Roadmaps for Digital Health Solutions

Dec 13, 2018

By John Sharp, Senior Manager, Personal Connected Health Alliance

Recently, two publications were released which provide guidance for developing digital health solutions: one from the American Medical Association (AMA) and the other from NODE Health. They each provide a unique perspective, the AMA focusing on the Remote Patient Monitoring use case and NODE Health focused on testing a validation of digital medicine solutions.

The AMA's Digital Health Implementation Playbook provides ten steps, from identifying a need to scaling a solution. Introducing the topic, the authors state their premise for the playbook:

Digital tools that enable new methods and modalities to improve health care, enable lifestyle change, and create efficiencies are proliferating quickly. Clinical integration of these tools is lacking. We want to change that.

The playbook is designed for care teams and administrators in medical practices to guide the process of implementing digital health solutions. It uses remote patient monitoring as an example throughout helping patients become more proactive by engaging in their health. Each step clearly delineates stages in the process. For instance, the authors wisely state that one should identify a need or pain point first, rather than be attracted to new technology for its own sake. “Prioritize opportunities identified by frontline staff that align with your organization’s strategic goals.” That seems obvious but may be overlooked in this hot market of digital solutions.

Another essential element the playbook points out is defining success using measurable outputs, both in the short and long terms. How will these impact your practice and your patients? These clear goals support the next step which is “Making Your Case” to executive leadership and identifying what resources are needed to create the solution. Three later chapters promote designing the workflow, preparing the care team for implementation and including the patient. One could argue that including the patient is essential from the beginning of the project, but it is helpful to incorporate this step, which has often been neglected in healthcare design. According to AMA Chair-elect Jesse M. Ehrenfeld, M.D., M.P.H., "The AMA is committed to making technology an asset, not a burden, and the Playbook provides the medical community with widespread access to a proven path for implementing digitally enabled health and care.”

The roadmap from NODE Health (Network of Digital Evidence) takes a different tack, with a focus on digital medicine testing and clinical validation published in the journal, Digital Biomarkers. They have developed an algorithm for testing digital health solutions which includes the following phases:

  1. Usability study: Does it function? (the importance of design thinking)
  2. Is it used by target populations?
  3. Efficacy study: Does it work?
  4. Pragmatic trial – real world efficacy.

In each case, they look to see whether the technology is the point of failure or other factors. The authors also provide a list of questions to ask startups to evaluate product maturity, fit with healthcare and research experience. There is also a helpful crosswalk of clinical versus digital medicine testing phases, a comparison rarely seen in evaluating solutions. They conclude with three case examples of how this approach can be applied.

These two roadmaps demonstrate the maturity of the digital health market and evidence base, and will help to reduce what can be a chaotic, speed to market approach, leading to a more systematic and success approach to development, validation and adoption.