of training their staff. Furthermore, we caught payers’ attention, with a follow-up on telemedicine and digital interventions that loosened rules and offered generous reimbursement codes.

The dust needs to settle, but I believe one thing is for sure: Telehealth and remote monitoring are here to stay. Still, investment in solving market barriers will ensure companies’ relevancy in the world following Covid-19. McKinsey, among others, has raised a few valid models considering the market request for security, workflow integration, effectiveness compared with in-person visits, and the future for reimbursement.

In my opinion, the best practice is to focus on developing excellent P2P interactions by collecting relevant data, reflecting clinical insights, facilitating staff relationships and saving on workloads with secured, measurable and reimbursed services.

For instance, the company where I work leads a full solution in the space of home sleep apnea diagnostics. While the traditional procedure — referral to in-lab diagnostics — takes three to four months, our solution was able to shorten it to one to two weeks by sending a reliable and fully disposable device to the patient’s house, adding remote training and consultation, and connecting to therapy and compliance tracking.

My advice for the marketing and business leaders involved in these priorities would be to take a humble approach and work with a multidisciplinary team to properly define a relevant and cost-structured innovation road map. The dialogue should be based on a clear market understanding, and you should remain focused on market gaps. A best practice is to innovate around your company’s core strengths, leveraging world and industry trends, while being vigilant about guidelines, workflows, healthcare providers’ readiness and business models.

Only by spending time together — marketing, sales and product teams, clinical leaders, and doctors — and diving into details about these opportunities and challenges can successful solutions be defined.

In Conclusion

Digital Y has a great positioning with chronic disease management and relevant solutions and momentum for the new Maslow needs after Covid-19. Yet we need simple and aligned strategies focused on addressing market barriers and trends, with the leading priority on P2P-centric workflows, based on data ruthlessly validated by a multidisciplinary team of experts.