Assessing Digital Health Solutions
It’s not rocket science…it’s about the basics
Sanjiv Luthra, EVP Employer Health
The new rage in employer benefit offerings
Digital health tools are the new rage in employer benefit offerings. Not only are they being touted as cost-effective vehicles for helping employees be more engaged in their health, they are also being marketed as the solution for controlling employer costs.
According to the 2020 Mercer Health on Demand survey, two-thirds of US employers are looking to invest more in digital health over the next five years. How workers react to and adopt these solutions, however, will depend on their design and effectiveness and how employers position them.
In our view, success depends on providing trusted meaningful solutions that are all about the employee. Digital Health Assistants are one example of digital health solutions; click here to read our previous blog on Digital Health Assistants.
Top ten assessment considerations
To help employers assess and prioritize these solutions and determine which ones should be in their portfolio, we offer the following ten considerations:
- Target population alignment
A critical first step in assessing any solution is aligning the health profile of your employee and dependent population with the focus of the digital health tool.
Employees of a Fortune 100 employer we are working with averaged ten scripts per employee per year; however, only 4 out of 10 employees had routine provider interactions. Our digital solution, therefore, emphasizes different features based on the employee targeted. The content, services and call-to-action for employees on active medications for example, are very different than the digital interactions with employees needing provider interactions.
2. Value clarification
While related, the ability to deliver value to employees is different from delivering value to employers. Our suggestion is to focus on solutions that are all about delivering value to employees; if employees don’t use and engage with the tool, employers are clearly not going to see value.
Employees need to understand how value is accruing to them. This can be done by demonstrating results in both financial value (show me the money) and in non-financial value (e.g., show me less effort, better care or better health). Participating in a program that uses a wearable device for tracking blood pressure automatically is valuable only if the employee believes in managing vitals for his condition, it makes financial sense and doesn’t require undue effort.
3. Stamp of approval
According to Mercer’s 2020 Health on Demand survey, 48% of workers are more to somewhat more open to considering digital health solutions promoted or sponsored by their employer.
Adoption rates, however, in our analysis are much lower compared to consideration rates and are more likely going to be in single digit ranges. What influences these rates is the performance of the solutions on the considerations outlined here. Additionally, provider stamps of approval are a very strong influencer on actual adoption rates.
4. Usage expectations
While results obviously vary from person to person, it’s important to have a sense of potential employee (and dependent) usage of a digital health tool. How often would they use it? For how long? And in what situations?
In our experience, initial adherence to digital programs for participating individuals can easily be in the 90% to 95% range. It is not unusual, however, to see anywhere from a third to half of the initial users falling off and ending up with adherence of 50% or less after 6 months of participation. What is needed at that point are, therefore, new employees and dependents entering the program.
5. Simple and understandable
Digital tools need to be simple and understandable for the users.
Content needs to be in plain simple language, not in medical and provider terms. Additionally, why do we need 3+ pages of legal disclaimers (do we actually think users read these?). Why can’t we use language that people understand (or for that matter grandmothers and 12-year-olds) — what ever happened to the days of simple English — take 2 aspirins and call me in the morning?
6. They just work
Digital tools need to follow the mantra that Apple has mastered — open the box and it just works.
Users looking to integrate data from wearable devices and Electronic Medical Record (EMR) systems with digital health solutions (via Apple Health, for example), should be able to just do that. Users not looking for all this technology should be able to do simple manual data entry. Ensuring that digital solutions handle both scenarios seamlessly is important for broad adoption. Just like Turbo Tax, users should be able to import financial data (from their banks) if they want or enter it by hand; both experiences need to just work — and easily.
Any value impact of digital health tools, whether financial or non-financial, needs to be meaningful.
An example of meaningful financial impact is our work with a client improving engagement of individuals taking chronic medications. Paying cash for these medications (instead of using the employer benefit) produces $4 in savings per month per employee or $150-$200 per year for anyone on 3–4 medications — a meaningful amount that enables greater adoption. Similar considerations for meaningful impact also need to be given to non-financial value elements.
Digital solutions need to fit the individual. They also need to operate differently depending on the health needs of different individuals.
Bob and Mary are both on blood pressure medications — that’s where the similarities end. Bob historically has not taken medications and has limited knowledge about hypertension. Mary, on the other hand, is well versed with the disease having lived with it for over 10 years. She uses digital tools primarily to check drug-drug interactions of new medications. Bob, however, wants and receives regular content (including support for managing his condition). Same tool…varying services…driven by different needs…and yet a great fit for each individual.
Digital health tools need to be expandable and grow with the individual.
Jim, a healthy 25-year old, wants to stay on top of getting annual physicals. He has no health issues, doesn’t take meds and is not a utilizer of healthcare resources. All he needs is a simple tool. If and when he takes meds, he would value education. It certainly would be nice if the same digital health solution could evolve as his needs change. Jim is a great candidate for digital tools that are expandable — in this case, familiarity does not breed contempt.
10. Managing interactions — but controlled by the individual
Digital health solutions need to give individuals the ability to control what they receive, how and when. They need to allow individuals the ability to enter, record and synchronize their health information the way they want to. And they need to provide them the ability to control what they share, with whom and when.
Whether it is one-way passive content, 2-way active engagement or something in the middle, digital solutions need to accommodate the spectrum. They also need to allow multiple modes of communications (e.g. emails, text, in-app). Interaction methods and frequency need to come pre-configured, but individuals need to be able to change them as needed. People need to be in control of what they receive and what they share…after all, it’s their data and it’s their health.
Getting employees more engaged in their health is fundamental to managing healthcare costs. Digital solutions do exactly that — they help in managing chronic conditions. They help in managing health before it becomes a chronic condition. And they help in managing infrequent healthcare utilization.
As an employer, you need to bring more horses to the water — and get them to drink. After all, your horses need to be derby winners. And with engaging digital health solutions, they certainly can be.