The Value of Digital Health Companies

I literally have no idea what “digital” health means.  It is just one of those words that companies and pontificators use to signify that something is cool or innovative or better yet, disruptive.  It appears to maybe have something to do with telecommunications, data, analytics, who knows what else.  ( I would distinguish actual telemedicine, where real care is being delivered, just not face-to-face.)  But one thing for sure is that there is a lot of hype and little value, except for the investors who puff up these ideas and pass a company on to the greater fool.  A Health Affairs study looks at whether digital health companies are doing much for really sick, complex patients.   (HA Article)   According to the article, 296 digital health firms received $4.2 billion in funding in 2016 and consumers are expected to spend $49 billion on digital health solutions by 2020.  All with basically zero evidence of benefit.  The authors examine the companies which have received the most funding and attempt to see if they were adding value where it is needed most, for expensive cases and care.  They looked for peer-reviewed studies of these companies products.  (uh, good luck with that)  They focused on the top 20 companies in terms of funding, which received an average total of $67.5 million and were relatively large in terms of number of employees and had greater longevity, because presumably these firms had greater opportunity and resources to conduct trials.  Analytics, big data, artificial intelligence and biosensors, including wearables were common descriptors of these companies’ products.  There was a total of 156 studies, only 104 of which were indexed in PubMed.  These were generally low-quality studies, few participants, not published in well-known journals, lack of methodological rigor, etc.  Only 15% of the studies had clinical effectiveness as an outcome.  Only 28% of studies targeted a high-burden or high-risk population, with mental health being the most common condition researched.  Most of the studies used healthy volunteers as subjects.  Even among these populations there was no outcome related to disease prevention.  No research looked at cost or access outcomes.  This survey is consistent with an earlier one looking at “mHealth” apps, which similarly found a limited number of low-quality studies and little beneficial evidence.   As I said, lot of hype, little demonstration of any real value in improving patient health or health care.