Important Insights from Athena Madros at Open Minds

Executive Briefing | by | December 5, 2017


Athena Mandros
Athena Mandros

It appears we’re on the verge of moving to an era of digital treatment. It’s not like we haven’t seen web-based and smartphone-based therapies in the previous decade, we certainly have. In fact, there are over 165,000 health and medical apps on Google play and in the app store, and about 30% of the adult population owns a wearable (see The Impact Of Tech In The Future – & The Reality Of Tech In The Presentand Remaking Health Care With Wearable Technology & Digital Health – A View To The Future).

But, from a policy perspective, the FDA has finally officially recognized that many of these therapies go beyond advisory or adjunctive and will become an integral part of the treatment process. (For more on coverage of the FDA activities in this area, see Digital Health; FDA Selects Participants For New Digital Health Software Precertification Pilot Program; and Thinking Of Creating A Digital Health App?.)

What is the range of digital treatment technologies? Digital treatment technology is a broad term used to describe a technology tool that can be used to treat a consumer’s physical, behavioral, or cognitive health condition. These tech tools include mobile apps, devices that feed information into medical apps, wearables, and telehealth.

In the past few months, we have seen major digital treatments cleared by the FDA in the behavioral health space. In September, the FDA approved reSET®, a prescription mobile cognitive behavioral therapy (CBT) app for non-opioid outpatient addiction treatment. It is the first mobile application for addiction via a prescription (see FDA Approves Pear Therapeutic reSET Prescription Mobile CBT App For Outpatient Addiction Treatment). And, in November, the FDA approved Abilify MyCite, the first pill with an ingestible digital sensor to track medication adherence. The sensor records that the medication was taken and communicates that information to a mobile application, via a wearable patch (see FDA Approves Abilify MyCite® (Aripiprazole Tablets With Sensor), A Pill With Digital Sensor To Track Oral Antipsychotic Ingestion Additionally, Carrot received FDA approval for the first FDA-cleared digital smoking cessation program (see The FDA just approved the first mobile device and app to help you quit smoking). Another non-behavioral device that has received clearance is WellDoc, who received clearance for BlueStar, a diabetes management program (see WellDoc receives FDA clearance for non-prescription version of diabetes management app). In total, there are now 220+ FDA-cleared medical apps on the marketplace. And, to review what’s been cleared check out: Examples of Pre-Market Submissions that Include MMAs Cleared or Approved by FDA.

What does this mean for strategy and clinical service delivery for provider organizations? There are implications for planning, for clinical operations, for financial sustainability, and for consumer engagement. The planning implications are straightforward. Management teams need new planning capabilities—the ability to evaluate digital treatment technologies and, for those selected, recommend as appropriate. And, when using these new treatment technologies, establishing a process to use the “big data” that comes from digital treatment both in individual treatment planning and in population health management.

The operational implications are more obvious. The selected digital treatment technologies need to be integrated into existing treatment protocols and along with that integration, clinical teams need to accept and learn to excel in using these new tools. But the financial implications are more complex. Bringing in these new technologies will inherently create a “substitution effect” with technology replacing some elements of care delivered by staff changing the cost of care and price points.

Finally, these new digital treatment technologies alter an organization’s relationship (and clinical professionals’ relationship) with consumers. There is more consumer control and more consumer information transparency. Digital treatment technologies allow for real-time feedback and detailed data collection that is in the hands of consumers and direct caregivers. The treatment process and the information relies on consumer involvement in the care management process.

For most provider organization executive teams, “technology” has traditionally meant billing systems and EHRs. In the years ahead, technology will be more focused on the twin goals of population health management and consumer engagement (see How Technology Is Changing Case Management)—and be an integral part of the treatment process.

For more, join us at The 2018 Strategy and Innovation Institute in New Orleans on June 5 for the session Innovation In Addiction Treatment: The New Community-Based, Tech-Enabled Models led by Steve Ramsland, Ed.D., Senior Associate, OPEN MINDS.

There are great opportunities in the chaos that is our health care system. Even the investment climate is disorganized.

Fortune

One effect of the Affordable Care Act, a.k.a. Obamacare? A spike in venture interest in health care startups. Digital health care companies raised $2.3 billion in the first half of 2014, which surpasses the total raised in all of 2013, according Rock Health, a health care-focused seed fund. That figure is impressive given that 2013 was already a record year at $1.9 billion raised. (That’s a 39% increase year over year, even as biotech investment grew just 8% and medical devices investment fell by 17%.)

Funding rounds that engaged traditional venture capital firms grabbed most of the headlines: Flatiron Health raised $130 million in May, Doxmity raised $54 million in April, Zenefits raised $66 million in June, Teledoc raised $50 million this week. Look past the big VC firms, though, and you may notice that non-traditional investors—in particular, large health insurance companies—are increasingly participating and investing in the startup…

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Big Data Advancing The Greater Good

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