The Tipping Point for Digital Therapeutics is Here

Digital disruption in healthcare has been underway for years, with healthcare organizations aiming to digitize operations and processes to maximize efficiency, reduce costs, and provide comprehensive, quality care.

This disruption is driven forward by advances in interoperability, data analytics, EHRs, artificial intelligence, and subsequent development of mobile health and digital therapeutics (DTx) applications. It’s also being driven through regulatory, societal, and economic change.

However, nothing can match the global impact of the recent COVID-19 pandemic.

The DTx adoption tipping point is closer than payers and the broader healthcare industry may realize. In the wake of the COVID-19 crisis, the pace of digital health transformation is accelerating on a massive scale, with development timeframes for new remote-work technologies, telehealth and telemedicine services and other pandemic related projects compressed from months and years into days and weeks. Health plans can prepare now to keep ahead of the curve and take advantage of the changing dynamics. But first, let’s take a look at what exactly the “tipping point” for DTx adoption means.

Crossing the digital therapeutic chasm

In a forward-looking The future of biopharma article, global consultancy firm Deloitte explains that the digital health tipping point will have arrived when “health systems, health plans, and large pharmacies prioritize digital therapeutics over prescriptions and costly interventions and pay for them.” That was written just before COVID-19 hit.

Telehealth visits have since soared, as several health plans waived consumer cost sharing and public health officials encouraged the use of virtual care services. At Kaia Health, we recently experienced a single-day 40% spike in usage for our virtual musculoskeletal (MSK) lower back pain app; we expect these spikes to become more frequent and sustained. It’s becoming clearer each day that instead of decades, we’re now looking at just a few short years until DTx adoption critical mass is reached.

In the short term, the pandemic creates uncertainty. This includes significant financial challenges for payers as the cost of COVID-related claims increases while membership enrollment decreases with lower employment levels. Care delivery organizations owned by health plans are also struggling to deliver rehab, MSK and mental health care to patients whose mobility has been severely restricted.

However, consumer and employer demand for remote healthcare is soaring. Payers also have an opportunity – and fiduciary and social responsibility – to more effectively prepare and better serve members who are struggling and can benefit from the massive changes in digital health that are underway. This means aggressively engaging commercial sales and product teams, who source technologies and drive innovation forward to prepare for this new DTx world. 

Today’s digital transformation 

For all the uncertainty and pain experienced today, it’s clear that the future will be digital. For payers, this means a boom in digital therapeutics app development and healthcare delivery. As new technologies and payment methods are adopted to cope with the new post-COVID world, clinician visits are increasingly going virtual. Furthermore, the FDA, CMS and other regulatory and reimbursement bodies are streamlining and speeding up approvals and guidance to ensure physicians and clinicians can treat those in most in need. DTx apps for mental health and chronic health conditions – including addiction, diabetes, blood pressure, and MSK pain – are leading the way and reshaping care.

DTx are increasingly effective, evidence-based and scalable. Non-pharmaceutical (digital) interventions, including those focused on behavior modification and chronic disease, have more potential than ever to greatly reduce or eliminate demand for medications and interventions while improving quality of care and lowering medical spend.

Driving the shift to better outcomes with DTx 

The options available for preventing and managing chronic diseases and health conditions digitally are expanding rapidly. Health insurance companies and employee benefits providers can prepare now for this impending tipping point by:

• Gathering clinical data in support of the most promising digital therapeutic solutions.
• Partnering with DTx developers on pilot programs to facilitate real-world data collection.
• Formalizing how DTx therapies are evaluated for effectiveness and coverage.
• Understanding how streamlined FDA guidelines will rapidly propel certain DTx apps through regulatory approval.
• Leveraging the digital, analytics and personalization capabilities of DTx to improve the value of care.
• Collaborating with care providers who understand the value in DTx and other remote therapies.

The COVID pandemic has been a difficult, highly disruptive and transformative event. However, this painful chapter in history also presents an unprecedented opportunity for payers to prepare for the wave of change that is coming. As health plan members and their employers continue to seek out and shift to digital health technologies, the need for human interaction, clinical expertise and support is stronger than ever.

To learn more about making a positive change for your population, schedule a brief intro call or demo with our team.