Pathways to reimbursement for digital health companies can be elusive. A new report by Research2Guidance reveals the outcome of a survey in which 638 digital healthcare stakeholders provided insight into how digital health solutions can monetize their offerings and which countries are more welcoming to the technology.

Ralf-Gordon Jahns, managing director of Research2Guidance, sat down with MobiHealthNews for an exclusive interview to discuss the company's white paper and how the research report's findings can help digital health providers. 

MobiHealthNews: Who are the digital health stakeholders researchers spoke to for the report?

Ralf-Gordon Jahns: So it's a mix of digital health CEOs, founders of digital health companies, managers within healthcare companies, especially pharma, medtech, [a person] taking care of, and they're responsible for their digital health, either strategies or a single digital health solution. And then we also have a few investors that are overlooking a portfolio of digital health solutions.

Some hospitals, but not a lot – they're not very active in our sample. Yeah, and then some researchers, but the bulk is really digital health company founders, CEOs, and managers from healthcare companies that oversee digital health activities and initiatives within their companies.

MHN: And what are some key takeaways from the report?

Jahns: The key takeaway, I mean, there are obviously many, because the question is very simple – how do you make money in digital health? But then the answers are not that simple. Especially when we look at the current situation of the digital health market, I mean, there's hype, and everybody talks about it.

I just came back from four or five conferences, and everybody was really enthusiastic about digital health and what is all possible. If you stay in those conferences, you're really in a bubble. But then, if you look at the current status, the current status basically says that it's still a marginal market segment today.

So digital health today, in real healthcare, doesn't play a major role. One must admit that. After 10-12 years, it's still a niche. And it's a niche in terms of revenues. It's a niche in terms of funding. Maybe even in funding it's a bit different, but a niche in terms of funding. It's also a niche in terms of usage. 

If you really look at the current situation and then look at the discussions in the bubble, then there's a discrepancy. And it was interesting to see how people are basically shaping their strategy within that very, very difficult market. 

So we asked the question, who is going to pay for all this? What we found interesting is that it doesn't really change. So the hype, yeah you're changing the entire healthcare system with the new digital health tools, but when it comes to who's paying for all this, then it's a very traditional answer. It's a payer. So there's no change.

MHN: So, stakeholders are taking the traditional pathway, but then the report showed that digital health companies have to consider all these nuances within that pathway.

Jahns: That's right. If a digital health company would ask me, "We want to go and get into reimbursement. What should we do?" Then I think country selection is the first question that you have to answer.

So which country do you start? Because if you are building your business model on reimbursement, then it's a national thing. All reimbursement systems, they work differently. We have that in Europe. We have 26 countries, 26 reimbursement systems. So it's not one fits all, and then you really have to prioritize where you put your resources in the end. So that's the first choice you have to make.

And then the survey participants, they also helped, in a way, to answer the question, what is it that you should offer if you selected the country? Then it looks like telehealth. If you have a telehealth solution, then it's more likely that you get into reimbursement, especially after COVID, or RPM [remote patient monitoring]. DTx [digital therapeutics], it's a broader thing. You can summarize basically all digital services under DTx.  

So, I would say there is some hope for digital health in the near future to get reimbursement, but you have to definitely concentrate on a certain list of countries and not try to enter into full Europe or full American countries, for example.

MHN: Another thing the report touched on was the difficulty of provider adoption. What do you see as the most challenging task amongst stakeholders to garner that adoption?

Jahns: I think it's not clear yet for most of the companies how to best do it, but it looks like there's a two-way approach. So, one is approaching the doctors, which is the hardest approach. And we are seeing that digital health companies are creating sales teams going directly to those HCPs. 

In parallel, we have marketing approaches towards patients directly to create this pool from the patient side so that there are some situations when the doctor sits together with the patient, the patient then says, "Oh, by the way, what do you think about this application? Would that be a good addition to our dialogue or to our treatment?"

MHN: What do you hope the digital healthcare realm gets from this report?

Jahns: It's basically a status check where, when people are reading it, they get maybe a confirmation about their own thinking. It's more a benchmarking of their own strategies, country selections, business model selection. So I think it's always good to see what others or what the majority thinks and then to potentially challenge your own thinking. So that's one thing.  

And then it might give some direction when you're completely off or you have a completely different view or a different business model. You might learn from it and get a new direction.