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Digital Health is Having an Identity Crisis

 

This edition covers:

  • The signs of digital health’s identity crisis
  • Why differentiation in digital health matters
  • How virtual care sets itself apart

In October I attended HLTH USA in Las Vegas—my favorite meeting of the year. Where else can I see the latest Samsung release, test the Aktiia BP cuff, meditate with Lyra in the Zen Dome, and also pet a therapy dog in a puppy park? But this year I couldn’t shake an unsettling feeling as I passed booths touting SaaS, consumer solutions, therapeutics, and clinical care: digital health is in the midst of an identity crisis.

 

What are the Signs of Our Identity Crisis?

Without figuring out this identity crisis, I worry digital health stakeholders may struggle to reach their full potential. The FDA describes digital health as “technologies that span a wide range of uses, from applications in general wellness to applications as a medical device.”That broad definition was on display as I walked the floor of HLTH and took in the many offerings. While there, I identified questions I had that pointed to signs of digital health’s identity crisis:

  • Are we vendor solutions or care providers?
  • Are we consumer-grade wearable devices or clinical-grade devices?
  • Who pays our fee? The consumer, the government, the health plan or the employer?
  • Should we be funded by venture, hospitals, health plans or the government?
  • Digital health is regulated, but does it make sense that different companies are regulated by different entities?
  • Should we publish our outcomes in journals or self-published white papers?
  • How will AI change how we identify ourselves?

Even our customers are often different, which would seem to invite different standards. For example, if a health plan is the customer, the standard of care should be clinical-grade. But if we’re talking about selling to consumers (think wellness apps and wearables regulated by the FTC), the standard of care isn’t the same. I think it’s time for us to align on nomenclature, and more formally divide and conquer as we collectively try to create a better system for patients. It’s clear at this point that all the different ways digital technology is used in healthcare are too big to travel together.

 

Why does Digital Health’s Identity Matter?

In my view, the stakes of this identity crisis are high. I worry that we will never fully “grow up” and be taken seriously within the healthcare ecosystem until we settle on what each of us are. If we don’t, we risk experiencing setbacks in important arenas.

For example, if there’s continuing lack of clarity regarding what digital health solutions can reliably deliver in terms of health outcomes, it undermines patient and provider trust. Individuals may be hesitant to engage with digital tools that lack evidence.

 

How Should our Industry Move Forward?

It’s time for us to gather and align on a framework that helps the industry categorize us by who we serve, how we are regulated, and, most importantly, the value we each bring:

  1. Clarify and Standardize: Companies should define their value propositions clearly. Whether it’s for SaaS platforms, consumer wellness apps, asynchronous care delivery, and clinical tools, clarity in purpose and function is key. This involves distinguishing between consumer wellness products and clinically-rigorous solutions that drive specific outcomes.
  2. Enhance Clinical Rigor Across the Board: Emphasizing evidence-based approaches and committing to rigorous clinical validation can elevate the entire industry. This might require voluntary adherence to higher standards, even for those not required by regulation.
  3. Help Modernize Regulatory Pathways: Digital health companies should collaborate to participate in public rule-making processes. This would help ensure that, as regulations evolve to encompass digital health, what regulators are doing is consistent with how segments of the industry see themselves and with where technology is going.

We need to categorize ourselves as what we are: SaaS, FDA-regulated therapeutics and devices, consumer apps, and virtual care providers.

 

Virtual Care Is Its Own Category of Digital Health

For Omada, we are not a wellness solution. We’re a virtual care provider and we deliver clinical-grade care. We hire licensed and credentialed providers, we bill through CPT codes, we publish research, and we are subject to HIPAA standards for privacy. In contrast, a wellness solution may have no human staff, charge consumers directly, release outcomes solely via white papers, and not adhere to well-accepted clinical protocols in the information they give to individuals. And yet, neither the term “digital health” nor our industry distinguishes among us.

This distinction is significant, as it highlights the journey Omada has been on for over a decade to form a core identity: between-visit virtual care that works seamlessly with traditional healthcare. We’ve also made strides to assess the value we deliver our customers inspired by the American Medical Association’s (AMA) Return on Health framework. That’s based on:

  • Clinical Outcomes, Quality and Safety
  • Access to Care
  • Patient (or Member) Experience
  • Care Team Experience
  • Impact on Healthcare Cost and Utilization

As virtual care providers, we’re trying to build a world where between-visit virtual care complements traditional, in-person care perfectly. In my view, everyone should have a highly capable care team in their pocket. This will help fill key gaps in traditional healthcare, as up to 90% of a patient’s health status is based on their life outside a doctor’s care. In order to get there, we need to be taken more seriously as clinical-grade care. The next logical step is carving out virtual care’s own identity separate from other digital health categories that undermine the clinical rigor merits of virtual care providers.