- Oct 6, 2021
- 6 min read

Value-based healthcare and the digital health revolution.

Updated: Oct 7, 2021

What is Value-based healthcare?

Value-based health care (VBHC) is a new perspective on how to set up the health care system. Foremost, it is an evidence-based concept that deviates from the other organizational types because it has a definite ability to measure its impacts [1]. Second, it focuses on a team-oriented perspective, where several physicians work together to solve health problems in a collective manner, freeing up time and resources in the long-run due to less repeat patient visits [2]. Last, there is a greater incentive for the physicians as their time is allocated more towards taking care of their patients rather than in bureaucracies and paperwork [1].

Under VBHC, the focus is placed solely on the patient and their successful health outcomes.

Under VBHC, the focus is placed solely on the patient and their successful health outcomes, not number of physician visits, hospitalizations, procedures, and tests [3]. With the focus being on the quality of patient care, the aim is to reduce the time spent under primary care and minimize the development of chronic diseases [2]. Essentially, value-based care empowers patients and enables caregivers to provide better care at a lower cost, resulting in benefits for all parties: patients, providers, payers, suppliers and society [2].

What is digital health?

Digital health indicates the use and development of digital technologies for health-related treatments. This main term can be branched into more defined topics of electronic health (eHealth), mobile health (mHealth) and emerging areas such as the use of artificial intelligence (AI) and big data [4]. As the world population ages and chronic diseases become more prevalent, there is an ever-growing burden on healthcare systems. The WHO asserts, “universal health coverage cannot be achieved without the support of eHealth” [4], emphasizing the need for adaptation on how care is delivered.

Universal health coverage cannot be achieved without the support of eHealth. (WHO)

Digital health tools meet these demands as they allow expansion outside of traditional care and treatment settings. By bringing efficiency and accessibility, the development of new digital health solutions is crucial to facilitating prevention, early diagnosis of life-threatening diseases, and management of both acute and chronic conditions [5]. Current tools available include online appointment scheduling, online bill payments, telehealth, and more [6]. For example, AI has advanced to the stage where it can facilitate treatment by providing more reliable and lower-cost services in fields such as pain management or physical therapy. Similarly, AI can use the greater availability of health data to identify and prevent emerging health issues, such as musculoskeletal (MSK) conditions.

Upwards of 9 million people undergo physical therapy (PT) in the US alone.

Each year, an upwards of 9 million people undergo physical therapy (PT) in the US alone [7]. Over 90 percent of the rehabilitation sessions will take place in home-based settings, away from the guidance and expertise of the therapist. This period of time allows for harmful deviations from the prescribed treatment, leading to prolonged recovery times and increased health care costs. However, it is possible to remove these unintended alterations through the adoption of digital tools. Computer-vision, a subset of AI, is proving to be a key digital tool within healthcare for facilitating sustainable recoveries within PT and MSK conditions. By adopting mHealth solutions and integrating computer-vision to track and analyse patient movements and enforce correct alignment, clinics can use the aggregated data to map the patient’s recovery process and create highly tailored rehabilitation plans. Research has also shown that patients are in overwhelming favour of using mHealth devices, reporting that patients believe mHealth will encourage them to make better health decisions and take charge of their healthcare [8].

Creating digital services and platforms to provide more information in less time, regardless of location, ensures that all patients receive the same standard of care [3]. When combined with software, better and richer datasets allow health system managers to identify, plan, and allocate resources more efficiently [4]. This shift will fuel the ability to incorporate value-based health care because patients can receive more personalized, coordinated care along with better and faster treatment at a lower cost [4].

This shift will fuel the ability to incorporate value-based health care because patients can receive more personalized, coordinated care along with better and faster treatment at a lower cost.

In addition to the added benefits for individual patients and physicians, the potential benefits to the economy from the adoption of digital health are significant as well. One 2013 study estimated that mHealth technology could result in $400 billion worth of cost savings over a 5-year period in high-income countries [4]. This is in part due to increased productivity as patients receive faster and more accurate diagnoses and treatment.

How can digitization in healthcare help with the implementation of VBHC?

The introduction of digitalization efforts within health is a steppingstone to a VBHC system and many countries have already started to recognize the importance of national digital health strategies. According to a 2015 survey conducted by the WHO, 58 percent of the 125 member countries have defined national digital health strategies and corresponding plans to implement them [4]. The global pandemic has further intensified the strains on current healthcare systems, putting more pressure on governments to make changes.

58 percent of the 125 member countries have defined national digital health strategies and corresponding plans to implement them. (WHO)

With healthcare expenditure amassing to USD 8 trillion globally in 2020, of which USD 2 trillion is in Europe and USD 3.5 trillion in the US [9] (nearly 18 percent of the Gross Domestic Product [1]), there is an opportunity for a reduction in spending through digital solutions and highlighting the value lying in patient outcomes. The focus then lies on how to best facilitate the digital health technology innovations [4].

Healthcare expenditure amassing to USD 8 trillion globally in 2020.

Reimbursement plays a key role in the adoption and overall success of new digital health solutions, which means decisions need to come in a top-down manner. These changes can be seen, for example, in Germany where its Digital act permits reimbursement by the statutory health insurances for new digital solutions, resulting in these new solutions becoming more broadly accessible [10]. Furthermore, as part of the act, the government is investing EUR 200 million (USD 234 million) per year in the innovation fund until 2024; the hope is to integrate new technology quicker into German healthcare [11].

As part of the Digital act in Germany, the government is investing EUR 200 million (USD 234 million) per year in the innovation fund until 2024.

The UK also recognizes the potential of digital health solutions and the impact it has on the ability to provide higher quality patient care. The NHS's digital division, NHSX, is investing more than GBP one billion (USD 1.37 billion) in their digital health care transformation [12]. The NHSX states “automating certain aspects of NHS administrative tasks could substantially increase capacity in our healthcare system by releasing the clinical workforce to focus on their most valuable task at hand – patient care,” [13] aligning with a systemic shift towards a VBHC.

The NHS's digital division, NHSX, is investing more than GBP one billion (USD 1.37 billion) in their digital health care transformation.

In early 2020, the FDA in the US published the Digital Health Innovation Action Plan, outlining their efforts that all Americans have timely access to high-quality, safe, and effective digital health products. This highlights how digital technology has been driving a revolution in health care [14]. Part of the new policies by regulatory bodies also addresses how to treat data generated by new digital technologies, which is an important issue to consider in aiding innovation.

It is not only western countries that are adopting digital healthcare reforms; the Global Digital Health Index observes that Malaysia, the Philippines, and Jordan are well advanced in this area, [4] with Malaysia in particular is highly praised for its integrated digital health strategy, which has been ongoing for already 15 years [4]. As another example, mid 2020 South Korea announced their Digital New Deal to help boost the digital economy, growth, and innovation. Part of this deal is to support data, network, and AI ecosystems and to foster research and development within digital therapeutics (DTx) for non-face-to-face industries [15]. Guidelines were created with the intention to help speed up the commercialization of key technologies in the non-contact era [16].

Digital health holds transformational potential for health care around the world and many digital health products are already proven, available, and adaptable to all countries, yet the connected global framework to realize the full potential of digital health is only at an infant stage [4]. The digital health policies enacted by governments play a key part in the long-term systemic change and how care is delivered. The advancement within digital health supports value-based healthcare by making health information, care, diagnosis, and treatment more accessible and by giving patients more autonomy over the management of their personal health and well-being. Furthermore, these new policies create a huge potential for companies within that space to develop solutions which make long-lasting, meaningful impacts. As more therapies become remote and treatment is supported using digital platforms, there is a greater opportunity to gather data and deepen the research and understanding of medical issues. In the end, adopting digital services and forms of treatment will free-up resources for practitioners, lower costs to society, and most importantly enhance the quality of care for patients.

Do you also see the value in creating new digital solutions?

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