The four success factors for establishing digital health applications in standard care

by Melanie Dening


You've developed a digital health app? Great!  

Is your product already certified as a medical device? Do you meet the requirements for data protection and interoperability? Do you know the positive care aspects of your DiGA by heart? You are preparing for the testing procedure at the BfArM or have already successfully passed it and are already listed in the DiGA directory?

Awesome! Have you already asked yourself how your DiGA can be established in standard care? We asked experts from industry, medicine, startups and patients and summarized the decisive factors for establishing DiGAs as an integral part of statutory healthcare.  

Digital health apps will become increasingly important for the healthcare system  

With the introduction of the Digital Healthcare Act, a lot has changed for medical apps: As low-risk medical devices, digital health apps are fully reimbursable. As a result, manufacturers of digital health apps are looking at a market of 73 million patients with statutory health insurance. However, digital health applications, so-called DiGAs, have so far been prescribed by doctors only hesitantly and are still little used by patients. According to a survey of 1,000 doctors conducted by BARMER from March to May of this year, just under half of those surveyed are positive or at least partially open to apps. However, 56 percent of physicians feel ill-equipped to provide advice on apps, and just under half of them have never been asked by patients about an app. Demand will increase – industry, medical experts agree. What can startups do to push their apps? The following four factors will determine whether a DiGA is included in standard care:  

1.) Acceptance by the physician and patient community

2.) User benefits

3.) Active use: recognizable user benefits and user-friendly design 

4.) Awareness: More information, please!  



1.) Acceptance by the physician and patient community: physicians are the key to the DiGA world 

"The success of the digital transformation in healthcare stands or falls on the extent to which patients, the insured and healthcare providers accept digital solutions," according to the Bertelsmann Stiftung.

Doctors in particular are key players in the DiGA world: they prescribe the apps and their recommendations have a high value for patients. Whether the patient community accepts a DiGA depends primarily on the acceptance of the medical profession – but this is not sufficiently given for DIGAs in general. Many physicians still do not know what a DiGA is. There is a massive need for information here: according to the BARMER survey, 74 percent of respondents would like an overview of the existing apps. "In order to be able to assess and use a health app, short fact sheets with all the relevant facts are helpful," says BARMER's regional manager in Schleswig-Holstein, Dr. Bernd Hillebrandt. Accordingly, DiGA manufacturers must provide sufficient information for better acceptance. Acceptance is also closely related to active use and user benefit. 

2.) User benefits: Clear added values!    

The most important user benefit for both the service provider and the patient is better care. If the physician is provided with more data about the patient via DiGA, fewer physician visits are necessary. The patient has less need to contact the physician as a result of the information provided in the DiGA, since evaluated information is transmitted via the DiGA.  

Other user benefits also include closing gaps in care, especially in structurally weak or rural regions, and gaining knowledge about the patient's condition by generating data on a regular basis.  

DiGAs without clear user benefits are either not taken up by patients or ensure rapid discontinuation of use. In this context, focusing a DiGA on direct added value is a must-have. The user benefits should also be communicated with sufficient clarity.   

3.) Active use: recognizable user benefits and user-friendly design 

Active use is the basis for developing the benefits of a DiGA for the patient. The more intensively a patient uses an app, the more convinced he or she is of its user benefits. Patients who experience improvement, relief, or similar benefits from using a DiGA tend to remain adherent.   

Active use correlates with physician acceptance: they prescribe the application. Whether and how intensively the patient uses the app depends on the usability and the user benefit or added value of the app. This is where the manufacturers are called upon: only a well thought-out design based on a genuine understanding of the patient's world can ensure that an app is optimally integrated into the everyday lives of patients. Cleverly selected touchpoints between the patient and the app, as well as simple and intuitive handling also important.  

4.) Awareness: More information, please!  

Doctors will only prescribe an application if it is sufficiently well known and if it is meeting a positive response. Patients access a digital health application either via the medical profession, but the patient can also request the app from his or her health insurance company – therefore, it is important to inform these target groups as best as possible about the important framework data such as indication areas, important functions or duration of use. The medical associations and the associations of panel doctors can also be used as multipliers in the distribution of information and provide support in the use of the app, for example by providing customer support for upcoming questions. Cooperation with other DiGA manufacturers or pharmaceutical companies in the area of distribution can be a target-oriented strategy to provide these informations. 

Conclusion: It's all about information

The basis for the successful establishment of a DiGA in standard care is extensive information distribution. This is where the DiGA manufacturers come in: they must ensure that the medical profession, patients and health insurers are informed about all the key points, above all the concrete user benefits. The provision of information, in turn, is the basis for awareness, for acceptance by the medical and patient communities, and for active use. These factors are closely interrelated: the better known an app is, the more accepted it is and the more accepted it is, the better known it can become, and so on.  

Collaborations between startups and Pfizer for better medical care 

The Pfizer Healthcare Hub Berlin and the experts from Pfizer support startups with their contacts to physician and patient networks to communicate the user benefits of a DiGA, to promote its active use as well as acceptance among physicians and patients, and to increase awareness of the application. The Healthcare Hub team also provides support for all other challenges related to DiGAs - for example, by providing advice on preparing for approval as a DiGA or with collaborations on market studies. Strategic collaborations between startups and Pfizer can be helpful to achieve the common goal: relieving the burden on the different healthcare players and complementing existing therapies for better medical care. 

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