Digital Health is known for both fast-moving innovation and insufficient adoption. So, could the speed of innovation be part of the problem? Let’s re-open the digital health adoption conversation from this angle. Let me explain why.

I decided to engage in digital health, then known as eHealth, when PubMed was launched. Access to that incredible digital library opened world of possibilities for healthcare. I was painfully aware of the issues that were keeping patients from benefiting from the quality of care that could be theirs. And I decided to make the leap into the expanding world of health innovators, because I loved what I saw: that patients were participating as peers, that many professionals knew that information had to be better shared at the point of care, that informatics and the Internet, as they were referred to then, could bring significant progress.

We were about to live through waves of promises, and very fortunately I did not know how hard the way forward would be. The potential we yearned for was that

→universal, complete electronic medical records would make healthcare safer and more satisfying for professionals …

→ the World Wide Web and PubMed, would reduce the friction in the sharing of medical information amongst academia, clinicians, patients

→ the expansion of telemedicine with the acceleration of connectivity and late mobile apps, thanks to smartphones, would enable healthcare to come to the patient...

→ connected objects would collect and facilitate the sharing of relevant, actionable health data.

→ virtual reality applications would be used to diminish anxiety and pain in medical procedures, for phobias, and more

Given the potential, we thought that these innovations would scale the way other aspects of medicine have– pharmaceuticals, imagery, surgical techniques.

While we often speak of the impediments of regulatory challenges, insufficient ROI, lack of knowledge or training, could there be another cause? Is the acceleration or multiplication of innovation impeding adoption in digital health? And if so, what can we do about that?

First, why is Digital Health important?

With its purpose of improving access, quality and efficiency in medical services and making truly universal preventive health possible, digital health could be absolutely transformative. And as all of these tools come to be supported by multiple AI-driven applications,  the promise to empower professionals and patients with real-time insights and personalized solutions that drive better health outcomes, is only extended. And so the obvious objective would be for as many patients as possible to benefit from these advances. Yet, unfortunately, there are no digital health categories whose satisfactory use is as ubiquitous as let’s say proton pump inhibitors.

If we look at some of the digital health companies that have made it into the scale-up phase, interesting examples could include:

While these products demonstrate the value of digital health, the healthtech industry at large grapples with not only the time and cost of regulatory approval and applying for reimbursement, but as well the paradox of insufficient distribution.

In 2021, CB Insights recognized 150 promising private digital health companies, noting that 90% were new entrants compared to the previous year.

Is the barrier of entry for the creation of start-ups and new solutions too low?  Or would making it harder to get started lead us to  lose brilliant new ideas? 

Perplexing Change in Digital Health

Innovation drives progress in digital health, but its relentless pace can overwhelm healthcare systems and stakeholders. A hospital department might invest in wearable devices or telehealth equipment, only to find newer technologies or updated clinical guidelines emerging shortly afterward. This frequent change adds complexity to decision-making and discourages long-term planning, particularly in resource-constrained environments. If you’re a hospital department or clinic director, do you know if you’re technology set-up is worldclass? While organizations like HIMSS and ORCA can provide evaluation tools, are these tools being used massively?

Healthcare’s inherent complexity demands a cautious approach to adopting new technologies. When innovation accelerates, there are unwanted consequences

• Fragmentation Competing apps, devices, and platforms create a fragmented ecosystem. A wearable device might not sync with a hospital’s electronic health records (EHR) system, reducing its clinical utility. This fragmentation disrupts workflows and discourages adoption.
• Regulatory Lag Regulatory bodies often struggle to keep pace. Programs like Germany’s DiGA and the FDA’s Digital Health Pre-Certification Program aim to streamline the approval of high-quality solutions. However, delays for tools can deter companies and providers from embracing new technologies.
• User Fatigue Healthcare providers already face demanding workflows, and the regular introduction of new digital health tools, often without sufficient training adds to their burden.

Missed Opportunities for Standardization in Digital Health
Could rapid innovation be sidelining the establishment of universal standards for interoperability, security, and usability. And healthcare organizations will hesitate to invest in technologies that face unknown obsolescence.

Balancing Innovation and Adoption To unlock greater potential and distribution of digital health, can we try to achieve a better balance between innovation and stability?

Further Prioritizing Interoperability Can more means be invested in creating systems that communicate seamlessly. Initiatives like FHIR (Fast Healthcare Interoperability Resources) provide a foundation for standardizing data exchange, ensuring compatibility across platforms. The French government’s Mon Espace Santé (My Health Space) also ensures  compatibility amongst pre-validated applications.

Streamlining Regulatory Pathways
Programs like the FDA Digital Health Pre-Certification Program and DiGA in Germany need to be evaluated. DiGA’s structured approach allows digital therapeutics to be prescribed by physicians and reimbursed by insurance; while maintaining safety and efficacy. But do the majority of physicians adopt and pursue these applications ? These are important questions.

Focusing on User-Centered Design Technologies that integrate into existing workflows with minimal disruption are more likely to gain acceptance. Developers must prioritize intuitive designs that meet the needs of both providers and patients. This seems like a no-brainer and yet is extremely difficult to execute. But is it worth it to pursue the product with which the user will struggle?

Thinking Long-Term Benefits Companies could emphasize sustained benefits over frequent introduction of new features. Doctolib’s success lies in its consistent value proposition—simplifying patient-provider interactions and improving the physician’s administrative efficiency with peer-tested tools.

Encouraging Collaboration amongst Complementary Companies Fragmentation of the offering hinders buyers. By fostering partnerships and alignment on shared goals, digital health companies, in concert, could perhaps drive greater adoption.

Better Manage Digital Health Innovation with the help of AI ?
Digital health is poised to revolutionize care delivery, thanks to AI. But, can we harness AI so that it first enhances interoperability, automates regulatory approval, creatives more intuitive user interfaces, better predicts market needs, and prioritizes long-term value?

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Is there an approach that could open the door to greater success for a selection of digital health tools? I would submit that we urgently need to build “best practice digital health packages“. The vision is that professional working groups, augmented by AI could establish per discipline or patient pathway the “essential digital health components” with mention of specific categories of apps, how-to instructions, training programs. We need to focus not just on making new things, but on making them work well together, generating measurable results, and lasting.

If not, the risk is that AI, the tremendous accelerator that it is, will further contribute to the vicious circle of acceleration, destabilization of decision-makers, and low adoption rates per innovation.

What do you think? Let’s discuss!

Denise Silber