Second Opinion - Wristbands To Websites – Let’s Talk Digital Health

Welcome to another issue of Second Opinion. This week, we’re going to explore the field of digital health, an area which many say will be the cornerstone of pharma innovation in the coming decade.

The more we see of the industry’s approach to digital health, the more we see a need to understand the nuance of the field. To understand where a scalpel is needed versus a sledgehammer. And as always – it starts with the patient.

We’re on hand to give you a helpful guide to the stats and facts surrounding the industry’s increased investment in digital health, as well as a whistlestop tour of how to navigate the approvals landscape for digital health projects that seek to break the mould.

One last thing – we’re excited to announce that PEN, in collaboration with Boehringer Ingelheim France, has been nominated as a finalist for the PMEA 2022 Excellence in Organisational Transformation award! We’re very proud of our colleagues at BI, as well as the work we support them with. You’ll find all the information on the award here.

As always, if you’d prefer to listen to our perspectives instead, you can find us on Spotify, Apple and Soundcloud.

DIGITAL HEALTH: IT IS DEFINITELY NOT BINARY

The buzz around digital health has increased exponentially as it is approached from evermore angles; in digital care coordination apps by healthcare, in digital care services by pharma, and even in digital diagnostics by smartphone companies.

However, there are consequences to this. The true purpose of digital health can get lost in the noise, which raises questions along the way. Is digital health now about Fitbits and Apple Watches? Is it about the digital delivery of outpatient services such as cognitive behavioural therapy? Perhaps it is broader than that, a spectrum of solutions and services that can uplift the total value delivered to healthcare and patients.

What we do know is that the perceived importance of digital is high. As this perceived importance and willingness to invest rises, it is vital to nail down the definitions involved, as they are key to developing a cohesive strategy.

Instead of focusing on any rigid definition, let’s look at what you’re actually trying to achieve, and the key steps to building a digital health strategy that is both ambitious and tangible.

• 🏥 The Healthcare & Patient Perspective: How Can Digital Health Help Transform Care?
• At Second Opinion, we love to talk about decentralised care, as well as our vision for a healthcare system that can operate closer to patients at lower costs using high-tech solutions for care delivery. For a quick reminder of this vision, listen to our documentary from 12:25 to hear a hypothetical scenario for how this could play out for a real patient suffering very real challenges.
• That vision, however, is a grandiose one. We shouldn’t start by looking at big solutions to big problems, which require massive changes to infrastructure and ecosystems. Instead, we must remember that digital health interventions do NOT have to be massive – they simply have to solve a key problem.
• Turn your mind from nationwide access to point of care testing, and instead be inspired by exemplars in simplicity, prioritising outcomes over bells and whistles.

• 🔓 The Pharma Perspective: What Does Digital Health Unlock for You?
• From pharma’s perspective, this is a simple proposition. Digital health is the first step in expanding the value chain, evolving the level of influence pharma can have on improving health outcomes for patients.
• Through services and solutions which support patients before and beyond the point of treatment, pharma can deliver value to patients through more than just medication. It improves the outcomes upon which our revenue streams increasingly depend.
• Digital health therefore allows us to reduce our reliance on patients’ and physicians’ behaviours, instead leveraging digital interventions to deliver consistency in top-quality outcomes.

• 🏎 The PEN Perspective: Death to the use of ‘MVP’
• With that goal in mind, where do you start to invest? We often talk about starting small versus big – but how do you move steadily while still delivering impacts large enough to justify investment?
• First of all, the concept of ‘Minimum Viable Product’ needs to be reassessed. It was a successful theory in the early days of solution development; the idea that to build something big, you must first start small. But this belied a critical misunderstanding – the first step in building a car is NOT about building a smaller car, but instead building something that gets people from A to B.
• Similarly, when looking at the implementation of digital health, we should be considering how you can focus on how you can deliver on your physicians’ and patients’ needs first. Only then should you start thinking about the end product which achieves this. In short, don’t start with a cognitive behavioural therapy app, but instead think about how you can make CBT more accessible to your patients.

VOX POPULI: CONSUMER TRENDS IN DIGITAL HEALTHCARE

Digital health is becoming increasingly important to pharma companies, with rising expectations from consumers who have been, so far, navigating a fragmented landscape. This month, we dive into the consumer trends in healthcare, and what it takes for a pharma company to stay ahead of the curve.

1. Expectations of Healthcare Are Soaring:

Today’s business environment is one in which connectivity, personalisation and digitisation are driving elevated consumer expectations across all industries. In a report that surveyed 6,000 individuals worldwide on their expectations of the healthcare industry, 83% said their experience with a company is ‘as important as its products’, but almost half surveyed believe the life science industry is more focused on their own needs than on patient needs. There is an ample gap between the experience consumers desire and increasingly expect, versus what they believe the industry is capable of and willing to deliver.

Meanwhile, the fragmented digital solutions available in pharma are in direct conflict with consumers’ expectations for a seamless, connected experience; for example, being able to quickly access a comprehensive health record, and have preferences known across multiple touchpoints. 82% of those surveyed said they would ‘switch providers as a result of a bad experience,’ which demonstrates that consumers are willing to find alternative sources of care.

2. Consumers Value a Personal Touch:

It’s no big surprise that in the digital healthcare world, consumers value a personal touch. Physicians and care teams have been forging close relationships with patients for years, and in the same vein, consumers continue to value clarity and personalisation. Consumers expect communication from providers to be proactive (for example, calling before an appointment) and tailored specifically to their needs. However, from the same report as above, just half of consumers say communications sent from providers are relevant to them, and only 20% of the communications are completely understood.

3. Healthcare Needs to Fit Around the Consumer:

Consumers remain eager and excited by the promise of on-demand, quality healthcare solutions that can expand access. From a recent report, many are interested in solutions that can fit around busy schedules, such as walk-in clinics that don’t require an appointment (94%) or in-home visits (76%).

While email, phone, and in-person visits remain the typical engagement channels, there are a number of emerging digital channels that younger consumers value. However, while channels of engagement may differ among generations, half of all consumers now expect to ‘find whatever they need from a company in three clicks or less’ thanks to the rapid evolution of technology.

4. Looming Trust Crisis for Pharma:

In the healthcare industry, personal data is involved by necessity, which means trust is fundamental to building positive experiences and business outcomes. Tellingly, only 13% of people surveyed in a 2021 report said they completely trust pharmaceutical companies, which scored lower than providers, payers and medical device companies.

Around half of consumers also show concerns about the ‘future of privacy in healthcare’ as technology evolves. However, most surveyed consumers remain somewhat willing to share health data that improves outcomes for themselves and others (assuming it is secure and transparently used). With the need for trust rapidly increasing, companies should build on this by following up more frequently with patients while providing relevant, easy-to-understand communications. 

AWAITING APPROVAL: THE REGULATORY PATHS BEHIND DIGITAL HEALTH SOLUTIONS

If your interest in digital health is now piqued, you may be thinking: ‘How exactly do I get an innovative digital health solution to market?’. If so, you’re not the only one.

A recent DiMe survey found that 25% of developers didn't know whether their digital health products should be regulated. And of those who knew, 75% reported not being sure on the optimal regulatory pathway.

To bring some clarity to this murky world of digital health approvals and regulations, we have pulled together the key considerations that digital health innovators-to-be must bear in mind.

1. Know your market: The speed at which regulatory pathways for digital health solutions are evolving differ drastically across different markets. For example, Germany, Sweden, and the United Kingdom are relatively mature markets, but with different levels of maturity when it comes to securing reimbursement for those same solutions. Meanwhile, there is a lack of well-defined regulatory pathways in the likes of Italy and Spain.

Furthermore, some countries such as Germany have multiple solution-dependent reimbursement pathways that need to be considered. To help navigate your way through this intricate web of pathways and differing regulations, we recommend checking out the soon-to-come DiME Digital Health Regulatory Pathways tool, NICE’s guide to good practice for digital and data-driven health technologies and Boehringer Ingelheim’s Innovator’s Guide to the NHS: Navigating the barriers to digital health.

2. Know your stakeholders: As comprehensive regulatory frameworks are unlikely to be established any time soon, it is important to target specific stakeholders who have more to gain from your product to increase your chances of approval and funding. As an example, a GP in Germany is a more suitable target than payers for a remote counselling solution that reduces the number of GP visits made by patients, meaning visits are reduced with the same level of funding for GPs.

With this principle in mind, we have created a list of stakeholders to consider when seeking funding for your solution:

• Patients: Patients can choose to pay for a digital health solution for their health management, however, this may not be viable in countries that cover medical treatment costs.
• Healthcare providers: Healthcare providers can pay directly for a digital solution.
• Provider networks: Hospitals and provider networks can evaluate and incorporate digital health solutions into their standard care protocols, as this could provide a competitive advantage if margins are improved.
• Employers: Employers can choose to pay for a digital health solution to improve their employee value proposition, or to reduce levels of sick leave
• Medical societies and patient advocacy groups: Patient advocacy groups in Germany have developed certifications for apps and can contribute to systematic evaluations of Digital Health Technologies.
• Industry partners: Other companies, particularly those from pharmaceutical or medical device industries, might pay for a solution if it offers access to data or complements their products (for example, Roche’s purchase of MySugr, a digital health solution for managing diabetes).

Digital health is a new frontier in pharmaceutical innovation. Take the first step into the next generation of pharma companies by considering how you can leverage the latest technologies to bring new types of value to your organisation, physicians, and patients.

If you have any feedback or want to hear more about anything mentioned in this newsletter, please don’t hesitate to get in touch.

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