After a year of incredible innovation across the digital health market, the task remains of how to make these products available to consumers at scale. Oftentimes, this means partnering with a payer that can offer coverage and reimbursement for the digital solution.
While making those partnerships stick is easier said than done, it is possible to get stakeholders from different spaces in healthcare to come together to achieve positive outcomes, Dr. Kenneth Snow, the medical director at CVS Health, said during a panel discussion at DTx West yesterday.
Snow was speaking from experience, as he helped facilitate a research partnership between Aetna, Lifescan and Welldoc between 2018 and 2019.
The study examined the effectiveness of the OneTouch Reveal Plus mobile and web coaching tool for adults with Type 2 diabetes at improving A1c levels, reducing healthcare utilization and engaging with members.
Over the six-month evaluation period, the findings showed an average A1c reduction of 0.54, a 55% reduction in diabetes-related emergency room member costs, a 30% decrease in diabetes-related ER member visits and an average of 30 engagements with the app per member per week.
These results can be emulated with other digital health tools with the correct application of the “digital therapeutics engagement chain,” Anand Iyer, the chief strategy officer at Welldoc, said during the panel.
The chain progresses from targeting the right people, effectively outreaching to them, seamlessly activating them and finally, supporting them to keep up engagement, according to Iyer.
“I think that the first question always has to be ‘What are you trying to solve? What’s the problem that you’re looking solve with the technology?’” Snow said.
In their example, Snow and Iyer were trying to improve A1c levels, so they targeted people based on clinical criteria.
“But one could imagine that the solution being offered solved for a problem that’s occurring in a particular geography,” Snow said. “That it’s a telehealth solution that really has tremendous value in rural areas. Well then obviously you want to target your solution not based solely on clinical criteria, you want to bring in that geography issue.”
From there, companies must figure out how to reach their target population.
“We started from the assumption of ‘we want to be as light touch as possible’ because obviously the less involved the outreach is, the more scalable it is,” Snow said.
When gathering participants for the study, they sent a total of two emails to eligible Aetna members. In retrospect, however, Snow said he wishes they had engaged with participants more at the start.
“The lighter touch, the better it is in terms of scalability, but making sure that you’re not so light touch that you aren’t reaching folks,” he said.
As the rollout progresses, it’s important to keep up the interaction with participants, especially those who engage with the therapeutic less often so they can be prompted to experience the benefits of the intervention, according to Snow.
This aspect of real-time user engagement that digital therapeutics offer is particularly promising, Iyer said.
“There could be emails; there could be SMS’s; there could be letter mails; there could be phone calls; there could be links directly from an EMR,” he said. “There are so many ways to reach these people, and not just at timepiece zero but on an ongoing basis.”
When these technologies work and these partnerships are carried out successfully, the opportunity for value-based agreements to be created opens up, Snow said. But for these agreements to work, there needs to be cost-savings on both sides.
“If all the savings fall on one side, the agreement is not going to last very long. It doesn’t matter what side it is,” Snow said.
And if both the payer and the digital therapeutic company experience cost-savings, it’s because the patient had better health outcomes.
“This is sort of a win-win-win actually,” Snow said. “At the end of it all, the money saved means that adverse events haven't occurred to patients and that’s probably the best win of them all.”
Unsurprisingly, when there’s potential for all sides to benefit, there will likely be heightened interest in the digital therapeutics space in coming years, according to Snow. But to stand out to payers, he recommends making a clear picture of the problem the tool solves and how it solves it.
“That’ll go a long way to really trying to get that attention in what’s going to be just an even crazier crowded space over the next several years,” Snow said.