Introduction
The digital health sector is experiencing a rapid transformation, fuelled by advancements in technologies such as artificial intelligence (AI), digital therapeutics and remote monitoring. Despite the promise of Digital Health Interventions (DHIs), the industry struggles with unclear nomenclature. Which, in turn, hinders the process of evidence synthesis and the delivery of healthcare. The Professional Society for Health Economics and Outcomes Research (ISPOR)’s special interest group underscores the necessity of a unified framework for patient-facing DHIs, aiming to enhance their impact on health economic and outcomes research.
The Challenge of Ambiguous Terminology
DHIs offer unprecedented opportunities for patient-centred care, yet their diverse nature poses significant challenges. A plethora of terms and definitions lead to confusion, some overlapping, complicating the assessment of these interventions. The lack of standardisation not only hinders the comparability of studies but also the adoption of DHIs in clinical practice. Guidelines cover systematic evidence evaluation of DHI investigations. The Evidence in Digital Health for Effectiveness of Interventions with Evaluative Depth checklist guides DHI evidence quality assessment.
The Economic Implications
The ambiguity in DHI terminology carries substantial economic consequences. Moreover, healthcare providers and payers find it difficult to ascertain the value and efficacy of DHIs, leading to hesitation in financing these technologies. Systematic app evaluation is guided by the Target User, Evaluation Focus, Connectedness, and Health Domain framework. Kolasa et al. extensively assessed 11 DHI value frameworks. As of September 2022, payers have adopted 6 evidence-based frameworks for DHI financing choices. By embracing a standardised framework, we can streamline the evaluation process. Potentially reducing healthcare costs and fostering more widespread adoption of cost-effective DHIs.
The PICOTS-ComTeC Framework
To address these challenges, ISPOR’s research introduces the (population, intervention, comparator, outcome, timing, and setting) PICOTS-ComTeC framework. This tool therefore merges the established PICOTS approach with critical elements of technology and context, enabling precise definitions of DHIs. The framework is designed to aid stakeholders in selecting appropriate interventions and comparators, thereby facilitating better clinical decisions and health economic evaluations.
A Step Towards Standardising DHI Terminology
The adoption of the PICOTS-ComTeC framework represents a significant step towards unifying DHI terminology. By providing detailed, actionable information, it empowers clinicians, researchers, and policymakers to make informed decisions. This clarity is expected to accelerate the integration of DHIs into healthcare systems, ultimately improving patient outcomes and optimising resource allocation.
Conclusion
This research from ISPOR advocates for standardising DHI terminology through the PICOTS-ComTeC framework, which holds the potential to enhance clinical decision-making and health economics. As the digital health landscape evolves, clear and consistent definitions will be crucial in realising the full potential of DHIs, both in terms of patient care and cost-efficiency.
