Selecting Digital Therapeutics: A Step-by-Step Framework for Health Systems
Digital therapeutics represent an exciting opportunity for health systems to improve patient engagement, outcomes, and access to care. These software-based solutions use technology like mobile apps, sensors, and data analytics to help prevent, manage, and treat a growing range of medical conditions. However, with an influx of companies offering digital therapeutics, health systems face challenges in identifying the right solutions that are evidence-based, integrate smoothly, and align with organizational goals.
This article provides a step-by-step framework health systems can follow to evaluate and select digital therapeutics for their needs. We’ll cover:
- Assessing organizational needs and goals
- Evaluating clinical evidence and outcomes
- Examining integration requirements
- Analyzing patient experience design
- Reviewing costs and potential value
- Selecting the right vendor
Following a methodical selection process will help ensure health systems choose digital therapeutics that are impactful, scalable, and set up for long-term success across the organization.
Assessing Organizational Needs and Goals
The first step in any digital therapeutic evaluation should involve clearly defining the problems you need to solve or goals you hope to achieve. Bring together stakeholders from different areas of your organization to get a multidisciplinary perspective. Engage leaders and users from clinical departments, IT, administration, patient experience, population health, and other areas in the process early on.
Key activities in this phase include:
- Documenting challenges related to patient engagement, outcomes, costs, or staff efficiency for specific conditions. Be detailed in defining issues.
- Brainstorming opportunities where digital therapeutics could have the biggest impact based on organizational priorities and pain points.
- Prioritizing the top focus areas or use cases to evaluate potential solutions for.
- Developing clearly-defined objectives a digital therapeutic should meet like improving A1C levels by 0.5% for diabetes patients.
This stakeholder engagement and planning stage is essential to align on the biggest needs to address with digital therapeutics and set criteria to measure success against from the start.
Evaluating Clinical Evidence and Outcomes
Once target use cases are defined, the next element of evaluating digital therapeutics focuses on clinical evidence and real-world outcomes data. The level of evidence and proven results will vary widely between the multitude of solutions on the market. Thoroughly vetting this can determine whether a solution has the intended therapeutic benefits and safety.
Key questions to ask vendors and consider regarding clinical evidence include:
- Has the digital therapeutic been clinically tested in randomized controlled trials to support claims of outcomes?
- What measurable clinical impacts on specific health metrics has it achieved in trials?
- Are other health systems using this vendor?
- Are outcomes validated not just in controlled studies but also in real-world use in other healthcare settings?
The FDA has an emerging approval process for digital therapeutics as software as a device which can serve as a marker of quality. However, not all solutions will have formal FDA approval yet; therefore, published outcomes data are essential.
Examining Integration Requirements
Before selecting a digital therapeutic, it’s critical to determine how well it will integrate with your existing health IT ecosystem. Meeting technical and operational requirements ensures sustainable workflows. Key integration factors to examine include:
Technical and Operational Integration
- Can the solution integrate with your electronic health record system? Is patient data, progress, and insights captured in a dashboard accessible to clinicians in their workflows?
- How much training and support is required for clinicians, care teams, and patients to adopt the digital therapeutic?
- When customers interact with the solution, is there an escalation path for received messages?
- What are the requirements for supporting, updating, and maintaining the solution long-term?
Operational Integration
- How much training and support is required for clinicians, care teams, and patients to adopt the digital therapeutic?
- Are additional staff like health coaches or nurse educators required to manage the solution?
- What are the requirements for supporting, updating, and maintaining the solution long-term?
Scalability
- Can the solution easily scale to serve large volumes of patients across the health system now and in the future?
- Is the digital therapeutic vendor currently serving large health systems comparable to your scale?
It’s important to thoroughly test integration via demos, pilot programs to uncover any gaps before full deployment.
Evaluating Patient Experience Design
Patient:
While digital therapeutics must be clinically validated, the solutions also need to deliver an engaging user experience to drive adoption and sustained utilization. Evaluate factors like:
- Personalization: Are assessments, educational content, and features tailored to individual patient needs and preferences?
- Delivery modalities: Does the solution offer a multi-modal experience via mobile, wearables, sensors, websites, virtual coaching?
- Engagement strategies: Does it use proven behavior change techniques like motivational messages, reminders, incentives or gamification?
- Accessibility: Is the program design accessible to different ages, tech-savviness, languages, and disabilities?
Testing the digital therapeutic firsthand is invaluable in evaluating the user experience quality and appeal.
Analyzing Costs and Value
Upfront software licensing costs, recurring subscriptions, device fees (if applicable), and ongoing support expenses should be considered when comparing digital therapeutic solutions. However, also analyze long-term value:
- Does the solution offer clear opportunities to improve outcomes and lower associated care costs long-term for a condition?
- Can you project cost savings from reducing hospital admissions, readmissions, ER visits for target patient groups, based on available outcomes data?
- Will the solution help meet quality incentive or shared savings goals under value-based care contracts?
- For vendors that do not have strong outcomes, explore a partnership model for product validation.
Anticipated value should be weighed against costs, keeping in mind that higher price does not always guarantee better results or value.
Selecting the Right Vendor
Developing a comprehensive vendor scoring system across the above factors will help compare solutions head-to-head and make the final selection. Key steps include:
- Start by making a list of vendors and their capabilities and integrations. You can use AVIA Marketplace’s DTx Market Map to help with that.
- Creating a scorecard incorporating all the criteria above, weighted by importance. Assign points per criterion.
- This is something AVIA develops for its members and through consulting.
- Scoring each vendor solution in your current consideration set based on how they fulfill the criteria.
- Comparing total scores to identify the technology that optimally fits your defined needs and preferences.
- Performing product demos and pilot tests with one or two top choices to confirm the right fit before fully deploying a selected digital therapeutic across the organization.
View AVIA Marketplace’s Top Digital Therapeutics Companies report for a list of the top solutions in the space.
Conclusion
Focusing on solutions that align with the organization’s needs will drive greater adoption and value. Part of that is appropriately vetting and scoping projects that match patient and provider goals and desires. By following a structured selection framework, health systems can evaluate options and identify the right technology that delivers demonstrable value.. While digital therapeutics require an initial investment of time and resources in the selection process, the long-term benefits of choosing the right fit makes this upfront effort well worth it.
For an in-depth discussion by AVIA digital therapeutics experts, see AVIA’s Exploring the Potential of Digital Therapeutics webinar.
