As the availability and variety of digital health tools continue to increase, evidence is also being presented that those tools are having a meaningful impact on health outcomes. A recent report, Digital Health Trends 2021: Innovation, Evidence, Regulation, and Adoption, offered by the IQVIA Institute for Human Data Science, looks at the proliferation of digital health tools, recent innovations in the market, and contributions and barriers to their adoption.
Findings presented in the IQVIA Institute report include the following:
- Multiple types of digital health tools contributed to mitigating the impact of the COVID-19 pandemic and are now established as part of the digital health landscape. The pandemic had significant effects on the apps individuals downloaded and used in 2020, including telemedicine, exercise, and mental health apps.
- Consumer apps remain the most widely available and used digital tool, with more than 90,000 new digital health apps added in 2020—an average of 250-plus apps per day—resulting in more than 350,000 apps currently available.
- The availability and use of digital therapeutics and digital care products—incorporating software as a means to treat, prevent, or manage specific diseases or conditions—have been increasing as well. Digital care products include care platforms and tools that typically address broadly defined clinical conditions and can often be tailored or personalized to individual needs, requiring active involvement from providers or coaches.
- Wearable connected sensor and digital biomarker use is also increasing. Activity monitoring devices that measure heart rate, steps taken, distance traveled, and calories burned account for about 55% of the 384 wearable devices currently marketed to consumers.
- The overall body of clinical evidence on app effectiveness has grown, with more than 2,000 studies published since 2007, including almost 1,500 published in the last five years.
- Expanded access has offered opportunities for developers to attain an economic return on investment for digital health tools supported by robust evidence and user demand. Multiple commercialization pathways now exist for digital health tools, with four broad commercial models now in place and being used to generate payment or reimbursement for digital tool developers: direct-to-consumer, value-based contracting, “device-like” reimbursement, and “drug-like” reimbursement models.
While the IQVIA Institute report presents a promising depiction of the outlook of digital health tools, particularly consumer-facing apps, other researchers are presenting findings that remind us there is work left to be done, especially when it comes to gaps in access to and adoption of telehealth and other digital health solutions that disparately impact certain populations.
A recent report from the University of Michigan’s Institute for Healthcare Policy and Innovation’s Telehealth Research Incubator considered what the future holds for telehealth, and how providers, insurers, and policymakers can use the experience of the last year and a half to decide what kind of virtual care they will support once the COVID-19 pandemic ends.
Some key highlights of the University of Michigan report include the following:
- Telehealth use grew during the COVID-19 pandemic, but total care remains at the same level as prior to the pandemic, suggesting that telehealth has largely been used as a substitute for in-person care.
- Smaller and rural practices have lower rates of telehealth use.
- Compared to nonusers, patients using direct-to-consumer telehealth were more likely to be female, be a nonelderly adult, live in an urban area, or have fewer simultaneously occurring conditions.
- Patients who are older, are African American, need an interpreter, have Medicaid as a primary insurance, or live in a zip code with low broadband access were less likely to use video visits.
- While patients who live in rural zip codes had a lower probability of using video visits, low broadband access—not just rurality—appears to more strongly predict the probability of using video visits.
- While individual patient demographic, socioeconomic, and geographic factors will influence the probability of using video visits, many patients will face multifactorial barriers to care. By predicting each patient’s probability of using video visits, one can determine the overall probability that the population of patients for a particular health system, county, or state will use video visits.
These reports offer a reminder of the enormous potential in the continued innovation in the types of digital health products that have recently become a part of daily life for many of us, along with the need to emphasize health equity in developing and implementing telehealth and other digital health solutions.