It might be easy to think of pharma and healthcare as conservative industries, but the reality is that digital health is now far further along than we predicted it would have been 10 years ago – or even one year ago.
Much of this is, of course, down to COVID-19 – but it’s clear that digital health was already on the up and up long before the pandemic hit.
When the industry first started talking about digital health, we were really talking about ‘beyond the pill’ strategies, which mostly included things like apps to boost adherence and patient support programmes.
Now, though, what we are seeing is true digital health, which does encompass beyond the pill, but also focuses much more on digital therapeutics – including digital devices that are complementing medicines directly for therapeutic benefit (rather than just adjacent factors like adherence), as well as digital interventions which are themselves therapeutic.
No one could have predicted ten years ago that the sector would develop as quickly as it has. In fact, ten years ago we were really just on the first wave of digital health, and the first wave of what we might call ‘personal diagnostics’. The iPhone hadn’t been around for long at that stage; it wasn’t collecting the kind of data we are able to collect now with more advanced smartphones and devices like Fitbit.
Back then, no one thought digital health could become so diverse, or that there would be much investment in it at all. And nobody thought it would transform medicine, and for the first time enable a true emphasis on preventative care.
The smart digital health companies are the ones who are now treating product development like they would medicine development. They understand that they need to have clinical evidence of efficacy, safety, and cost effectiveness.
That’s a critical factor, because even a good digital therapeutic is going to struggle to gain traction if it doesn’t present strong evidence for doctors to feel comfortable prescribing it, and if it doesn’t save health systems enough money to justify the case for reimbursement.
Likewise, health systems themselves also need to be ready for, or at least open to, upcoming innovations. These factors combined are arguably what made it difficult for Proteus Digital Health, an early (perhaps even ahead of its time) company pioneering digital medicine for adherence management through ‘connected pills’, to gain traction, despite the rich evidence the company had available.
A second trend is that companies are becoming more conscious of the fact that digital should not get in the way of, or try to replace, the doctor-patient relationship.
We can now be confident that technologies like AI will not replace doctors – rather, a combination of the two is a much better option.
That’s not to say there aren’t some digital health devices that can have benefits on their own, but there’s a real trend towards products that also have the ability to connect the patient to an individual for direct engagement.
Examples include Healios, a UK application for treating mental health disorders, and mySugr, a diabetes management app that was acquired by Roche – both of which link patients to medical professionals for advice and intervention in novel ways.
In other words, many devices are now closing the loop between patients and physicians, rather than replacing this interaction.
Similarly, the ability to link patient data to clinicians is becoming a key feature for many devices, and there are several companies focused on collecting real-world evidence (RWE) in this way. If companies build large real-world evidence databases, looking at patient outcomes, that will in turn start to shape the positioning for the products themselves.
Like many sectors, pharma and healthcare must wrestle with a balance of short-term and long-term goals for digital health. Big companies often face pressure to deliver immediate value for shareholders, which, understandably, drives a short-term focus within digital. This results in their digital projects mostly being focused on commercial considerations, such as how these tools can boost sales force effectiveness or internal operational effectiveness.
That challenge ties into a second one, which is that digital is an incredibly broad terminology, and it is applied in the industry in countless ways.
It can refer to using digital for commercial benefits, to accelerating R&D, or innovating with the way we diagnose and treat disease, among many other definitions.
Some companies have created a challenge for themselves by grouping all these areas together under the massive umbrella of ‘digital pharma’. And when it is grouped together like this under roles such as a chief digital officer, these people have a lot of pressure to focus on the more immediate, commercial side, even though investing in aspects such as digital transformation in R&D is likely to lead to longer-lasting benefits.
There are also external challenges common to all companies. For example, it’s still not easy to integrate digital products with global markets and healthcare systems, because they’re all trying to adapt to this rapidly changing landscape as well.
We have to remember that these are systems that were built to cope with the development cycles of medicines and devices, which take longer to come to market than digital tools – and although they can certainly assess digital tools in a similar way to traditional products, many health systems and regulatory authorities don’t yet have the expertise to do that.
Luckily, we are starting to see a lot of investment by regulators such as the FDA in personnel that come from a digital health background and understand the area. We’re also seeing pathways for reimbursement being developed, such as Germany’s ruling last year about reimbursement for digital health products.
That said, there’s still enormous variation across the world, and familiar challenges such as IP protection will remain.
It’s also important to remember that there are many markets where you can’t get access to the whole healthcare system. The UK is a good example of this, where you have a number of different regions, such as Clinical Commissioning Groups (CCGs) and hospital Trusts. Because of that, the adoption of innovation tends to be quite fragmented, which can slow uptake.
When you have that good idea, you need the right management team and the right personnel to bring that idea to life. Having an idea is quite easy – making it happen is much harder.
There also needs to be a good investment approach and a good finance system in place.
All that needs to be allied with the right technology execution, because it’s important to get the product developed efficiently and onto the market to generate the right data to support your business case, which is driven by at-scale adoption and engagement of the user’s base with the product.
Finally, like a lot of things in digital, you need the ability to pivot when necessary and take a slightly different route based on the evidence that you’re seeing.
A lot of the digital companies we’re talking to as part of the conference could have had their applications in more widespread use years ago – but sometimes the key barrier to adopting these products is simply behaviour change. As human beings, we’re creatures of habit – we like to do things the way we’ve always done them, and it takes a big push to make us change that. That’s what COVID has done.
We’d like that to be the key message people take away from the conference – that things are really looking up for the sector, with rapid acceleration of behaviour change and investment around digital.
Stakeholders are starting to see that digital health is not just some interesting, innovative curiosity on the sidelines of medicine – digital health is now a core part of healthcare, and it’s here to stay.
Frontiers Health has emerged over the last years as one of the premier global events on digital health and innovation in healthcare. In the last five years, the conference has turned into a unique platform for deal making, networking and learning in the industry and has been repeatedly defined as “a home to the digital health ecosystem”, gathering thousands of innovators, leaders and key players from the health industry each year in Berlin and in other locations across the world.
The format of the 2020 edition will combine online global streaming together with offline events and activities held at Local Hubs in multiple locations such as Italy, Germany, Finland, Malta, Spain, Switzerland and USA – all of which will also be streamed globally.
The conference will be dedicated to digital health innovation in the context of the ‘new normal’, focusing on telemedicine, digital therapies, breakthrough technologies, patient-centricity, healthcare transformation, investments and ecosystem development.
The programme will start at 2:00 pm CET on both days with plenary sessions (talks and panels) and parallel break-out sessions (masterclass, workshop, deep-dive formats) in pure Frontiers style.
The iconic Start-up Discovery sessions have also moved online opening more opportunities to connect with both earlier-stage and more established digital health start-ups.
Roberto Ascione is the CEO and founder of the Healthware Group. He is active in the digital health ecosystem in various advisor capacities, both in Europe and in the US, to companies, start-ups and investors. Among others, he has been recognised as Decade’s Best Industry Leader by Health 2.0 Conference – 10 Year Global Retrospective Award in 2016, nominated Transformational Leader at the 2017 PM360 ELITE Awards and named among the 100 Most Inspiring People by PharmaVOICE in 2017. He is a founding member of the Digital Therapeutics Alliance, past President of the Health Tech Summit and he is chairman at Frontiers Health.
Dr Paul Tunnah founded pharmaphorum in 2009, which combines industry leading publications with a specialist strategy and content marketing/communications consultancy. He is a recognised author, speaker and industry advisor on content marketing, communications and digital innovation, having worked with many of the world’s leading pharmaceutical companies and the broader ecosystem of healthcare organisations. In June 2020, he became chief content officer for Healthware Group, a next-generation integrated consulting group that operates at the intersection of the transformation of commercial operations and digital health, offering a unique range of services combining design, strategy, communication and innovation with technology and corporate venturing. Connect with Dr Tunnah on LinkedIn or Twitter.