Peterson Health Technology Institute (PHTI)’s Post

PHTI is filling a critical evidence gap in digital health evaluations with its assessment of digital diabetes management tools. Our executive director Caroline Pearson discussed key findings and the path forward for payers, providers, and innovators. Watch the webinar recording:  #DigitalHealth #DiabetesManagement #HealthcareInnovation #HealthTech

In real world use, I don't think anyone anticipated that these types of solutions would work for all users and generate a specific ROI due to lower health emergencies. Type 2 diabetes is hard. Behavior change is hard. Life gets messy and complicated even with the best of intentions and support. This report looks for signals indicating how payers could use these solutions effectively. We're reporting on the findings soon OPEN MINDS Circle Be ready! Andrea Mander, MAS-PHM thoughts?

I've been looking forward to the reports from Peterson Health Technology Institute (PHTI), and this report does not disappoint! Whether you agree or disagree with the findings, buyers should look at their performance guarantees. Peterson Health Technology Institute (PHTI) recommends that buyers "Refocus performance guarantees on patients with the highest HbA1c — As discussed above, people with higher starting HbA1c who are newly starting insulin are likely to experience greater benefits from the use of these technologies. Populations that have high HbA1c are also more likely to be low-income and disproportionately Black and Hispanic. While some contracts with digital solutions include performance guarantees, they are often not focused on specific subpopulations. Purchasers should define meaningful clinical and economic impact targets that emphasize success in these important subpopulations who may be more likely to benefit from the solution."

Well that is surprising in the not good way.

A very informative post was written by Erin Brodwin about the newly published report from Peterson Health Technology Institute (PHTI) regarding the effectiveness of Digital Diabetes Management Tools. Although the headline-grabbing summary is that these tools "do not deliver meaningful clinical benefits, and they increase healthcare spending relative to usual care", I believe there are some additional compelling points made later in the report that developers of these platforms need to strongly consider. 1. A strong, collaborative relationship is needed between the patient and provider to effectively manage chronic conditions. The developers of these platforms need to ensure they design their solutions so they are complementary to patient care and integrate within providers' clinical workflows. 2. Providers are seeking, and will continue to seek, outcome-based contracting arrangements with performance guarantees as they begin reevaluating their digital health strategies. This comports with what I've heard from healthcare leaders. That is the provider/patient relationship is key to driving the adoption of these tools. If providers see little value in the use of these platforms (i.e., clinical and economic value), they are unlikely to integrate them into their clinical practices and recommend them to their patients. Accordingly, patients trust their healthcare providers and are more likely to adopt and compliantly use digital health tools their providers recommend and which their providers use to manage patients' chronic conditions.

most digital solutions in healthcare suck they miss the #1 point ... engagement just like all AI or LLM's need is "attention" all we need in healthcare is "engagement" but how ???? easy ... build what patients actually want ... not what you want them to want!

Super interesting to see the conclusions of this analysis on digital health tech solutions for diabetes.

Not a great outcome for the manufacturers of these digital tools, but I think PHTI's process itself is a step in the right direction for raising the bar on data and evidence generation to demonstrate value to patients. #HTA #Value #Evidence #digitalhealth

Danielle Richards thanks for sharing this. I think it's notable that for all three devices analyzed, economic savings were associated with whether or not the device produced clinically meaningful improvement in diabetes control. That is a message that clinical effectiveness drives value in many cases. However, I have 2 issues with this analysis: 1. there's no sensitivity analysis; in the limitations they note that the results are dependent on their assumptions, but they don't explore how robust their results are when those assumptions vary, and 2. what would be helpful would be a deeper dive into subgroups of patients for whom the devices DO produce clinically meaningful results - do those patients produce economic savings? If so, then we should be exploring HOW to use the devices and WHO should be using them if we want to reduce costs! Effective use of technology is often strategic and requires a deeper understanding of the care pathway and flow of value!!

These are the kinds of data that need to be reported out and shared broadly. Kudos to the Peterson Health Technology Institute (PHTI) for doing this great work. Unfortunately for digital health companies, the findings are not so rosy. Couple of summary thoughts/quotes: 1. The interventions don't really work that well: "...the evidence rarely reported improvement that exceeded commonly-used thresholds for meaningful clinical benefit. Further, evidence suggests that such small benefit will reduce over time." 2. Despite significant disparities in diabetes outcomes by race/ethnicity and income among others, these interventions did not address health equity: "...the studies reviewed do not show compelling evidence that these solutions are preferentially addressing health disparities." 3. And, they increase healthcare costs overall: ...After accounting for the average price of these products, these solutions increase net healthcare spending for purchasers." My recommendation for digital health companies (and their investors) is to be more diligent about evidence generation, especially for tools that are directly focused on improving health outcomes. Also, health outcomes cannot be significantly improved without addressing health equity so tackle those opportunities head on. #digitalhealth #healthequity #diabetes