Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

Abstract

Background Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products. Objective In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals. Methods A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis. Results We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure. Conclusions The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system’s readiness for digital therapeutics.

Maximizing the value of patient and public involvement in the digital health co-design process: A qualitative descriptive study with design leaders and patient-public partners

“…Co-design should continue throughout the lifecycle of the product to ensure that the product is adapted to meet users’ changing needs and sustained within health systems in flux. A recent review by van Kessel et al mapped the factors affecting the widespread uptake of digital health innovations in health systems [ 44 ]. Their review suggests that some of the frequently reported factors affecting uptake include developing sustainable funding options, robust digital infrastructure, novel professional guidelines and protocols, ongoing digital health training, interoperability across the health system, and tailoring to account for different needs across populations and disease stages [ 44 ].…”

“…A recent review by van Kessel et al mapped the factors affecting the widespread uptake of digital health innovations in health systems [ 44 ]. Their review suggests that some of the frequently reported factors affecting uptake include developing sustainable funding options, robust digital infrastructure, novel professional guidelines and protocols, ongoing digital health training, interoperability across the health system, and tailoring to account for different needs across populations and disease stages [ 44 ]. The results of our paper corroborate the findings of van Kessel et al, and suggest that the value of co-design would be diminished if patient-public insights are not used to foster the viability of digital health innovation.…”

An exploration of facilitators and barriers to patient navigator core functions with breast cancer patients: Implications for the development of a human-centered mHealth app

“…As supported by the literature [ 30 , 31 , 34 ], an introductory video and language that is understandable across all health literacy levels can enhance familiarity with technology and user engagement in a prospective mHealth app. mHealth apps provide a direct communication pathway to the exchange of information [ 34 ] and the interoperability of mHealth apps in clinical workflows may improve care delivery [ 53 ].…”

“…Understanding the sociotechnical aspects of these challenges in existing technologies and PN workflows [ 27 , 28 ] from the perspectives of BC patients, PNs, and oncology care providers (OCPs) is needed. The human-centered design (HCD) framework [ 29 ], which emphasizes understanding people and their needs, engaging stakeholders early on and throughout the design process and designing a solution for their needs, can provide insights into these complex care challenges from patient and provider perspectives and offer design solutions to respond to these needs [ [30] , [31] , [32] ].…”

“…Engaging BC patients, OCPs, and PNs throughout the mHealth app design and development process is needed to identify and address real-world needs and priorities [ 46 ] to optimize healthcare delivery for BC patients at the health system level [ 4 , 30 ]. Drawing upon the HCD framework [ 31 ] in mHealth development, the present study sought to elicit PN stakeholder perspectives on the daily activities, workflows, and processes to identify currently unmet needs of the existing technology and services within their practice settings.…”