Digital health tools hold exciting potential here in the wealthy world – to boost adherence, for example, or to facilitate a smoother patient experience. But for poorer, less-developed, and/or more rural quadrants of the world, mobile health apps, telemedicine and other emerging digital tools could have an enormous impact on provision of care. The World Health Organization has been paying close attention to these technologies and thinking about how health systems can best incorporate them. Their latest set of guidelines, released last month and entitled Recommendations on Digital Interventions for Health System Strengthening, offers valuable insights into the pain points for global patients and healthcare providers in markets rich and poor alike, and how mHealth tools and services stand to salve them – or exacerbate them.
Will digital tools ease the burden of care – or add to it?
The WHO sees these tools as extenders of patchwork health systems, enabling HCPs to work more efficiently in rural and remote places and to “expand their range of tasks as well as take on tasks previously assigned to higher-level workers.” However, the WHO researchers caution that some HCPs feel “these interventions do not reduce their workload and in some cases increase their workload” as digital tasks are simply foisted on top of already-overburdened providers’ real world ‘To Do’ lists. Usability issues and poor integration with other digital systems are cited as factors.
That should sound familiar to anyone who’s ever spent time in an EHR system. In our U.S. physician research last year, we learned that among these doctors, who spend more than 3 hours per day using an EHR system, less than half are satisfied with the resources in their EHR – and 2 in 3 must seek out information outside of the EHR. While the EHR market in the U.S. is fragmented and largely off-limits to pharmas, there may be whitespace for pharma tools in other markets – in Brazil, 53% of physicians are interested in pharma-sponsored patient education and support materials in their EHRs. In China, 80% of physicians are interested!
Worries about data privacy and eroding physician autonomy are universal
The WHO report highlighted anxieties around data privacy and the impact of these technologies on physician autonomy, which jibes with our research – last year, we found that nearly 2 in 3 U.S. physicians worry about data privacy when using voice search, and that 43% think AI/machine learning applications for decision support will further constrain their diminished prescribing autonomy over time.
The use of mobile devices and apps to keep patients in the loop and on treatment is another use case explored in the report. While highlighting concerns about dangers of targeted mobile communications to patients regarding sensitive topics (sexual health) or stigmatized conditions (e.g., HIV), the researchers spell out the potential. Patients “describe the messages as providing support, guidance and information, and give a sense of direction, reassurance and motivation,” with some valuing “the increased access and the consistency and continuity of care it offers,” and others reporting that “it increased their independence and self-care.”
Telemedicine remains an iffy proposition for HCPs
And the report recommends patient-to-provider telemedicine “to complement, rather than replace, the delivery of health services,” reflecting, in part, ongoing legal fuzziness and questions over who will pay for what services. In the U.S. last year, we found that 3 in 5 physicians worry about liability issues with telehealth, while nearly as many have concerns about reimbursement, and more than half are concerned about data privacy in tele-consults. And they’re really giving those DTC telemedicine offerings the side-eye – 54% fear that these startups will fail to uphold an adequate standard of care.
Of course, physicians’ reservations about telemedicine aren’t necessarily shared by patients, who are likely to find the greater convenience virtual consults afford appealing. In Brazil, where 37% of consumers had already used virtual consults, according to our 2018 patient research, a whopping 84% are interested in doing so, especially for second opinions (66% interested), condition management (63%), therapy sessions (62%) and urgent care issues (61%).
Learnings for pharma
- Opportunity in Rx apps: There’s fertile ground here for brands that can develop tools that really add value for patients – and by extension, the HCPs treating them. In the U.S., our 2019 physician research has found that 44% of physicians are interested in prescribing a patient-focused app (e.g., Pear Therapeutics’ reSET-O for opioid abuse patients); 4% have done so already. App design should ensure that digital interventions are well-integrated into traditional care – concern that patients might skip HCP visits was a top concern for non-prescribers of apps.
- Data privacy is a sore spot – and a potential differentiator: Anxiety about data security has been a major sticking point for developers of digital medical tools and services, though some heavy hitters in tech have been working on it (witness Amazon’s recent announcement that it’s HIPAA-proofed its Alexa voice assistant). Brands and companies working on these sorts of solutions should be prepared to invest in locking down patient data – or partner with platforms that have already figured it out.
- Effective solutions must mesh seamlessly with HCP workstreams: The WHO seems bullish on prospects of using digital tools to track patient health and improve adherence – but only “Where the health system can support implementation of these intervention components in an integrated manner.” When implementation creates new problems and demands on the time of your medical workforce, it can’t be called a solution. Whether simple self-reporting tools or sensor-enabled apps logging longitudinal data, these tools can be game changers – but only if HCPs can plug them into their EHRs with no additional effort.
For more information on DRG Digital’s global patient, physician and payer studies, or to learn more about potential whitespace opportunities for your brand in the markets you care about, contact us at firstname.lastname@example.org.