Digital health innovation consultant at Bax and Company, David Chadima, explores the challenges of using digital solutions for the prevention of chronic diseases. 

Chronic diseases are a tremendous burden to patients and the healthcare system alike. In Europe, they account for 86% of all deaths. The UK is no exception, as the World Health Organisation (WHO) estimated chronic diseases account for 85% of total deaths in the UK more than a decade ago.

Individuals with chronic diseases experience a lower quality of life, which often leads to other chronic conditions such as decreased mental health and overall well-being.

Another part of this burden are the related healthcare costs involved. In 2019, the UK spent £50.5billion on related long-term chronic conditions next to roughly 700billion euros spent at the European level, making chronic diseases one of the major socio-economic challenges of our time. The prevention of chronic diseases is thus an increasingly popular topic as it also offers new opportunities in the age of digitalisation.

Digitalisation has already begun to revolutionise every aspect of the healthcare system. Over the past decade, healthcare has seen a paradigm shift with the rise of digital health tools to prevent the onset of diseases as well as to detect and treat diseases at an early stage.

Preventative measures play a key role in reducing healthcare costs and are thus receiving increasingly more attention due to the possibilities that they offer. However, prevention also breaks down and threatens the classical paradigm of the care model, where a patient is in need of treatment, to a patient-centric model where the focus is on health and disease prevention; therefore, posing a number of challenges.

This article takes a novel look at what these challenges are and why, despite these challenges, digital tools for the prevention of chronic diseases have a high potential for wide use. These tools are already gaining support as they are in-line with the popular concept of value-based healthcare. This concept is praised by the well-known economist Michael E. Porter who strives for patient-centred healthcare reform and quality-based valuation care models, which are in favour of prevention.

Challenge #1: The complex stakeholder landscape in healthcare

Key catalysts of this paradigm shift are small and medium-sized enterprises (SMEs), which also are often core innovators in healthcare. SMEs come from the private sector and, unlike most healthcare stakeholders who are focused on day-to-day care delivery, SMEs have a financial incentive to innovate new solutions that improve the existing system.

Nevertheless, SMEs do not have an easy task as they stand at the interface with the public healthcare sector, suggesting that they must navigate through the complex care model as well as the stakeholder landscape.

With a diverse array of stakeholders in healthcare, it is challenging for SMEs to propose innovations that meet everyone’s needs. When designing a business model for a digital tool for the prevention of chronic diseases, providers of care, patients, insurance companies and policymakers should all be considered.

This topic is most relevant for the latter two groups, as it can significantly contribute to cost reduction while also increasing the general well-being of the population. This suggests that both insurers and policymakers can benefit from the anticipated reduction of medical expenses linked to such chronic conditions in the population.

Implementing these digital tools on scale would also aid the process of sustaining high-quality care for the growing and ageing population, by allocating the costs saved by prevention to help cover the demands caused by these demographic trends.

Challenge #2: Incentivising care providers within this new model

Another major challenge is the financial reimbursement of these digital tools for the prevention of chronic diseases, which is crucial to achieving successful implementation and adoption.

Care providers are not incentivised to contribute to systemic change as they must focus on delivering care to the extent supported by the current healthcare framework. For example, physicians get reimbursed for the number of patient visits or for treatments provided, which directly contradicts the aim of prevention.

Therefore, new steps need to be taken towards redesigning the care model in a way that care providers can be motivated to support the use of digital tools for the prevention of chronic diseases.

As the first step, the benefits of these tools need to be demonstrated to policymakers and insurance companies based on data evidence, posing another challenge for SMEs.

Challenge #3: Obtaining the evidence

Digital health SMEs often struggle to validate the effectiveness of the tools they develop and thus fail to prove the added value of their solution efficiently.

Due to their small size and early stage of company development, they generally do not have the connections to access medical settings or approach healthcare providers.

Moreover, SMEs often lack the financial resources needed to invest in validation, which hinders the process of obtaining supportive data as evidence of the effectiveness of their proposed solutions.

Future predictions suggest that digital tools for the prevention of chronic diseases will have a highly significant impact.

Especially when looking at healthcare systems overwhelmed by growing and ageing populations, digital solutions offer new possibilities that may form part of the answer. However, the barriers discussed above need to be addressed on the systemic level to allow for these emerging digital tools in preventing chronic diseases to be implemented on scale.

New and modern views on healthcare, represented by frameworks such as value-based healthcare, are becoming an increasingly popular alternative as they place the general well-being of each individual at the centre of care. This is a promising sign for all the SMEs focusing on digital tools used for prevention and thus for new innovations to reach the market. Above all, this shift will hopefully help to decrease the prevalence of chronic diseases in society.