Library: Digital Health Engagement Institute – Return on engagement, and why it matters

August 2022 featured report:

If you hadn’t heard of the Digital Health Engagement Institute before, you can be forgiven because it only came into being in August 2021.

Its stated ambition in this white paper is to become “an established institution of excellence in research among the fields of digital health engagement and wellbeing platforms”. This paper looks at the role of digital health engagement platforms within the life and health insurance industry.

Developed nations’ healthcare systems are creaking under the strain of increased longevity. Those platforms are likely to play a considerable role in supporting the future health of these nations.

The global survey was conducted between November 2021 and February 2022 and received more than 1,200 participants. The aim was to discuss perceived value in deploying digital health engagement (DHE) platforms, concerns around data protection and privacy, ethical considerations in the use of DHE platforms, metrics used to measure engagement, and how engagement is evaluated.

The participants came from all around the world – the Americas, Europe, Asia, Africa and the Middle East.

Some highlights

Before we look at some of the key themes, here are some highlights. Four in every five (80%) of the respondents believe that DHE platforms will add value for industry players that are transitioning into insurance as a service (IaaS) models.

More than two thirds (67%) either have a platform or will launch one in the next 12 months, while 34% of respondents have no plans to implement one.

More than six out of 10 (61%) believe that providing a DHE alongside traditional insurance will reinforce their existing customer relationships. Almost as many (65%) indicated the risk of inherent bias in artificial intelligence (AI) systems would be of concern when evaluating potential DHEs.

There are two key deal breakers identified by the respondents that would stop integration of a platform with their own systems. Those are inadequate firewalls for data privacy and security, and a lack of regulatory approval.

No consensus on definition

Digital Health is a catch all term because there is no consensus as to what constitutes the term. In the past, digital solutions were not networked, but today’s proliferation and efficiency of smartphones effectively makes everything networked, and mobile.

The old health model that revolves around the hospital is no longer fit for purpose. Nor is it economically sustainable, say the authors of this report.

They’re calling for new models of proactive care that place digital technologies at the centre. A proactive approach is thought to potentially reduce healthcare expenditure by anything between 10% and 15%.

Four out of five (80%) of the papers examined for this report found that a proactive approach generally improved patient outcome.

Despite the fact the world has experienced two years of dealing with a highly communicable and potentially deadly virus with the COVID-19 pandemic, non communicable diseases (NCDs) are now the biggest risks to individuals from the use of tobacco, sedentary lifestyle, alcohol abuse, and unhealthy diets.

Reducing the impact of NCDs focuses on controlling unhealthy lifestyle choices, and there’s evidence that a product or service that uses technology to promote behavioural change can help influence different health behaviours that will contribute to these risk factors, say the authors.

Despite the prevalence of NCDs, people are generally improving in health. However, the cost comes in increased spending on gross domestic product. This has doubled in the past few decades alone, reaching US$8.5 trillion in 2019, or 9.8% of global GDP, up from 8.5% in the year 2000.

This growth is mostly concentrated in richer nations.

Despite the continued impact of COVID-19, NCDs are now responsible for 45% of all deaths worldwide or 80% of the top 10 causes of death (see figure five).

Ensuring healthy lives and promoting wellbeing for all ages is the third of the United Nations Sustainable Development Goals. Any nation that has signed up to these has committed to reduce premature mortality from NCDs by a third by 2030 – just over seven years away – through prevention, treatment and through improved mental health and wellbeing.

Better tech pushes up prices

The authors highlight the paradox of medical technology, which tends to push up prices when it is introduced. In the US alone, healthcare economists estimate that between 40% and 50% of annual cost increases and healthcare expenditure can be traced to new technologies – or the intensified use of older ones.

While technology should lower prices and improve clinical outcomes, the paradox lies in the fact that because of its efficacy, demand for its application increases.

It is hoped that digital health may not have such an impact because rather than developing new treatments, digital health is more likely to streamline the more notoriously inefficient healthcare delivery systems.

Ethically, the biggest concern was that interfaces are not user friendly, which could lead to consumers who are not health or tech literate being disadvantaged.

The next greatest concern was worries about the quality of data being collected, or a lack of standardisation or regulation.

Privacy and security were less of a concern than smartphones, and wearable medical devices could be hacked, leading to errors in data collection and analysis.

The lack of smartphones wasn’t considered to be a problem for many respondents, who are more concerned that digital tools which engage directly with insurers may undermine relationships between physicians and patients.

Given these platforms are going to be driven by artificial intelligence and machine learning, two thirds of respondents were concerned that there may be inherent bias in data analysis.

Measurement is important

Perhaps surprisingly, given the claims that digital health platforms will improve the health of populations, the most important metrics continue to be participation rates, number of monthly active users, and retention rates rather than necessarily the improved health outcome or reductions of users versus non users.

The reason for measuring engagement was also considerably less important. It ranked fifth, with half the rating of the previous response on client retention.

When asked about measuring engagement, highest on the list was to ensure regular data collection, followed by to measure success as a KPI.

Need for tailored engagement is clearly evidenced, as well as providing the right tools for a target audience through customer segmentation.

However, the factors considered most likely to undermine engagement were consumers not achieving their goals through the platform, getting frustrated, and becoming disengaged.

The other was a poor quality onboarding process that fails to make the features of the platform clear. Naturally, data privacy and security were major issues as was the backing of any regulatory body. After these came the technology issues around integrating with an insurance ecosystem.

The need for DHE is self evident

The authors of this report say there’s a growing body of evidence that supports the contribution of DHE platforms to both make global health systems more financially sustainable, while improving outcomes for patients.

Lifestyle diseases will continue to increase the financial burden on individuals and states. This requires a shift towards a value for money approach that focuses on prevention and wellbeing through behavioural science combined with the power of mobile technology.

For more, see the full report.

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