A framework for coverage decisions for digital health technologies

  • J. W
  • C. T
  • S. G
ISSN: 1098-3015
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Objectives: Digital health solutions are an emerging trend in healthcare delivery, with over $3 Billion dollars being invested in the space in the first three quarters of 2014 alone, surpassing total medical device venture funding and representing 100% YoY growth. Healthcare, technology, and industry stakeholders are collaborating to develop tools that provide near patient monitoring, engagement, and interaction with providers with the expectation that these technologies will improve care and potentially decrease costs. However, little work has been done to develop methods to evaluate digital health solutions for payers and HTA decision-makers. The objective of this study was to determine the framework with which US payers will make coverage decisions for digital health technologies. Methods: In-depth interviews were conducted with 15 US payer and HTA decision-makers to determine preferences for evaluation frameworks for digital health technologies, drivers of value, evidence requirements, and economic impact expectations. Results: Most payers reported that they were currently experimenting with digital health technologies in small populations but were not yet ready to make formal coverage decisions or support widespread adoption of specific technologies. Most payers were optimistic about the promise of digital health solutions, with the greatest expectations for chronic disease management. Skepticism about incremental value and costs led most respondents to desire stringent evaluation criteria and evidence standards, with standard benchmarks of value preferred. Most expected digital health solutions would need to demonstrate decreased costs and improved clinical outcomes. The most commonly desired attributes of digital health technologies are randomized clinical trial results, proven patient compliance, and EHR/EMR integration. Conclusions: Developing standardized evaluation criteria for digital health technologies will drive more consistent coverage outcomes and facilitate faster patient access to novel digital health technologies.




J., W., C., T., & S., G. (2015). A framework for coverage decisions for digital health technologies. Value in Health, 18(3), A48–A49. Retrieved from http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71896073

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