Reality check: The challenges of digital health

Hassan Chaudhury, Digital Health Lead, Healthcare UK, Department for International Trade, looks at the challenges of digital health and why pharma should bet big but tread carefully.

We face a global crisis in healthcare. There simply aren’t enough trained professionals to meet the growing burden to deliver care. Estimates vary but the global shortfall of healthcare professionals of all types by the end of this decade is forecast to be at least 15 million.

There is no coincidence then that digital health has become such a hot ticket. Without supporting citizens to self care, better use of data for prediction, faster and more accurate diagnostics, stratifying and redirecting to more appropriate care settings, augmenting our workforce to do more and automating routine tasks, there is no version of the future where we have a sustainable model that will still be standing in 15 to 20 years’ time.

“IT ISN’T ALL ROSY IN DIGITAL HEALTH AND IT PAYS TO BE AWARE OF SOME OF THE CHALLENGES”

Should pharma be betting on digital health as a partnership model with healthcare? Certainly. However, it isn’t all rosy in digital health and it pays to be aware of some of the challenges.

Challenges

For a start, digital health is not a panacea. It does not and cannot cure all. The fundamentals of a health system firstly all need to be in place for digital health initiatives to be fruitful. Infrastructure, medical education and training, regulation and governance of both people and things (drugs, devices and so on) are all examples of necessary steps.

There is also a concern that health systems which are still developing do not have enough leaders grounded in digital health to be able to exploit the potential. Instead they bring in management consultants and large tech corporations who sell them tactical solutions without having a clear and thought out long-term strategy.

“EACH PROMISING DIGITAL HEALTH FIRM IS ESSENTIALLY TRYING TO REINVENT A WHEEL THAT PHARMACEUTICAL COMPANIES AND MEDICAL DEVICE FIRMS IDENTIFIED AND MASTERED LONG AGO”

In more mature health systems a key challenge is revenue. There are countless digital health firms in the market but how many have a sustainable commercial model? How many are consistently generating sales, whether B2C or B2B? The overall impression is of lots of excitement, repeated fundraising and the occasional blip where a once-promising firm runs out of cash.

The problem is that it is not that easy to sell to healthcare systems and I’ve never seen one as difficult to enter as the NHS. Germany has earned plaudits for its announcement in November that it would reimburse digital therapeutics but that only highlights just how many markets are still left to do the same.

Each promising digital health firm is essentially trying to reinvent a wheel that pharmaceutical companies and medical device firms identified and mastered long ago. Even the very best of them could never compete with the machinery around branding, market access and sales that global life science firms view as their day-to-day. There is typically a point in the life of a digital health firm where they face a reality check. How will they overcome the barriers in front of them? Healthcare is unique and we don’t have the options available to other industries, for example offering free software to then exploit user data, of which Google and Facebook are often accused.

Solutions

The answer for pharma cannot just be to get involved with digital health with an incubator or a showcase. It can’t just be about having a cool, innovative digital health product to support a brand or therapy area. Instead it has to be more about supporting states to strengthen their health systems, promote better leadership in digital health and then guiding firms to be able to sell to health systems and build sustainable revenue based on decades of collective pharma sales and market access experience.

Bets should be made on all types of digital health innovation. It’s just a sad truth that without support in what pharma finds relatively easy, it is likely that many of these bets will fail.

Hassan Chaudhury is Digital Health Lead, Healthcare UK, Department for International Trade (DIT).

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