In the wake of a global pandemic, the predictability and reliability of the national healthcare system has been understandably questioned. The fractures in the model became increasingly apparent as the demand grew beyond capacity. Challenges are exacerbated by a complex set of stakeholders including payers, providers, IDNs, government pharmacies; evolving legislation with changes in mandates, coverages, and reimbursement; and consumers who are more confused, frightened, and frustrated than ever before. The good news is the chaos catalyzed a traditionally slow-moving market to rapidly embrace technology as a means to fundamentally change the way care is delivered. “Telehealth” services often offered as an afterthought or through small pilot projects, became the primary path to deliver care. With overnight adoption at scale, the value of enabling patients to engage with their care teams remotely was proven to improve access to care, reduce unnecessary utilization of traditional services like emergency departments, protect the vulnerable from exposure to illnesses and engage the most qualified specialists regardless of location. Telehealth, however, is only the beginning of the digital transformation of healthcare. According to the American Telemedicine Association (ATA), “Telehealth effectively connects individuals and their healthcare providers when in-person care is not necessary or possible.” And while important, true innovation requires thinking outside the virtual visit and evolving the entire continuum of care. The real question is not how can we deliver more virtual care visits but rather how can our healthcare system transform how clinicians and patients engage with each other as well as transform patient behavior, clinician and patient outcomes – all while doing it on a more continual basis? That’s where digital health comes into play.
Defining Digital HealthWhile definitions may vary, at its core digital health promises more comprehensive transformation. Here’s a sampling of definitions out there from doctors, to publications, to the Federal Government: Dr. Omar Manejwala, Chief Medical Officer at DarioHealth: “Digital health has the power to redefine how we think about care delivery within the context of people’s everyday lives and choices. It can do more than alter the site of care; it can evolve the very nature of care by making it ongoing, scalable, personalized, and multi-conditional.” Federal Drug Administration (FDA): “The broad scope of digital health includes categories such as mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalized medicine […] Digital health technologies use computing platforms, connectivity, software, and sensors for healthcare and related uses.” Healthcare Information and Management Systems Society (HIMSS): “Digital health connects and empowers people and populations to manage health and wellness, augmented by accessible and supportive provider teams working within flexible, integrated, interoperable, and digitally enabled care environments that strategically leverage digital tools, technologies, and services to transform care delivery.” In short, digital health is more than simply a video call between a clinician and patient but instead has the power to bring together every stakeholder across the care continuum in entirely new ways and drive optimal outcomes for all.
The Digital Health ImperativeIt’s no secret that the US Healthcare system in its current form is unsustainable, representing 18% of GDP and continuing to rise faster than inflation.  In 2007, the Institute for Healthcare Improvement launched the Triple Aim “to make care better for individuals, improve health for populations, and reduce per capita cost.”  Legislation followed in 2010 with the passing of the Affordable Care Act defining explicit goals of making health insurance more affordable, expanding Medicaid, and supporting innovative medical care delivery models designed to lower the costs of healthcare generally. Acknowledging the challenges the healthcare system imposes on providers, Dr. Thomas Bodenheimer, via the Annals of Family Medicine, amended the Triple Aim to include the wellbeing of providers, leading to today’s widely accepted Quadruple Aim. To summarize, the Quadruple Aim encompasses the following focus areas:
- Improved clinical experience
- Improved patient experience
- Lower costs
- Better outcomes
Rising Costs Healthcare Costs
- 6 in 10 adults in the US have a chronic disease; 4 in 10 adults have 2 or more
- 90% of the nation’s $3.8 trillion in annual healthcare expenditures are for people with chronic and mental health conditions4
- Two-thirds of ER visits are avoidable, according to a study by UnitedHealth Group. Those unneeded visits cost the system $32 billion.
- US age 65+ population is set to outpace total population growth (48M in 2015 to 76M in 2050)
- 200% increase in people over the age of 85 between 2018 and 20603
- Expected shortage of 46,900 to 121,900 physicians by 2032 in primary and specialty care
- Average wait time for a physician appointment in the US is 24 days
- 12 million Americans suffer a diagnostic error each year in a primary care setting— 33% of which result in serious or permanent damage or death
Rising Mobile Connectivity
- 97% of the US over age of 18 own a cell phone with 85% owning smartphones
- 83% of the US population are mobile internet users
- In 2021, 276.8 million people in the US accessed the Internet through any kind of mobile device