There's an app for that, but nobody's using it: Insights on improving patient access and adherence to digital therapeutics in Germany

Abstract

Background Mobile health applications and their subset digital therapeutics—defined as evidence-based software interventions to prevent, manage, or treat a medical condition—offer great potential to improve patient care. However, such solutions often struggle to reach widespread adoption. Objective This study seeks to explore healthcare stakeholders’ roles and potential for fostering patient access and adherence to evidence-based digital therapeutics and thereby improve health outcomes from the perspective of digital therapeutics developers and distributors. Methods Semi-structured qualitative and semiquantitative interviews were conducted with 19 experts from developers and distributors of digital therapeutics in Germany to discuss their perceived relevance of different healthcare stakeholders and strategies in promoting patient access and adherence to digital therapeutics. Results Healthcare professionals were found to have the greatest potential to promote both access and patient adherence to digital therapeutics, followed by health insurers, pharmaceutical companies, and patients themselves. In terms of patient access, healthcare professionals have potential due to their ability to prescribe digital therapeutics. Other stakeholders’ potential stems from their capacity to influence healthcare professionals prescription decision. In terms of patient adherence, only healthcare professionals are of high relevance by onboarding patients and monitoring digital therapeutics use. Most healthcare stakeholders currently do not fully leverage their potential. Further educating healthcare professionals and simplifying processes for them, empowering patients to seek treatment with digital therapeutics, and designing digital therapeutics’ product features for better adherence can help improve patient access and adherence. Conclusions Established healthcare stakeholders and digital therapeutics developers both need to take action to improve patient access and adherence to digital therapeutics. Several macro-level changes can support these efforts, including broader information dissemination, improved financial incentives, simplified prescription and activation processes, and a wider adoption of blended care and pay-for-performance payment models.

Empowerment for the Digital Transformation: Results of a Structured Blended-Learning On-the-Job Training for Practicing Physicians in Germany

“…Diverse variables of the future workplace are still undefined, and the difference between a high-tech future and a currently under-digitized workplace is still high [ 60 ]. However, our results show that practicing physicians need to be addressed by education as well as by politics and industry as the important stakeholders and gatekeepers that they are in the health care system [ 9 , 10 , 11 , 12 , 13 , 36 ]. There is a high demand on catching up in order to educate and train the user of digital technologies not only in university but also in professional contexts.…”

“…Physicians play a central role in patient care. They have to advise patients and provide them with modern medical care [ 10 , 11 , 12 , 13 ]. However, at present, physicians do not feel well-prepared for the challenges of the digital transformation and express a high demand for structured continuing training [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

“…Instead, we should focus on practicing doctors as well as on every other group in the health care system and offer them structured guidance. Empowerment for doctors is highly recommended and inevitable, as they are the gatekeepers for the use of digital technologies both for patients and for medical students as well as for informed and critical decisions about therapies, diagnostics, technologies, software, and processes [ 10 , 11 , 12 , 13 , 28 , 36 ].…”

Welche Potenziale und Mehrwerte bieten DiGA für die hausärztliche Versorgung? – Ergebnisse einer Befragung von Hausärzt*innen in Deutschland

“…Die Konzeption des Befragungsinstruments (siehe Onlinezusatzmaterial) erfolgte unter Rückgriff auf mehrere quantitative und qualitative Vorstudien der Autoren, die sich unter verschiedenen Fokussen mit den Einsatzmöglichkeiten von Gesundheits-Apps im haus- und fachärztlichen Setting befasst haben [ 19 , 20 , 22 ], sowie einer Literaturrecherche (u. a. [ 6 – 8 , 12 , 15 , 17 , 18 , 21 , 23 , 24 ]). Es besteht aus 27 Fragen mit 4 inhaltlichen Schwerpunkten: Bekanntheit und generelle Beurteilung des DiGA-Konzepts, Einstellungen und wahrgenommene Nutzungspotenziale von DiGA für die Versorgung, Voraussetzungen einer DiGA-Anwendung im Praxiskontext, Anwendungsbereitschaft und -erfahrung in Bezug auf DiGA.…”

Digitale Gesundheitsanwendungen (DiGA) in der Primärversorgung – Erfahrungen und Beobachtungen von Hausärzt*innen hinsichtlich der Anwendung von DiGA

“…Zum Ferner wünschen sich die Befragten ein breites Angebot an CME-zertifizierten, professionellen Fort-und Weiterbildungen, die Hausärzt*innen die Möglichkeiten und Rahmenbedingungen einer Integration von DiGA ins Versorgungsgeschehen näher bringen [13,14]. Aus Sicht der Befragten wäre zudem von großer Bedeutung, dass Krankenkassen Patient*innen in Bezug auf eine DiGA-Nutzung konsequent und proaktiv beraten und Ärzt*innen diese Aufgabe nicht allein überlassen bleibt.…”