When it comes to healthcare, digital health is the next frontier. The trend has been accelerated through the COVID-19 crisis and governments and citizens are waking up to the advancements and possibilities it brings. Within the next ten years, it will be so prevalent and mainstream across public health services, we won’t remember how we lived without it!
Across Europe, many countries have followed Germany’s example in passing legislation such as the Digital Health Application Act (DiGA), enabling digital apps to form part of recognized treatment programs and therefore be accredited and funded by state insurance. Any digital apps put forward will need to go through the same rigorous regulatory procedures as new vaccines – albeit with digital regulators rather than pharma – with clinical trials sanctioned country by country.
Digital solutions support the macro trend of value-based healthcare, which is defined by being able to effectively measure the success of treatment options for patients versus cost – does a treatment plan produce the best results for the investment made. The still to be tested hope is that with large amounts of data able to be extracted from digital health apps, this assessment can be easily achieved. Digital apps that produce personalized healthcare plans for individuals automatically, that can be managed by patients, should be an extremely cost-effective solution for healthcare systems that are stretched. This hypothesis can only be established through data and careful work with clinicians, which is the vital next step in our journey.
Surprisingly, given their status as digital frontrunners, the Nordics have yet to push digital healthcare legislation through, although they are close. The Council of Nordic Ministers is already tasked to manage this uniformly across the region.
SelfBACK is leading the charge in digital health apps. It is a self-management program for non-specific lower back pain and the current results from high-quality clinical trials we have undertaken are very positive, with SelfBACK currently being implemented in new digital pathways in Denmark, Norway and NHS England.
Lower back pain is the most significant contributor to disability in Europe. Every year, about 1 in 15 people in the European population will consult their general practitioner suffering from it, and it is one of the most common reasons for activity limitation, sick leave, and work disability. Finding treatment programs for those affected is a top priority given the massive personal, social and economic implications it brings.
The reason SelfBACK is such an important tool for back pain management is that it has essentially digitized a vast amount of clinical data, building on decades of research. The app is powered by AI, which means it can match individual profiles with vast knowledge of successful treatment plans for each profile producing evidence-based advice that no human could have the knowledge to deliver.
The next stage in large-scale roll out for digital health apps is understanding how to successfully implement at scale and to monitor if the good effects are maintained. Here, public and private sector organizations must work together and map out processes.
SelfBACK is acting as a pilot for this process and tackling some vital questions that surround delivery such as:
Liability as a licensed product, the app must form part of a treatment plan that is overseen by a medical practitioner. Although there is scope to open the app to the public, the pathways and advice may have to be tweaked to adjust liability from clinical to personal.
Data sharing who owns the data produced and how is this managed securely and in-line with regulations. At SelfBACK, we believe the patient owns their data and this is clear within the application, however, we ask our patients to opt into sharing anonymized data with us because the more data we can use, the better the treatment plans can be personalized for individuals.
Network, stability and scale producing an innovative app with cutting-edge technology is something small digital organizations, like ours, are fantastic at. Bringing it to scale requires the expertise you can find in large global digital organization. Partnerships can be extremely helpful here in managing both innovation and scale.
We are on the cusp of a digital health revolution – there is no doubt. Delivering digital treatments with proven results at low cost must be a focus for worldwide healthcare systems and has powerful implications for reducing healthcare inequality and bringing better outcomes to all. What’s needed now is a huge research effort to begin to prove the hypothesis around digital treatments’ effectiveness and cost benefits.
Focus is required from governments to manage the integration, implementation and outcomes carefully. This starts with legislation, for which a working framework already exists in many countries. After this we must start to pilot apps such as ours, identifying any hurdles there may be and resolving them. Gaining understanding – through research – of effectiveness, cost and any other issues we may encounter such as disenfranchised groups and any digital divide that may impact outcomes, is vital for safe and successful roll-out.
The pandemic has shown us that digital healthcare can bring huge benefits to citizens, let’s keep the momentum going to push the benefits forward.
“SelfBack is a great example of what we can expect to see more of in the future, when we combine big data and AI with user-centered experience design to build the next generation digital health solutions.”
Professor Paul Jarle Mork
Norwegian University of Science and Technology
“We are passionate about partnering with the best and brightest innovators in the tech community. They bring us innovation at speed, and we bring them scale, security and expertise in complex delivery. The combination of these skills are vital to the health sector as it undertakes its digital revolution.”
Health and Life Sciences Industry Lead – Nordics, Atos
“We have only seen the beginning of the digital revolution in healthcare. The potential to improve public health and patient care is enormous. It is important to prioritize research that can help us understand where digital health solutions can be an advantage, for whom, what they should look like, and to study outcomes and cost. Just as in the physical world, one size is not likely to fit all.”
Professor Jan Hartvigsen,
University of Southern Denmark and co-developer of the selfBACK app