I’ve always believed that you get what you pay for, and digital health is no exception. Despite the promises of digital transformation to make healthcare services better, safer and more efficient, analogue healthcare services – visits to the doctor/hospital, therapies and drugs – have proved remarkably resilient.
The reason seems to me quite obvious: analogue services are paid and reimbursed by European publicly-funded healthcare systems. Digital services such as mHealth apps, personal health management, remote monitoring, diagnostic algorithms etc. are often not.
That is the premise of the paper “Proposed Guiding Principles for Reimbursement of Digital Health Products and Solutions” that the European Commission’s eHealth Stakeholder Group (eHSG) just released. The eHSG was set up in 2015 as a Commission expert group contributing to the development and implementation of eHealth policy at the EU level, and to provide input on the Commission’s eHealth-related activities.
The paper was developed by a small band of stakeholders including industry, providers, healthcare professionals and pharmacists in a series of workshops and cooperative exchanges over the better part of two years, before it was reviewed and validated by the full eHSG in 2018/19. Although I personally joined the effort only after September when I became part of MedTech Europe’s team, I’m pleased to say that my colleagues and members at MedTech Europe have contributed quite substantially to this important work.
The paper contains recommendations seeking to give guidance to healthcare authorities about principles and criteria to consider when making funding decisions about digital health. They call for specific criteria, funding, guidelines for evidence generation, and specific instruments for assessing digital health.
I detect a growing awareness that digital health reimbursement is a major issue holding back deployment. Sebastian Gaiser, chair of the MedTech Europe Digital Health Committee, observes:
“European funding and reimbursement systems need to be adjusted to digital health. There may be a need for new dedicated reimbursement frameworks for evidence-based digital health solutions. Only a few health systems have started developing specific assessment criteria for this category. Industry, providers, physicians, payers and governments need to do more if we want digital to transform our health care systems and health care delivery.”
Just a few weeks ago, on 15 February 2019, an alliance of German associations in the digital and health tech field asked German policymakers to include digital health products and solutions in regular care (“Regelversorgung”) in the interest of advancing access for patients. The eHSG recommendations are seeking to do the same across the EU.
But I remain convinced that more work is needed. MedTech Europe is now working on a targeted document, offering reflections and recommendations for specific technologies such as remote monitoring, connected cardiac implants, robotic surgeries and AI (expected publication later in 2019). What seems clear: digital transformation of healthcare services will require reforms of our financing and reimbursement systems. The health digital revolution will not happen overnight, but it will evolve, one step at a time, if we work together.
The paper “Proposed Guiding Principles for Reimbursement of Digital Health Products and Solutions” was one of four documents developed by the European Commission’s eHealth Stakeholder Group. They are available here.
