“When people think about digital health, they usually think of apps and wearables,” Anne Smart, Managing Director of ClearView Healthcare Partners, says. In reality, mobile health apps and wearable devices are only two solutions across a broad range of digital technologies that also includes (but is not limited to) electronic health records, remote monitoring, and predictive analytics platforms using artificial intelligence, such as machine learning.
“It’s important for medtech companies to understand that digital health technologies represent an enabling, disruptive set of tools that are being used today to gather data and develop real-world evidence to improve outcomes and quality, lower costs, and increase overall access to care,” she says. Companies are using digital solutions to increase the value of existing devices and services, capture value by tracking outcomes and behaviors that weren’t otherwise discernible and enhance the patient experience through tighter linkages to caregivers and physicians. However, she thinks we’re only at the tip of the iceberg in terms of adoption of these new technologies.
The time to consider whether to integrate and deploy digital solutions is here. “Different types of digital technology are already commercialized, and in use across our industry,” Smart points out. Companies today, therefore, should determine which digital technologies can enhance their traditional solutions.
The industry has evolved as commercial business models, decision makers, and the understanding of value are changing, she says. Providers and payers conduct their own analyses to identify technologies that confer the greatest value in terms of the best outcomes at the lowest cost and we see the delivery of healthcare shifting from hospitals to lower cost alternatives. Patients increasingly expect to be informed and involved in their care. Smart says that this broader set of decision makers is demanding greater demonstrated clinical and economic value, opening the door to digital combinations as "value-adds," spanning the care continuum.
Mapping the source of substantial benefit to a technology is challenging, but necessary in this new ecosystem. Integrated connected health innovations can add new data that enable deeper insights and thereby demonstrate value. “For example,” Smart says, “consider a medtech company that competes in the thoracic surgery space. The good outcomes they expect to see post-op may degrade once the patient returns home due to continued smoking, for example. Mobile apps that provide a smoking cessation support network to patients or a wearable sensor that measures a patient’s own carbon monoxide levels can be used to monitor and modify patient behaviors and, by extension, contribute to increased effectiveness of the surgical intervention.”
Developing a digital solution
Before embarking on a digital strategy, “companies must do the work upfront to understand the stakeholders, their needs, and how these may evolve. Determine how value is defined for each group and what are their own incentives/disincentives,” Smart advises. Patients may be interested in improving daily life, while caregivers may emphasize improving outcomes, and payers may measure value in terms of cost effectiveness, for example. Determine whether a digital solution can address and align with those needs.
In a practical implementation, she says a medtech company could partner with a digital company that has a clinical validation platform to identify, collect, and analyze real-world, behavior-based outcomes. For example, this could be set up as a retrospective study of patients in a certain geography who have undergone a specific procedure in order to correlate outcomes with patient behaviors and demographics (via smartphone app). The results could identify the "perfect patients," meaning those individuals who are most likely to benefit from this intervention in the future. The medtech company benefits because they better understand behaviors that impact patient outcomes, and can use this in their R&D and commercial strategy. That knowledge can help physicians and patients better manage disease and deliver the most value from the interventions. Payers are interested too because they can focus their resources and see what works before they approve new technologies in their populations. She says this is but one of many examples where digital solutions can be used to drive value and growth of a medtech portfolio.
The pace of development differs
Developing or incorporating a digital solution into a portfolio, however, isn’t like developing pharmaceutical product or medical device. “There are different skill sets involved, different know-how in tech, and the pace of innovation and development is completely different,” Smart says. “Medtech timelines run faster than pharma, but not as fast as technology.” As digital health converges with the life sciences market, both sides need to understand the different capabilities, needs, and business models, and work together to drive value.
“I think medtech companies are optimally positioned to exploit digital innovations,” Smart says. “They have established relationships and are close with key stakeholders, including end-users of their products, and have a strong presence across care settings. Devices are obviously great conduits for data and connectivity, making these companies empirically data-driven. They are patient-centric already as they are allowed to speak directly to patients, unlike pharma. Plus medtechs are used to faster timelines and are facing an increasing number of market challenges, which translates to a stronger willingness to develop partnerships with digital and move quickly. There is a great opportunity here.”
Digital solutions are here to stay
Digital solutions, she says, “will totally change healthcare. We’re at level one of where the innovators and early adopters are there, but the field is advancing rapidly. Novel technologies are being commercialized, and they’re steadily becoming less expensive, smaller, and more capable.” As these technologies continue to be introduced, medtech companies have the opportunity to leverage them to empower patients, improve outcomes, and enhance value across their portfolio. She thinks companies that incorporate digital solutions as "value-add" to understand patient behavior, connectivity, needs, and pain points will win in the future.
“It’s no longer a question of whether medtech companies should incorporate digital technologies into their solutions. Incredible solutions are available, and in five years there will be a whole different set of technology and solutions,” she points out. “Companies need to get on this train because it’s moving,” Smart says.