Tag Archives: VBC

SPI Digital Health: The Hanging Questions of Babylon

Last week, Babylon Health announced that it had secured a $34.5M interim loan to support ongoing operations as it embarks on a wide-ranging restructuring and re-capitalisation programme. At the same time, the company said it would come back into private ownership next month.  

The news comes as the UK-based provider juggles widening net losses, mounting debts and rock-bottom shares, despite burgeoning revenues from its US value-based care (VBC) activities. 

The bridging loan and delisting plan are the latest in a stream of efforts by Babylon Health to slash losses and restructure debts with the goal of becoming profitable. Last year the company, which offers virtual, in-person and post-care services in 15 countries, said it aimed to cut annual costs by $100M. 

Babylon Health says the interim loan, which is part of a framework agreement with VC firm AlbaCore Capital, will buy it time to implement the restructuring and re-capitalisation programme. The company says the loan will strengthen its balance sheet and provide additional liquidity to support the privatisation plan. Under this plan, Babylon Health’s core operating subsidiaries will be sold to a new entity capitalised by AlbaCore and other investors.  

The Signify View 

With losses widening, Babylon Health has little option but to take these latest steps in its battle for survival. The company has, over the last two years, tried several different approaches to stem the tide of losses and, in its words, ‘provide sufficient capital for Babylon’s funding requirements through profitability.’  

It sold consumer health engagement firm Higi at the end of the last quarter, having acquired it just months previously. The company has also signalled its intention to sell Meritage Medical Network, which has around 700 specialist and primary care physicians and which generates $400M in annual revenues. Babylon also received an $80M private placement 12 months ago (as part of its 2021 IPO) to support the business. It has also made substantial job cuts. 

But Babylon’s main problem remains: the soaring costs it faces to provide care services to customers (it provided 5.1M consultations in 2021). Between Q1 2022 and Q1 2023 losses widened to $63.2M from $29.1M. For every dollar Babylon earns, it loses money, a situation also faced by telehealth giant Amwell (which we detail in this Insight).  

Babylon’s total Q1 2023 revenues were a healthy $311.1M ($266.4M in Q1 2022), but the faster its revenues grow, the faster its losses are mounting. Achieving scale is coming at a big cost. 

State-Side Shift 

This double-edged sword has its roots in a 2021 decision by Babylon Health to shift its strategic focus. 

Formed in 2013 in London, the firm cut its teeth with the NHS in the UK. But its presence in that market was unpopular with the predominantly small primary care GPs practices in the country. They were wary of what they saw as a large, VC-backed provider coming in and poaching their young and healthy (ie cheaper to care for) customers, and leaving them with more complex, older and costlier patients. 

Realising their UK business was never going to properly scale in that environment, Babylon Health pivoted to the US value-based care (VBC) market in 2021. The decision was quickly vindicated, and this market now accounts more than 90% of the firm’s total quarterly revenues. For example, of its total $289M Q4 2022 revenues, it earned $268M from providing services directly to patients, or by outsourcing services to third-party providers, under Medicaid, Medicare and commercial insurance VBC contracts.  

While the rapid uptick in revenues in impressive in and of itself, growth is easy if you’re willing to make a loss to achieve it. Babylon Health’s success in the US VBC market is therefore both a blessing and a curse, especially when it was assumed that by scaling, profits would materialise. 

The SPAC Curse 

This is not the only strategic curse to have struck Babylon. At around the same time as it was pivoting to VBC in the US, the company decided to list on the US market to cash in on surging demand for its virtual care offerings at the height of COVID. It wasn’t the only vendor to jump on the IPO bandwagon at the time – SOC Telemed (via a so-called Special Purpose Acquisition Company (SPAC) listing) and Amwell (via a traditional IPO) did likewise – believing the hype generated by massively elevated interest in telehealth. History now shows that telehealth companies were overvalued and short-sighted. They listed, the pandemic receded, and virtual care demand growth decelerated. Share prices collapsed, and never recovered. 

In Babylon’s case, its listing via a SPAC merger was, in its CEO’s words, a ‘disaster’. A SPAC listing effectively means the target company (e g Babylon) merges with a ‘blank cheque’ company (the SPAC) set up solely to raise capital through an IPO. SPAC listings were trendy in 2020 and 2021. VC firms and investment houses, in particular, found them an attractive vehicle to raise money from the public and then deliver much-needed liquidity to their merger target companies. 

And so, during the SPAC boom Babylon Health’s merger with SPAC Alkuri Capital was approved. The deal promised $575M from the listing for Babylon, but things quickly went downhill. Uniquely with this type of listing, even if a merger has been approved by a SPAC’s shareholders, they are able to cash in their shareholdings at any time, including pre-merger.  

Unfortunately for Babylon, 90% of Alkuri Capital’s shareholders opted to do just that shortly before the deal went through. Babylon was left with just $275M, a significant shortfall on the original, and its shares fell off a cliff. This then set in motion the chain of events we described earlier in this Insight as Babylon scrambled to recover from the blow. 

The SPAC boom was short-lived, and Babylon Health was one of several ‘victims’ of it. The 10% of Alkuri’s investors who chose to keep their money in the business could also be excused for feeling like victims in this too. As Babylon goes private again next month, much of their money will vanish with the deal.   

The Long, Lonely Road to Profitability 

While its SPAC experience has been serious for Babylon, the company has since fought hard to restructure its debts, raise funds and cut costs to keep heads above water. It has succeeded in the sense that it is still a going concern, and it has an admirable VBC model in the US. 

But the path to profitability remains a painful one, and Babylon Health will need deeper costs cuts. But how?  

The company’s losses indicate that it is unable to deliver care within the budget of the VBC contracts under which it operates. To do so, it needs to be more proactive and predictive in managing population health; for example, better managing those with chronic conditions, reducing hospital admissions/readmissions, knowing who to screen and ensuring all patients undergo an annual wellness visit.  

It also requires investment in better resource care management teams to manage more expensive patients, in better IT to fully understand its populations and facilitate risk stratification, and in population analytics so Babylon knows where to prioritise resource. A long-term investment approach, where losses can be absorbed until financial savings are realised, is needed.  

The company has already shed assets that would have helped it offer that more proactive care. Higi was a VBC-geared provider offering BMI and other health screening services in US retail outlets.  

Double-Edged Sword 

There is no doubt that Babylon Health can be a serious disruptor in the US VBC vendor market. But its biggest enemy right now is its own success in quickly growing its customer base, which has led to growing losses.  

The bridging loan and the re-privatisation plan buys time, and in a business bleeding money and accumulating debt, time is arguably its most precious commodity right now. 

SPI Digital Health: Philips Virtual Care Management: More Than a Remote Chance of Success

As the patient care pathway moves steadily away from the hospital, Philips launched its new Virtual Care Management platform in March. The company says the platform will offer a ‘comprehensive’ approach to telehealth for patients, providers and payers, improve patient engagement and health outcomes, lower the cost of care, and make workflows more efficient. 

The Signify View 

Philips Virtual Care Management brings onto a single platform the company’s legacy remote patient monitoring (RPM) business as well as the chronic disease management capabilities of BioTel Care, the RPM arm of BioTelemetry (BioTel). Philips acquired BioTel, a powerhouse in the cardiac monitoring market, in 2021. 

The launch of Virtual Care Management in the US market is the latest move by Philips to deepen its roots in the burgeoning home care market in the country. The BioTel acquisition provided Philips with the technology to advance its own RPM and chronic care management business, where it had been a tier-2 vendor. 

BioTel Care accounted for less than 10% of BioTel’s total revenues when Philips made the acquisition, but it brings a number of strategic and competitive advantages to the table. Two years on from the acquisition, Virtual Care Management is, therefore, a powerful prospect. 

On Point 

Philips claims that the Virtual Care Management platform will reduce pressure on hospital staff and reduce the cost of care by managing chronic disease more efficiently. The platform will leverage BioTel Care technology targeting condition-specific protocols including diabetes, hypertension, heart disease, chronic kidney disease and chronic obstructive pulmonary disease (COPD), as well as gestational programmes for diabetes and hypertension.  

Generating data and actionable insights, Virtual Care Management goes beyond the ‘traditional’ capabilities of RPM solutions, says Philips. 

Many Rivers to Cross 

While that may be true, the success of RPM solutions and their vendors is typically determined by the reimbursement models that support them. In most geographies RPM does not have as clear a reimbursement structure as the US, and to date Philips’ Virtual Care Management platform has been launched exclusively in that market. 

The Virtual Care Management platform targets the clinical chronic care management programmes that have been eligible for RPM reimbursement for a number of years now. However, Philips’ ability to really disrupt the US chronic care management market is far from certain: actual reimbursement volumes remain stubbornly low, covering just a few hundred thousand lives being managed to date. No vendor has yet been able to scale successfully in this environment, and is also an extremely competitive space. Philips will have its work cut out here too with the Virtual Care Management platform. 

Home Truths 

Where the platform could fare better is in the emerging ‘hospital-to-home’ market (as opposed to the ‘hospital-at-home’ market). Hospital-to-home relates to supporting the transition of patients from acute to post-acute settings using virtual care. Specifically, Philips is not targeting the ‘hospital-athome’ market, the segment that relates to supporting patients at home via the use of technology, that otherwise would still require support in an inpatient setting. This is currently reimbursed in the US by the Acute Hospital Care at Home (AHCaH) waiver programme.  

Philips does not refer to this in relation to the press material accompanying Virtual Care Management, but it ties in closely with the goals of reducing the costs of care (i e Value Based Care (VBC) and alleviating pressure on hospital staff. 

This, understandably, is an interesting area for Philips and the Virtual Care Management platform aligns nicely with hospital VBC contracts and other fee-for-service reimbursement codes.  

Unlike in RPM where reimbursement is a one-off payment for a service provided (for example, every time a vendor ships a device, or monitors a patient, it gets paid), hospital-to-home VBC reimbursement takes into account a range of criteria, for example rewarding a hospital for preventing patient readmission. It is a lump-sum payment for which the vendor takes a cut, and which covers the hospital’s cost of providing care and then (hopefully) leaving some profit. It is a win-win situation for both parties. 

Contrast that to hospital-at-home, which Philips is not specifically targeting. This strategy is sound: currently around 200 US hospitals are licensed to provide hospital-at-home services under the Acute Hospital Care at Home (AHCaH) waiver programme, but the actual number of people whose managed care has been billed for this is very low – just a few thousand at most. We wrote in this recent Insight that the hospital-at-home market had yet to take off, but that has not deterred provider Atrium Health and Best Buy Health, a unit of the world’s largest speciality consumer electronics retailer, taking the plunge as partners. 

But, given the need to educate patients and enable technology in their homes, hospital-at-home is more complex than hospital-to-home. Uncertainty around longer-term reimbursement has also deterred many providers from going down this route. The current AHCaH waiver programme was extended by the CMS until May 2025, but the scheme is a hangover from COVID emergency measures. Uncertainty over what happens after May 2025 continues to act as a brake on this market, and yet like RPM, it is a very competitive area dominated by start-ups. Philips will do well to steer clear from it, at least in the short-term. 

Feeling the Love 

As it rolls out Virtual Care Management, Philips might draw inspiration from the success of BioTel Heart, a leader in the mobile cardiac telemetry market and whose wearable ECG devices have been very successful. But it is a more rounded service – Philips provides not only the device but also the data monitoring services and report generation capabilities that takes pressure off hospitals and ambulatory care providers. It follows, then, that in terms of its Virtual Care Management platform, Philips will not be a pure chronic care device supplier per se. Elements of the legacy Biotel Heart service can be used in conjunction with the Virtual Care Management platform and services to provide patient pathways that allow for technology to be used to support patients remotely. This can be from diagnosis to on-going monitoring (particularly in relation to heart rhythm disorders). It will take readings remotely, physicians (and algorithms) will pore over and analyse the data, and prepare a report that is then sent to the hospital with a diagnosis. This is a tried and trusted formula in ambulatory cardiology in the US, and would translate well in chronic care management. In essence, Virtual Care Management therefore makes money from the service, not the device. 

Fighting Chance 

It is against this backdrop that vendors are now playing in the chronic care management market. It is an intensely competitive space where success is defined as much by the quality of solution as the reimbursement structures in place for each solution. These factors pose significant challenges for vendors and limit their ability to scale. 

And yet, if any vendor can make a success of this, it is Philips. The company already has an impressive, well-rounded installed base in the US hospital monitoring and remote diagnosis markets, which provides a good link into the process to then move patients out of the hospital and to the home.  

As such, Virtual Care Management gives Philips a fighting chance to drive success in the hospital-to-home market, and really push back against the crowd of start-ups vying for a piece of the action.

SPI Digital Health: As Patient Activation Remains a VBC Provider Pain Point, is Cisco’s CPaaS the Remedy?

The value-based care (VBC) IT ecosystem continues to evolve and mature. But patient activation and engagement remain the ‘missing links’ on the ‘last mile’ of the VBC chain. Hundreds of vendors are seeking to close this gap, but most solutions fail to find the sweet spot of giving care managers the tactical intelligence to guide their care strategies, while enabling populations to take greater responsibility for their health. 

At last week’s HIMSS2023 show in Chicago, Cisco demonstrated its enterprise communications platform (CPaaS). Having enjoyed some success in the NHS in the UK with it, Cisco now has high hopes for CPaaS in the US, by far the world’s most developed VBC market. 

The Signify View 

A complete PHM/VBC IT solution enables healthcare providers to aggregate all the data from different sources (e g EHRs, claims, social determinants of health) and develop risk stratification, clinical decision support and analytics tools so providers know exactly who their most expensive, highest priority cohorts are (as illustrated below).  

In recent years, IT vendors have developed and delivered an almost complete ecosystem of data aggregation, health insights and care co-ordination tools that are highly valued and used by ACOs, IDNs and other organisations where success under VBC reimbursement is paramount. However, among care management IT buyers patient activation and engagement remains a key challenge in executing on the workflows that these insight tools inform. The tools provided to support this are mostly falling short.  

Complete Integrated Care/PHM Solution

This area remains something of a ‘blind spot’ for providers and vendors. Leaning on the old adage ‘if you build it, they will come’, some providers have discovered (the hard way) that it is not enough to just build a portal or booking management tool and assume patients have the time, inclination or even the basic IT skills to register and log in to access their personal health information, book appointments and view content or care plans. Some providers acknowledge the struggle with their portals’ ‘digital front door’, where it might take several clicks for a visitor to find the information they need. 

Some healthcare providers also still rely on their EHRs to activate and engage patients. But data pulled into EHRs is not broad, particularly around social determinants of health and payer data that would offer an additional layer of information on how to handle different patients. The fact that some providers use multiple EHRs exacerbates the challenge. 

Indeed, all EHR and PHM vendors have a tool that claims to support patient activation and engagement, and EHR vendor marketplaces are awash with software bolt-ons. But most of these solutions fail to address some of the process and IT hurdles providers face in delivering VBC, and the hurdles patients face when interacting with these solutions. Multi-channel bulk communication (e g via SMS or WhatsApp) that triggers calls to action to a patient (for example sending a link to make an appointment) is available on many EHR platforms, and is one step up from asking a patient to log in to a portal or relying entirely on old fashioned calling for patient outreach, but it is still very manual. Providers recognise that good communication and education to change patient behaviour are key enablers in VBC.   

Solutions, therefore, that offer a more strategic and tactical approach to patient activation and engagement are valuable. More than ever, patients need more accurate patient activation and engagement tools with built-in intelligence that can identify care gaps. They also need solutions that improve the patient experience, are secure, are interoperable with different platforms used for patient identification, use software that can find unstructured data more easily and have AI/ML capabilities to identify rising risk patients through predictive analytics. 

Competitive, but no Game Changer 

By all accounts, CPaaS is a highly competitive solution that performs at the same levels of other leading products in this space. Cisco is very well-resourced with a pedigree in US healthcare via Webex and IMImobile (the UK company bought by Cisco in 2021), and the fact that CPaaS is geared towards VBC is another positive. But what would enable CPaaS to really stand out would be more focus on game changing ‘tactical’ intelligence around patient activation and engagement for care management teams. 

Cisco also faces stiff competition from other, more established vendors in the US VBC market. PHM vendors like Innovaccer, Inovalon and 1upHealth (who we wrote about last week in this Insight) – previously focused on data aggregation and workflow tools helping prioritise patients, develop analytics and offer best practice recommendations on how to manage patients with different conditions – are now focusing on patient activation and engagement, with some success. 

Some have achieved success by acquiring specialist technology, especially in the last couple of years. Recognising the opportunities in patient activation, Healthcare Catalyst, a major non-EHR vendor, bought Twistle in mid-2021.  

Leveraging more patient behavioural data to bring more intelligence into CPaaS, thereby allowing providers to gain a greater understanding on the best channels and best times for patient outreach and activation, would certainly help the product stand out in this competitive market. Further data on patient support networks and how these can be leveraged to support adherence to care plans, appointment booking and medication adherence, are also tools that buyers would value to enable a more tactical approach to patient activation. 

Big tech companies also enjoy obvious advantages in this market. The likes of Google and Amazon have a wealth of patient behavioural data without needing to rely on an EHR or clinical data. If anyone can manipulate human behaviour to follow care plans etc, it is big tech. Provided patient privacy concerns can be overcome, they could be a very disruptive element in this market. 

Different Routes to Market 

Given the above, and the fact that Cisco is launching CPaaS into a cauldron of a US market, it must choose its route to market carefully. Aside from selling direct to hospitals, what other options exist for Cisco? 

It is noteworthy that the company has a decent position in the US virtual care software market. It competes with telehealth specialists Amwell and Teladoc, video conferencing generalists like (Microsoft) Teams and Zoom and some EHR vendors that have their own virtual care platforms. Selling CPaaS as a provider-patient bridge to an established virtual care customer base could be a viable option. 

Another option would be to partner with a leading VBC IT vendor. As mentioned earlier, many of these vendors have focused on developing data aggregation and care management workflow/analytics tools, to the detriment of good patient activation tools. This is now a focus for many, and Cisco could have a part to play here by partnering with these vendors. Many will have the behavioural data needed to inform more tactical outreach, and the combination of this with CPaaS would offer the potential to really address the needs of provider care management teams.   

Lack of Definition 

Patient activation and engagement is the final piece of the VBC ecosystem jigsaw and is a current focus of technology investment. As IDNs and ACOs seek to arm themselves with the full suite of VBC solutions and close any final remaining care gaps, the patient activation and engagement tools market is ever more fiercely competitive.  

Launching CPaaS into the US now is good timing on Cisco’s part, but it is just one of any number of solutions and product differentiation will be its biggest challenge. How Cisco develops the product to address the points raised above will ultimately determine just how disruptive it can be.  

SPI Digital Health: Signify Research’s Top Five Predictions for DMEA2023

For many years the annual DMEA meeting in Berlin was very much a German affair; however, more recently the show has become Europe’s leading pan-continent digital health IT conference and exhibition. Whilst the agenda at DMEA2023, which will take place from 25 to 27 April, will still have a German bias, issues discussed, and products showcased, increasingly impact healthcare IT development across Europe. Here’s our take on the leading themes.   

KHZG: Funding Translating into Contracts  

Two years after coming into force, Germany’s Hospital Futures Act (KHZG) is slowly delivering on its goals to digitalise the nation’s hospital network. However, it is taking time for government funding to trickle down to IT vendors.  

Two vendors that Signify Research has historically forecast would benefit considerably from KHZG were CompuGroup Medical (CGM) and Dedalus. Whilst both vendors’ business in related markets grew in 2022 (CGM’s Hospital Information Systems group grew 7% and Dedalus’ DACH business is estimated to have grown ‘in the teens’), much more is to come. 

To an extent the fund allocation process has resulted in the bulk of the impact being back-loaded towards the end of the funding period (2021-2024). First, hospitals had to apply for funding by pillar. After being allocated funding, IT tendering began, with IT contract awards coming last. This impact was first felt in 2022, with more substantial effects being seen in 2023.  

Another reason why the impact has been slower for larger generalist hospital IT vendors is that initial activity was focused on KHZG’s ‘easier’ elements. Funding has been allocated by pillar, across 11 pillars (detailed below), with the initial focus on pillars where overheads, in terms of implementation, were lower. For example, the below shows that Digital Care and Treatment Documentation (mainly comprising dictation solutions) was the most funded pillar, followed by Patient Portals. More complex and costly areas in terms of implementation, such as Emergency Room IT and Process Digitalisation, ranked lower. Expect more to come in terms of more complex pillars over the latter half of the funding period.  

Source: November 2022 German hospital digital maturity assessment co-ordinated by Digital Radar (DR)

Many IT contracts to service this funding will now move towards contract allocation. Expect IT vendors at DMEA to position themselves as go-to-vendors for specific pillars, with a handful, such as CGM and Dedalus, positioning themselves as best equipped to support a multitude of pillars.    

Record European Government Investment in Digital Health IT  

Germany is not alone in allocating significant new public funding for healthcare IT projects in recent years. For many EU countries the post-COVID EU Recovery and Resilience programme was a key vehicle for revitalising and increasing the digital maturity of healthcare IT in general, with large amounts of public money allocated to projects. In specific countries new, well-funded projects were announced during COVID (some linked to the EU programme, some not) to upscale the sophistication of IT in European hospitals and elsewhere in the healthcare ecosystem. 

Examples include Gara Sanità Digitale (Italy), Ma Santé 2022 (France) and Le programme HOP’EN (France). DMEA has historically been DACH-focused, but in recent years is becoming Europe’s largest cross-continent digital health show. Vendors positioning themselves as able to deliver the IT required to secure contracts in countries where funding has been ramped up, will be a key feature of the show.   

Vendor Consolidation – Local Champions to Regional Heavyweights 

More than 500 vendors, from international heavyweights to start-ups, will exhibit at DMEA, a sign of a healthy, competitive ecosystem of IT and device companies addressing the European healthcare technology market. However, the backdrop to this is the recent emergence of several pan-European heavyweights, specifically in relation to hospital IT.  

CGM has, for many years, been relatively large, serving many European (and global) geographies; however, 2021 saw it breach the €1Bn threshold for the first time, and €1.1B in 2022. It has grown partly organically but also via ambitious acquisitions, most recently of Medicus, VISUS, New Line and eMDs. Its 2020 acquisition of several product lines from Cerner (now Oracle Cerner) also significantly boosted its hospital business.    

Dedalus has also rapidly expanded its business and footprint. As well as being the DACH region’s dominant vendor, it also enjoys tier 1 status in Italy, France and the UK, often in both inpatient and outpatient/primary care markets. This has largely been achieved via acquisitions.  

Many of Europe’s once single-country-focused vendors, such as TietoEVRY, Mesalvo (the merger of iSolutions and Meona), Cegedim and Cambio have attempted to scale internationally, sometimes organically, but more often via M&A. Further, the two dominant US inpatient health IT vendors, Oracle Cerner and Epic, now also hold a substantial presence across Europe.  

A key debating point at DMEA is whether Europe is heading in the same direction as North America, where most large digital health IT contracts (particularly inpatient EHR/HIS) are mopped up by a small number of incumbent vendors with the scale and resources to address increasingly demanding tender requirements.  

Signify Research’s view is that this will not happen. There will be increased consolidation, benefitting the likes of CGM, Dedalus and Epic, but at a slow pace. However, the specific geographic nuances of each country, the fact that European EHR and Clinician Information System (CIS) markets are still relatively independent, and the entrenched position of many leading local vendors (think Maincare (France), SystemC (the UK), Ines (Switzerland), Engineering (Italy)) will result in a healthy, and relatively fragmented, competitive ecosystem for the foreseeable future. The plethora of vendors that have already benefited from KHZG funding adds weight to this argument.  

New Models of Care Leveraging Integrated Data 

“New perspectives on health data use and analysis”, one of the key themes on the DMEA congress agenda, underlines the drive to develop connected healthcare ecosystems in many European countries. This has been a focus of German healthcare IT investment over recent years in the form of Gematik Telematikinfrastruktur (TI), a programme to connect the multitude of IT systems used across the healthcare network.  

However, whilst successful IT-wise, the programme has not ultimately changed how healthcare is organised and provided across Germany. There are examples in other European countries where data connection/integration programmes were a component of a broader reorganisation of healthcare towards a more integrated, holistic, predictive (as opposed to reactive) system. These include the creation of Integrated Care Systems in the UK, and Territorial Professional Health Communities (CPTS) and GHTs in France. To some extent these programmes mirrored US Value-Based Care/ACO programmes, although all have been slow to deliver on their promise.  

A key theme at DMEA will be how to accelerate the integrated care agenda across Europe, which models offer the best opportunity to tackle the increasing burden of healthcare provision across the region and, specifically, how this is implemented in DMEA’s home territories of Germany, Austria and Switzerland.   

Scaling Digital Therapeutics and Remote Patient Monitoring 

In November 2019 the German Bundesministerium für Gesundheit (Federal Ministry for Health) launched, with great fanfare, the Digital Healthcare Act (DVG).  Core to this was €200M($240M) annual funding to 2024 for Digitalen Gesundheitsanwendungen (DiGA) apps. These were digital apps prescribed by healthcare providers to support the management of a range of medical conditions from depression, panic attacks, obesity, anxiety, and osteoarthritis. Solutions could range from patient-focused decision support software, apps to manage medication dosage or solutions to monitor and collect data on patients related to therapy or condition. 

The launch was initially plagued by challenges, from delays in testing and authorising solutions on the official DiGa app register, to a lack of engagement from physicians in prescribing solutions to patients. In subsequent years, there has been some progress, but the programme is still far from delivering on the original fanfare.   

The DiGa experience is representative of many digital therapeutics and remote patient monitoring (RPM) programmes across the continent. For many countries, including Germany, making the step from small, regional trials tied to specific pilot programmes to scaled solutions addressing large sections of the population managing chronic conditions and mental illness remains an unmet challenge. Patients managing chronic conditions and mental illnesses are some of the most expensive cohorts in terms of healthcare provision. Grasping the opportunity that digital health offers to limit these costs must be prioritised.   

Europe has, largely, still not passed the latency inflection point in the product life cycle for both digital therapeutics and RPM, unlike the US which is now clearly growing owing to clearer funding mechanisms and a more holistic spending viewpoint via VBC. Much discussion at DMEA will relate to what is needed to move the dial on this topic across Europe.   

DMEA’s coverage will be broad, and these themes represent what we believe will the leading topics. A range of other issues will be addressed, from cloud migration, virtual care post-COVID, to the increasing influence of big tech in Europe’s health IT markets. In general Europe has lagged the US in healthcare digitisation. DMEA will be a bellwether as to whether the post-COVID influx of IT funding is narrowing this gap.  

SPI Digital Health: HIMSS23: Signify Research’s Top Five Show Predictions

‘Health that Connects + Tech that Cares’ are the two overarching themes of this year’s HIMSS Global Health Conference and Exhibition, being held in Chicago from 17 to 21 April.

These subject areas feel apt for an industry at a post-COVID watershed. Now IT is being leveraged not in pandemic crisis response, but to address some of its long-term ramifications:  relieving pressure (and burnout) on healthcare staff; reducing costs of healthcare provision as budgets shrink; extracting greater value from vast amounts of data generated by the industry (Health that Connects); and streamlining workflows. This is all set against the backdrop of the steady shift towards value-based care (VBC), in the US.

Here, Signify Research details five talking points that will define the show for delegates and participants at HIMSS2023.