Speeding the Path to ROI for Digital Health Software Products

Doug Mirsky, Ph.D.

There is an immense potential for digital health software products to transform the way we deliver and experience healthcare today. From Fitbit apps to remotely monitoring patient glucose levels and vital signs to ambient scribes alleviating the administrative burden on providers, products used by patients and care teams are demonstrating improved health maintenance and outcomes.

So what’s stopping us from achieving this future potential today?

The value and the barriers

There is incredible innovation taking place in digital health with over $10 billion invested to date. Digital health software products play a key role here. Today, there are over 350,000 health and wellness apps available directly to consumers, with over 30,000 companies behind these — some targeted at providers, some patients and some overlapping. Many of these products have the potential to dramatically improve lives and our healthcare system.

And yet, adoption of these products remains too slow with patients and providers being the ones left waiting.

Through our work at the Digital Medicine Society (DiMe), we’ve observed some consistent roadblocks to realizing this ROI with a lot of challenges tied back to where we are spending our time. For example, instead of focusing efforts on assessing a product’s ROI and leveraging products that are fit for purpose to deliver the best digitally enabled patient care, hospital leaders have to wade through the baseline criteria of evaluating and flagging issues with privacy, security, usability and evidence to even select a product to consider against the need state.

A closer look at the numbers

At HLTH meeting in Las Vegas in late last month, I had the opportunity to speak directly with digital and tech leaders from health systems across the country — large and small systems, urban and rural, well-resourced, and those with small budgets — and they all are facing this struggle.

Hospitals are spending between 75 and 100 hours reviewing each digital health software product that they consider using in their system. These individuals and teams (where they exist) do this same lengthy, complex evaluation process, on average, over 20 times each year, resulting in more than 1,500-2,000 hours a year, almost the number of hours of a full-time job dedicated just to evaluating and de-risking products.

Now let’s look at the scale. There are more than 6,000 hospitals in the U.S., amassing over nine million hours a year of diligence on products alone.

Beyond just the hours, it's not common for many hospitals to have a full-time role solely dedicated to evaluating software products – much less a digital team or a chief digital officer directing the overarching strategy and coordinating with the rest of hospital leadership.

A common scenario I heard at HLTH: the head of a department at a smaller regional health system reads an article about an exciting new app and forwards it to the chief information officer (CIO) requesting the hospital consider using the app. The CIO, who likely doesn’t have a digital team or the individual bandwidth to evaluate questions, and certainly doesn’t have a framework against which to assess this one-off needs to figure out:

• How does this app compare with others on the market?
• Did they make this app considering issues of equity?
• Will we be able to support the internal roll out of this app with our clinical team?
• Will it comply with existing safety and privacy policies and protocols?
• Are the Terms of Service written at the appropriate grade level?
• Are the claims made by the app legitimate?

Where do they even start?

Spending our time where it’s needed the most

The answer is relying on third-party evaluation.

The healthcare industry runs on third-party evaluation — FDA for evidence, SOC for healthcare privacy and security, and ISO for accessibility. By relying on outside experts, health systems can speed their internal review process while still selecting a digital health software product that is high quality and trustworthy. With an accelerated evaluation and trusted product in place, they can then spend time on using the innovation to improve their systems and care for patients.

To address this urgent need, DiMe developed a new platform to evaluate digital health software products in today’s rapidly evolving market. The DiMe Seal is a symbol of quality and trust granted to digital health software products that demonstrate performance against a comprehensive framework of standards and best practices in privacy and security, usability, and evidence with equity woven throughout.

Developers can apply for the DiMe Seal for their digital health software products online through a series of attestations and questions that incorporate complementary industry standards like SOC 2 Type II, HITRUST, Carin Code of Conduct, WCAG, ISO 27001, and more. If the product meets baseline criteria of evidence, usability, privacy, and security standards, it is awarded the DiMe Seal – a symbol that the product is built to a baseline level of quality and can be trusted.

Health systems can then access and search the freely available database of products with a DiMe Seal, or review the product through a platform partner, like AppGuide, Digital.Health, and Galen Growth, to make a shift and spend the majority of their time focused on the important question of if the product addresses the problem they are trying to solve and does so in a cost-effective way.

Our vision is that the DiMe Seal reduces the burden on health systems and allows them to accelerate their adoption of digital health software products to improve health outcomes, their operational structures, and the patient experience, getting more time back to focus on how to incorporate digital products into their work instead of sifting through the ever-growing list of products being developed.

Digital products are not a silver bullet, but their potential is significant. Continuing at the current slow pace of adoption and continuing to risk the adoption of subpar products risks this moment in time when so much incredible innovation is being created. To reach the full potential of the moment, we need to accelerate adoption of those products made well - the ones built with an attention to delivering a high quality experience that can be trusted by patients, providers and health systems alike.