“Health systems around the world clearly recognize the potential of digital health: over the past decade, they have invested heavily in national e-health programs. Yet most have delivered only modest returns when measured by higher care quality, greater efficiency, or better patient outcomes. And in some cases, e-health projects have been cancelled due to significant cost overruns and delays, such as the National Program for IT in the United Kingdom’s National Health Service (NHS).1 That’s because such ambitious information-technology initiatives—with a clear focus on IT support for clinical professionals—are typically beyond the core mission of healthcare systems, which also often struggle with legacy systems that impede data integration.
At the same time, the advent of smartphones, cloud computing, and global connectivity has created a universe of consumers accustomed to everything from checking bank balances, making purchases, and watching movies on mobile devices. Increasingly, those consumers wonder why health systems cannot provide similar service innovations. In that respect, digital-health companies would appear to be best positioned: innovation is in their DNA, they have attracted billions of dollars in venture capital, and they have the flexibility to design applications that cater directly to patient groups. Yet digital-health companies have been impeded by a lack of access to health data along with uncertainty about how to distribute the economic benefits generated by smartphone apps.
As system leaders struggle to unlock the full potential of technology in healthcare, they must answer the following three fundamental questions:
- Who should pay for digital-health applications and services?
- What evidence of effectiveness should be required to justify reimbursement?
- What conditions must be in place to provide start-ups that develop successful health
applications with a sustainable business model?
We believe the solution is to promote collaboration among providers and digital-health companies by enabling the exchange of health data—a vital enabler of more efficient care delivery. To drive technology advancement and adoption, each national or federal health system should consider an open innovation platform that holds healthcare data (beginning with highly standardized claims records), and provides data access that is enabled for application programming interfaces as well as common technical IT services such as identity, access, or consent management. This platform would serve as the basis for an ecosystem of digital-health-services innovation by certified third parties and could be steered by the respective health system.”