Breaking down the “four walls” of patient care: What is the state of the digital medicine industry?

January 26, 2017 Kymberly Drake

Amid tirelessly pursuing possible partnerships and investment opportunities to bring revolutionary medical products to market at Biotech Showcase™ 2017 in San Francisco, global executives were invited to explore the future of patient care known as digital medicine at a congruent event called Digital Medicine Showcase.

Co-produced by EBD Group and Demy-Colton at the Parc 55 in San Francisco Jan. 10–11, the event was bustling with industry dignitaries ready to explore the future of this emerging new approach to patient care.

The opening panel session, “The State of the Digital Medicine Industry,” facilitated a broad discussion and overview about what digital medicine is, why it is important to patient care, why many in the medical industry dismiss it, and where the future of this segment is going.

Moderated by Nicole Fisher, Founder and CEO, HHR Strategies, the panel comprised Adam Brickman, Director of Strategic Communications and Public Policy, Omada Health; Glen de Vries, President and Co-Founder of Medidata; Naomi Fried, Founder and CEO of Health Innovation Strategies; and Walter Greenleaf, Chief Science Officer of Pear Therapeutics.

The first agenda item at hand was to broadly define what digital medicine is.

Defining Digital Medicine

Brickman kicked off the conversation by saying this is the year that digital medicine is entering a post-hype phase.

“The technology has been around for several years and I think the incumbents in this space know it’s here to stay and they’re now beginning to understand how you differentiate what is truly digital medicine and what is ‘the toy vs. the tool,’ ” he said.

Brickman outlined five questions businesses should ask themselves to ensure they are making strides in the digital medicine space:

  1. Is your intervention or what you’re doing in this space based on an existing body of clinical evidence?
  2. Are you publishing your outcome data to validate yourself in a clinical space?
  3. Are you working to integrate into a clinical setting? Are you working with providers or big health systems? Brickman said it doesn’t matter if you have the greatest intervention or tool in the world if it doesn’t get into the hands of people who need it.
  4. Are you leveraging the unique facets of digital, specifically data sites, to start to personalize that data? He said when it comes to behavioral interventions, this practice can be very important.
  5. Are you creating a revenue structure that forces you to deliver outcomes? Are you operating on a system that is not pay-per-employee or pay-per-beneficiary per month but actually holding your company’s feet to the fire

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Fried said that when she thinks about digital medicine, it is in terms of what the technology does for the patient.

“The idea of differentiating between the health and wellness apps and clinical apps is really valuable,” Fried said. “There is an opportunity in patient care to further divide and explain what solutions there are out there.”

She narrowed down four main types of digital medicine technologies that benefit patients:

  1. Virtual care. The ability to deliver care via telemedicine and by remote patient monitoring. Emerging companies are making a market in the activity of connecting patients and clinicians virtually.
  2. Digital diagnosis. Tools that can diagnose conditions and diseases using digital solutions rather than having a physician diagnose them. One example is a tool that diagnoses pediatric pneumonia by “listening” to a child’s cough.
  3. Medical adherence. Solutions that help patients adhere such as a smart inhaler that determines when a patient has taken his or her asthma medication, smart pillboxes and blister caps.
  4. “Digiceuticals.” Digital therapies that directly treat a condition such as depression. Companies in this area are providing new ways to improve patient outcomes by deriving technologies, running clinical trials, collecting data, and making sure there are reimbursement models. According to Fried, having this substructure for patient care is a really helpful framework.

From there, Fisher encouraged panelists to ponder: How do we make sure digital medicine isn’t hype and that we’re actually moving things forward?

Don’t believe the hype

“We’re in the hype cycle of digital medicine,” said de Vries. “Everything in digital medicine ends with the word medicine. We need to treat it like that and we need to learn from the past.”

He emphasized that discovering new ways to diagnose and treat disease is non-trivial and we should expect failures along the way.

“The most important thing in controlling the hype cycle is to figure out whether it’s expectations from a regulatory perspective or from an outcomes measurement perspective,” de Vries said. “We need to start to play by consistent rules.”

Greenleaf added, “I’m looking forward to the day when we don’t say digital medicine. I think the term will disappear and it will be part of medicine and won’t be a separate category.”

Panelists were then asked, what are some of the tools that you see that will help usher in this new era?

Nothing but blue skies

Greenleaf outlined what he sees on the horizon as three big tools coming from each technology sector in digital medicine:

  1. Artificial intelligence (AI)
  2. Deep analysis of data
  3. Virtual reality technology

“Transformative technology, especially for behavioral medicine, will affect everything we do,” he said. “The new wave we are in is digital medicine 2.0. We started out with some apps on our cell phones and websites and now we have some technology that goes a little bit deeper and is extremely profound and changing how we do things. We’ve learned a lot from digital 1.0 but I think things are lurching forward into a new area.”

Panelists then explored the question, what are the barriers that still exist?

Healthy skepticism of adoption

Whether you are dealing with health plans or health systems, the approach should be what we call the “medical director” test, said Brickman.

“It’s being able to walk into those offices and make a strong clinical case just as you would for pharmaceutical intervention that doesn’t have digital medicine attached to it,” he said. “That takes time and effort and doesn’t necessarily line up with the business and hype cycle that a lot of businesses get pulled into where they’re rushing to commercialization.”

Policy side

“Medicine and healthcare is a highly-regulated space but the pace at which this industry wants to move often outstrips the ability of those who regulate it or make policy for it to keep up,” Brickman said. “We’re entering a space that doesn’t fully exist yet. It is a distinct change in thought process from agencies and regulators that have been doing the same things the same way for a very long time.”

Not enough barriers

“It’s easy to build an app and roll it out,” Fried said. “It doesn’t do the industry a great service. Apps aren’t tested and there isn’t the data behind it. There isn’t a business model.”

Disruptive innovation

Fried reinforced that with new technology and approaches the industry needs a new ecosystem, reimbursement policies, and a new overall model.

“Telehealth is bumping up against existing regulations,” she said. “Remote delivery of care has rules that prevent doctors from having a virtual visit with their patient such as for followup care.”

She said that because of existing regulations, doctors cannot offer virtual care for a patient from another state.

Fisher then asked the group, how do you see keeping patients at the center of digital medicine in the next few years?

  1. Measuring value. De Vries stressed that value-based care takes what used to be an epidemiological equation and realigns it to individuals. He advised companies ask themselves: Am I generating measurably valuable outcomes for individuals and is my business model and regulatory environment actually rewarding that vs. rewarding more population-based outcomes?
  2. Virtual visits. Fried sees this technology “breaking down the four-walled approach.” She said patients don’t have to think about parking or arriving to an appointment on time, and that it makes patients feel that clinicians care about their experience. Outcomes are also improved when there is easier access to followup care since patients aren’t making determinations about their own current condition, she said.
  3. Lower barriers to access. People who live in rural areas, seniors with mobility issues, and people with low-income and inflexible work hours benefit from lowering barriers to access, said Brickman, which can drive better patient engagement and outcomes.
  4. The right frequency of interaction. Patients who are evaluated regularly helps providers to be properly equipped with the information that has been accumulated between visits, and facilitates an efficient and effective visit for the patient and provider.

Where will the future of digital medicine take us? View this video “Digital Medicine: The Intersection of Technology and Medicine.”

Further exploration into the depths of digital medicine will continue at EBD Group’s upcoming Digital Medicine Showcase events.

 

 


 Join us for our Digital Medicine Panels at BIO-Europe Spring® taking place in Barcelona, Spain, March 20–22, 2017. Find out more here

 

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