How to Evaluate Digital Health Tools, Improve Selection Process

November 24, 2023 - Digital health tools continue proliferate, making it more crucial than ever for healthcare leaders to be discerning in their digital health decisions. 

On average, the number of digital health tools that providers used increased from 2.2 in 2016 to 3.8 in 2022, according to a survey from the American Medical Association (AMA). And 2022 saw the second-highest level of digital health spending and digital health dealmaking in the past decade, with the number of deals in 2022 (572) more than triple the number in 2012 (146).

With all of these options at their disposal, how can healthcare leaders make wise selections? In this episode of Industry Perspectives, Caroline Pearson, executive director at the Peterson Center on Healthcare, shared about the Peterson Health Technology Institute’s work to streamline that process for providers.

Caroline Pearson:

If someone is going to engage with a digital tool, they expect that they're going to get a therapeutic benefit similar to visiting their doctor's office or going to their physical therapist, and they deserve to know that that's been proven.

Kelsey Waddill:

Hello, and welcome to Healthcare Strategies | Industry Perspectives. I'm Kelsey Waddill, senior editor of HealthPayerIntelligence and multimedia manager at Xtelligent Healthcare Media. Industry Perspectives, in case you haven't heard, is a new short series that we are doing on Healthcare Strategies. We recorded these episodes at the HLTH 2023 conference, and we'll air them over the next couple of months.

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In this particular episode, I had the privilege to get to sit down with Caroline Pearson, executive director at the Peterson Center on Healthcare to talk about how the Peterson Center on Healthcare assesses digital health technologies to see if they are truly effective. I could go on, but I think it's better if you hear it from Caroline herself. So let's dive into the conversation, shall we?

Caroline, welcome to Healthcare Strategies. I've been hoping to have you on the podcast for a while, so it's great to actually not only have you on the podcast, but to meet you in person as well.

Caroline Pearson:

So glad to be here. Thank you for having me.

Kelsey Waddill:

Great. Well, to kick off this conversation, before we get into some of the details, we're going to be talking about digital health and what the Peterson Center is doing and also some of the trends that we're seeing around here at HLTH 2023. But before we get into all that, I'd love to just ask you to introduce yourself to our audience.

Caroline Pearson:

Wonderful. Well, as you said, Caroline Pearson. I'm the executive director of the Peterson Center on Healthcare, and we recently launched the Peterson Health Technology Institute [PHTI]. I'm also the executive director of that, so I guess I wear many hats. Prior to that, I spent about 20 years in policy-focused research and consulting really across a wide variety of issues in healthcare.

Kelsey Waddill:

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Amazing. Yeah. Well, excited to have you on and to hear more about what you're seeing here today. Before we get into that though, I was just wondering if you could tell me a little bit about what PHTI is doing right now with evaluating different tools for payers and providers. Obviously, a lot of our listeners are in the throes of that, constantly trying to figure out what's the best tool for them. And for our audio-only listeners, I wish you could see the booths here. It's like an incredible spread of technology and a great representation of all of the choices that healthcare stakeholders have to deal with. So how do you evaluate these different solutions that are out there?

Caroline Pearson:

Yeah, great. So PHTI or the Peterson Health Technology Institute, we were really launched as an independent evaluator for digital health tools, and this is the perfect place in Vegas to say there's a lot of hype in the digital health market right now.

Kelsey Waddill:

Definitely.

Caroline Pearson:

And you enter that exhibit hall and it is all hype all the time, and a lot of companies making all sorts of claims, right? Really wild claims about all of the things that they're going to deliver both to patients, providers, payers. They're going to save all the money, be super convenient, improve access, all the things. And the answer is some of that technology definitely has the potential to do that and we really want to drive adoption of the most promising technology out there and also really demand that every piece of technology has great evidence.

We really launched, having spent a lot of time talking to health plans, providers and employers, each of whom said, "We're totally overwhelmed. It's just we're besieged by all of these sales pitches and it's really hard to figure out how to sort the wheat from the chaff, and we don't totally know what we should be looking for. We're not convinced there's great evidence and we could really use some help." And there's a lot of folks out there claiming to do that, but they're mostly pay-to-play models. And as a philanthropy, we felt like there was a real opportunity to be a neutral voice in the space and really drive towards better care, better outcomes, and greater efficiency.

Kelsey Waddill:

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Yeah. And I bet that's super important, especially for the smaller organizations that can't necessarily pay but are often on the ground working out all the equity issues that we have. These solutions are really important for that, but if they don't have the bandwidth to evaluate, then where are they going to turn?

Caroline Pearson:

Exactly. I was on a panel yesterday with a woman who runs digital purchasing at Cigna, and she said she has a team of 200 folks to help do diligence and assessment.

Kelsey Waddill:

Wow. Oh my goodness.

Caroline Pearson:

But everybody else on the panel raised their eyebrows and said, "Oh my gosh." Most folks have one person in charge of this for their plan or their provider system. And so they really benefit from clear information and a review of the evidence. So I can tell you a little bit about how we're approaching it.

Kelsey Waddill:

I'd love to hear it. Yeah.

Caroline Pearson:

So we have an assessment framework. We released it in September, and we really have three core parts of that. So first is the technology context. It's actually remarkably hard to actually understand how all these digital tools work and how they are going to either replace or augment traditional care delivery. And so really just saying, "Here's the market. Here are all the companies in that market, and here is how they work," and map it all out is step one to bring clarity.

That's also where we start to talk about privacy and security, right? If you're going to be plugging into clinical systems, if you're going to be collecting health data, it's really important that we increase transparency about where that data goes and how it's being used. And so that's all part of the first piece.

From there, we dive into clinical effectiveness. And so this is really: is it safe, is it effective, and how does it compare to traditional care models? I always say if someone is going to engage with a digital tool, they expect that they're going to get a therapeutic benefit similar to visiting their doctor's office or going to their physical therapist, and they deserve to know that that's been proven.

So we look at all the clinical data, including things like user experience. If it's great for one week and then everybody gets annoyed at the alerts and stops using it, that's not super effective. And this is also where we look at health equity. It's incredibly important. Obviously, technology has the potential to improve access to rural areas, to really break down barriers for people with low health literacy or other language needs. But many of these tools have not had the time or the resources to build that out yet. And so we just need to be clear, right? This tool has a lot of potential but may not be for everyone or may not have been tested in Medicaid markets and FQHCs, things like that.

And then the third piece, assuming that its tools are clinically valuable, is really: what's it going to cost? And we really take a budget impact approach. So we're thinking from the minds of that health plan or that provider who's saying, "What am I going to pay for this and how much savings can I recognize? And how do we make sure that these tools are actually increasing efficiency in the market?"

Kelsey Waddill:

Yeah, wow. It covers the whole scope.

Caroline Pearson:

I certainly hope so. It's certainly what the market of purchasers have been saying they need.

Kelsey Waddill:

Yeah, makes sense. And talking about marketing purchasers, looking at all of these solutions here, without naming any names, what kinds of technologies are jumping out at you this year--especially as we're at HLTH 2023--that are leading the way and are important for healthcare stakeholders to be looking into and seeing if this could help them?

Caroline Pearson:

Sure. A few things come to mind. First of all, there's a lot of enthusiasm about remote patient monitoring [RPM] and the ability to really deliver chronic disease management and wraparound services outside of the doctor's office to really achieve the behavioral changes and the compliance that we're looking for. And so that holds tremendous promise and it's really variable and it's paid for in some strange ways. So I think that's a place where we're going to be looking closely to say for which patients, for which conditions, and for what duration is remote patient monitoring really going to be beneficial? So that's one.

In the healthcare world, there's tremendous enthusiasm about bringing care home. Obviously, COVID proved that we can deliver a lot of care virtually, but we can do better than just a Zoom call with your doctor. And that's another place where certainly I think there's tremendous potential out there.

And then the third piece is really things that are going to improve access. Behavioral health is the one that I hear most that everybody's excited about. It's a huge space, right? That ranges from substance use disorder treatment all the way to mild to moderate anxiety and depression, and we're looking at the full gambit.

Kelsey Waddill:

Yeah. It's interesting you brought up the RPM because I know that you just released that you're going to be looking into tools for diabetes and musculoskeletal, I believe.

Caroline Pearson:

Yeah, absolutely. So virtual musculoskeletal care like virtual physical therapy, and then remote patient monitoring for diabetes, including non-continuous glucose monitoring.

Kelsey Waddill:

Are you finding that it's [a] more effective approach to be looking at these technologies and evaluating based on disease case or population case, or how much does that affect your evaluation process?

Caroline Pearson:

We generally start with disease areas. We are really focused on generating more significant changes in spending, and so we look at disease areas that have large population impact or the ability to drive spending or savings significantly. We really do start with the clinical area and then crosswalk it with the tool or intervention. So RPM is going to be great for some things and maybe less effective for others. So I think it's really the intersection of the clinical area and the technology intervention that we need to be looking at when we're choosing our assessment focus.

Kelsey Waddill:

Makes a lot of sense. And I know we've been talking high level of that, these positive use cases. We also have, as you mentioned, a lot of tools out there that are selling themselves really high and maybe don't have the maturity yet or the evidence base yet to really sell into or to really invest in at this point. What areas are you seeing could use a bit more, maybe, growth before being fully adopted by the healthcare community?

Caroline Pearson:

Well, I think we're going to have to wait and see how the evaluations come out. As a good independent evaluator, I don't want to call anything too soon.

Kelsey Waddill:

That's very fair.

Caroline Pearson:

But we talked to a lot of folks. Certainly, we're trying to choose things that are at the right level of maturity, that they've had time to generate the evidence. And then our hope is really that if purchasers start demanding that evidence, the whole sector gets better, right? The whole sector really needs to prove the case.

And we certainly proved that technology has an important place to play after the COVID pandemic, and now we need to move on to the next phase of evolution where we really understand the clinical and economic effects of these tools and we're generating good data to prove it. And I think that's coming, and we're hearing a lot of excitement even from the companies and the investors in the room about the future.

Kelsey Waddill:

Yeah. I was just going to ask, what are you hearing in there? What's been exciting to you about HLTH, specifically, since we're here?

Caroline Pearson:

Well, for me, I have been really pleasantly surprised by how excited folks are about our launch and how willing they've been to engage. We weren't sure what people would think as we come in and have the potential to say, "This isn't living up to the hype." But I think, actually, folks really understand that they're not going to get away with a great sales and marketing guy anymore. And patients and payers deserve better than that. And actually, everybody has said, "We would love to work with you." Many of them also say, "Here are the challenges we currently face in generating data." Right? "The health plans keep our data, or we don't have access to this clinical outcomes. We can't tell the benefit that we're having."

And I think we have a role to play there in saying, "How do we bring that data together so that we really understand what we're getting out of these tools as a healthcare system, right? Not just as a point solution."

Kelsey Waddill:

That's exciting to hear. And exciting to hear that these solutions, these vendors are open to being more, maybe, forthcoming about some of the challenges that they're facing. We all need to be a bit more transparent about those challenges so that we can address them. But thank you so much for coming on today, Caroline, and I hope to have you back soon.

Caroline Pearson:

Thanks so much. Enjoy the party.

Kelsey Waddill:

Thank you.

Caroline Pearson:

It's a big one.

Kelsey Waddill:

It is!

Listeners, thank you for joining us on Healthcare Strategies | Industry Perspectives. When you get a chance, subscribe to our channels on Spotify and Apple and leave us a review to let us know what you think of this new series. More industry perspectives are on the way, so stay tuned.