Pfitzer Estelle, Giger Odile, Kausch Christoph, Kowatsch Tobias
Centre for Digital Health Interventions, School of Medicine, University of St. Gallen, St. Gallen, Switzerland.
MTIP AG, Basel, Switzerland.
BMC Health Serv Res. 2025 May 1;25(1):632. doi: 10.1186/s12913-025-12748-z.
Europe's healthcare systems face a triple burden: the rise of non-communicable diseases (NCDs), an aging population, and a shortage of healthcare professionals. NCDs, the leading causes of death, disproportionately affect older adults, placing significant pressure on healthcare services. By 2050, nearly 30% of Europe's population will be aged 65 or older, up from 20% in 2023. These challenges demand urgent solutions to sustain healthcare systems. Patient-facing digital health technologies (DHTs), such as Digital Diagnostics and Digital Therapeutics, offer promising tools to address this burden by empowering patient self-management, reducing strain on healthcare professionals, and enhancing system efficiency. Despite their potential, the scaling and adoption of DHTs remain limited. This study investigates: (RQ1) What key factors drive success across different patient-facing DHT categories? and (RQ2) How can companies implement these factors?
Following COREQ guidelines, we conducted semi-structured interviews with 29 executives and founders of European DHT companies targeting NCDs. Participants were identified using PitchBook, focusing on revenue-generating companies with over 20 employees. Virtual interviews were conducted in English between May and September 2024, lasting an average of 28 min (range: 21-40). Data saturation determined the sample size. Thematic analysis was performed, with two researchers independently coding the data to ensure reliability. Success factors were categorized as internal (e.g., employees) or external (e.g., partnerships). Ethical approval was obtained, and data was anonymized. A follow-up survey (n = 27) was conducted to confirm our findings.
We identified 18 success factors for scaling patient-facing DHTs. Health & Wellness companies prioritized business model flexibility, while Digital Therapeutics relied on regulatory compliance. Validation of health impact was critical across categories, emphasized by all respondents in Digital Diagnostics and Digital Therapeutics. Other key factors included customer awareness, strategic partnerships, and investor alignment, highlighting the importance of tailored growth strategies.
This study provides structured guidance for scaling patient-facing DHTs, emphasizing category-specific strategies aligned with operational, regulatory, and consumer demands. It offers actionable recommendations for founders and executives to allocate resources effectively and adapt to diverse market contexts. By addressing the unique challenges of scaling DHTs, this work contributes to advancing digital health research and improving healthcare system resilience.
欧洲的医疗保健系统面临三重负担：非传染性疾病（NCDs）的增加、人口老龄化以及医疗保健专业人员短缺。非传染性疾病是主要死因，对老年人的影响尤为严重，给医疗服务带来了巨大压力。到2050年，欧洲近30%的人口将年满65岁或以上，高于2023年的20%。这些挑战迫切需要解决方案以维持医疗保健系统。面向患者的数字健康技术（DHTs），如数字诊断和数字疗法，通过增强患者自我管理能力、减轻医疗保健专业人员的负担并提高系统效率，提供了有前景的工具来应对这一负担。尽管它们具有潜力，但DHTs的扩展和采用仍然有限。本研究调查：（研究问题1）推动不同面向患者的DHT类别取得成功的关键因素有哪些？以及（研究问题2）公司如何实施这些因素？
遵循COREQ指南，我们对29家针对非传染性疾病的欧洲DHT公司的高管和创始人进行了半结构化访谈。使用PitchBook确定参与者，重点关注员工超过20人的盈利公司。2024年5月至9月期间以英语进行了虚拟访谈，平均持续28分钟（范围：21 - 40分钟）。数据饱和度确定了样本量。进行了主题分析，两名研究人员独立对数据进行编码以确保可靠性。获得了伦理批准，并对数据进行了匿名处理。进行了一项后续调查（n = 27）以确认我们的发现。
我们确定了扩展面向患者的DHTs的18个成功因素。健康与保健公司优先考虑商业模式的灵活性，而数字疗法则依赖于法规合规性。健康影响的验证在所有类别中都至关重要，数字诊断和数字疗法的所有受访者都强调了这一点。其他关键因素包括客户意识、战略合作伙伴关系和投资者一致性，突出了量身定制的增长战略的重要性。
本研究为扩展面向患者的DHTs提供了结构化指导，强调了与运营、法规和消费者需求相一致的特定类别战略。它为创始人及高管提供了可操作的建议，以有效分配资源并适应不同的市场环境。通过应对扩展DHTs的独特挑战，这项工作有助于推进数字健康研究并提高医疗保健系统的恢复力。
