This article is one of two that reviews our findings related to the barriers of digital therapeutics (DTx) adoption. In our first article, we focused on lack of awareness. This second article centers on the remaining barriers we observed.
Inability of patients to engage with technology and DTx: Myth or reality?
Many healthcare professionals (HCPs) shared the concern that older patients may struggle with smartphones or other advanced technology. However, we also heard from DTx innovators and some early adopter clinicians that they have had positive experiences with DTx across their patient base.
While there are certainly cases where this barrier can be true (e.g., older patients with cognitive impairment) there is emerging evidence that supports older patients having positive experiences when engaging with digital healthcare solutions. According to a recent report published by Mobiquity, over 65% of older patients in the U.K. feel very comfortable using remote monitoring and wearable technology. In more broad terms, technology engagement in older populations has dramatically increased over the last two decades with more people over 65 using computers than ever. The notion that older people are not able to—or not interested in—using DTx may be driven by inherent biases and perpetuated by the small subgroup of patients who do not want to engage.
Education can help dispel the myth at a general level, however companies must still be ready to provide specific evidence that their product is accessible. This starts with careful human-centric design enabling a high-quality patient and HCP user experience. It also requires ensuring that this experience is further enhanced through appropriate educational materials and support programs. Once deployed, companies should be prepared to actively generate evidence (in appropriately representative populations) that engagement and outcomes can be achieved regardless of age or other social determinants of health.
The main technological challenges raised by physicians related to electronic health record (EHR) integration and data protection. In particular, the additional burden of introducing new platforms and utilizing new data sources were seen as key barriers to adoption. HCPs mentioned friction with accessing and utilizing data generated via DTx solutions. Compared to the other markets in our study, Swedish physicians considered the technological barrier to be lower, perhaps reflecting the more advanced nature of the Swedish digital health infrastructure and the country’s successful history of digitizing healthcare. This suggests that companies with digital health solutions dependent on more complex tech integrations or involving greater data privacy issues should think carefully about their market sequencing when taking their products to market, either prioritizing more mature markets or otherwise ensuring they are prepared to invest in the necessary partnerships to advance health IT in less mature ecosystems. From an optimistic perspective, pioneer companies willing to make these investments could realize competitive first-mover advantages as a result of the practical experience and relationships they would develop along the journey.
Strategies to drive adoption
The barriers to HCP adoption of DTx do not seem insurmountable. Our research has highlighted a variety of strategies that companies can employ to raise awareness, generate evidence of equitable user outcomes and ensure technological integration.
Which market sequence and commercialization strategies to adopt will depend on the nature of the product at hand, as well as the broader business case behind a company’s investment in digital health and efforts to shape the digital health adoption curve.
The barriers to broad digital therapeutics survey was internally commissioned and took place in Oct. 2021. The survey consisted of qualitative interviews conducted with 29 GPs and psychiatrists from 4 countries (Belgium: 6, Germany: 8, Sweden: 8, U.K.: 7).
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