Why Accreditations are Essential in Digital Health

February 2, 2024

Dylan Staniszewski

Digital health is rapidly growing and promises to make healthcare more accessible and convenient for patients. However, not all digital healthcare providers are created equally. Given the diverse offerings in the market it can be difficult to discern which providers truly deliver high quality care.

On top of HIPAA compliance, which is standard for true digital health providers such as Omada (versus wellness programs), another way to assess the quality and rigor of digital health programs is to determine if they have achieved accreditation from bodies such as the Utilization Review Accreditation Commission (URAC), National Committee for Quality Assurance (NCQA) and Centers for Disease Control and Prevention (CDC), HITRUST etc. To attain accreditations, providers must demonstrate to an independent third party that they are providing safe, high quality care and ensuring the privacy and security of patient data.

What is Accreditation?

Accreditation is a process that is common in traditional healthcare settings such as hospitals and clinics, but is not common practice in the digital healthcare space.

In fact, 14 of the top 20 hospitals in the United States are accredited by URAC, and more than 173 million people are enrolled in NCQA-Accredited health plans. Accreditation standards are defined by a body of industry experts and represent the consensus of best practices for ensuring patient safety, the provision of high quality care and, especially relevant in digital health, that patient data is secure and private. In order to earn accreditation, organizations must demonstrate to the accrediting body that they meet or exceed industry-standard, evidence-based benchmarks in the following areas:

Policies and procedures
Training and quality measures
Qualifications of their health providers
Data privacy and security
Program fairness and transparency to individuals

What Does Accreditation Mean?

Patients are Safe

Aligned with the Hippocratic oath, which states “first, do no harm,” a primary aim of accreditation is to ensure patient safety. Thus, to achieve accreditation providers must prove that they have robust processes and procedures in place to ensure that patients receive safe care. This includes ensuring that all patients interact with appropriately licensed or credentialed healthcare providers, such as physical therapists or Certified Diabetes Care and Education Specialists. Organizations must also show that their providers are supplying care within their scope of practice. Additionally, providers must be appropriately trained in technology and the nuances of providing individualized, personal care digitally.

A Commitment to Quality

Organizations that receive accreditations have made a commitment to quality healthcare outcomes. In addition to delivering care via appropriately licensed/credentialed professionals, organizations must demonstrate that their process and procedures for all facets of care provision, including maintaining health records, patient visits, care coordination and much more, meet care delivery standards set forth by the accrediting body.

However, simply meeting the standard is not enough to achieve and maintain accreditation.

To demonstrate their commitment to quality, care organizations must have quality improvement programs in place to monitor the quality of their care delivery and outcomes over time. For example, Omada earned its first NCQA accreditation in 2021, and succeeded in meeting quality standards again in 2023, renewing accreditation through 2026. Such processes ensure that organizations evolve alongside clinical best practices and emerging evidence to stay at the forefront of clinical quality.

Data is Private and Secure

Keeping patients’ data private and secure is imperative in all healthcare settings, but when all interactions occur digitally the stakes are even higher.

Privacy and security of health data is not a cloak an organization puts on with a nice seal on its website. It is derived from a comprehensive approach, from data architecture, to vendor agreements, to workforce training.

This comprehensive approach is a key part of what it takes to earn a HTRUST and SOC II recognition. These credentials are awarded after an independent third party has evaluated a company’s approach for rigor, thoroughness, and adherence to applicable best practices and legal standards..

In Conclusion

Determining the right digital care provider can be a challenge, but looking for a provider that has received a nationally recognized accreditation from organizations such as NCQA, URAC or CDC provides consumers assurance that the organization meets rigorous standards with regards to patient safety, data security and clinical outcomes.

Omada has been a pioneer in the digital health arena by becoming the first virtual care provider to achieve NCQA Population Health accreditation for their Diabetes and Diabetes + HTN programs, and again as the first provider to earn URAC telehealth accreditation for their MSK service line. No other virtual care provider has earned accreditation across diverse and complementary care lines the way Omada has, giving patients confidence in choosing Omada as a partner in their healthcare.