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The Future of Digital Health: How UX Design is Shaping the Industry

By PARV SONDHI

As the digital health world continues to expand, more and more people are turning to apps to manage everything from diabetes and obesity to depression and anxiety. People rely on these apps for their physical and mental health, so it’s crucial that product developers ensure a safe, effective, and engaging experience for them. Healthcare experts agree.

A team of researchers and health system leaders recently introduced a new framework called “Evidence DEFINED” for evaluating digital health products. This framework offers hospitals, payers, and trade organizations a precise set of guidelines to assess the validity and safety of a digital health product. It also gives digital health companies good benchmarks to work from.

As digital health companies create new products in the space, they should keep specific points in mind — from user experience design to considerations for data privacy. While clinical outcomes will always reign supreme, the framework suggests that patient experience, provider experience, product design, and cost effectiveness can’t be discounted.

Here are a few critical considerations that product delivery teams should plan for when creating digital health apps.

Clear navigation

First things first: a user won’t use an app that’s hard to navigate. To help people stick to their health goals, developers need to create apps that are intuitive and easy-to-use. When a user logs onto an app, they want to find the content they need immediately and be guided through the experience step by step.

A lot of different people use health apps, and not all of them are tech-savvy. Health apps need to be accessible to all demographics, including people of various ages who speak different languages. It’s also important to remember that digital health apps can be used across multiple platforms, so the navigation should remain clear when switching between devices.

While navigation might seem like a no-brainer, it’s often overlooked when designing for digital health.

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Beyond the Scale: How organizations should evaluate the success of obesity management solutions

By CAITLYN EDWARDS

Obesity treatment is often framed as a race to the bottom — how much weight can someone lose? Five percent? Ten percent? And with recent scientific advancements in anti-obesity medications such as GLP-1s, what about even 15-20%?

Obesity treatment, though, isn’t just about the number on the scale. It’s about moving the needle on biomarkers that really matter to overall health. Seven out of the top ten leading causes of death and disability in the United States today are chronic diseases that have links to overweight and obesity. The metabolic benefits of just 5% weight loss can be life-changing for many people with obesity-related comorbidities. This means that for organizations looking to treat their chronic conditions, obesity care shouldn’t be all about striving for the lowest possible weight.

Indeed, consensus and practice statements from groups including the American Heart Association, the American College of Cardiology, the American Diabetes Association, and The Obesity Society, support weight loss programs that achieve clinically significant weight loss outcomes, defined as greater than or equal to 5% of an individual’s baseline body weight. This number is derived from decades of research demonstrating that even modest weight loss has impacts on physiological health including type 2 diabetes, dyslipidemia, hypertension, and many kinds of cancer.

People who attain just 5% weight loss see the following health improvements:

  • Reductions in systolic and diastolic blood pressure
  • Risk reductions of developing type 2 diabetes by almost 60%
  • Reductions in HbA1c and fasting blood glucose levels
  • Greater insulin sensitivity
  • Decreased need for newly prescribed diabetes, hypertension, and lipid-lowering medications

Understanding that obesity outcomes include more than just the number on the scale, how can benefit managers and health plan leaders measure success? Here are some things organizations should look for when evaluating an obesity management solution:

N-size of outcomes

While a high weight loss average may sound impressive, it doesn’t tell the whole story. A better measure might be the number of people in a program able to achieve greater than 5% weight loss. The fact is that weight loss averages are easily skewed by outliers.  An exceptionally high average may not be representative of what is actually taking place at the individual level. What matters is that a large percentage of people in the program are able to see clinically significant results.

Emphasis on behavior change

Another way to measure the success of an obesity management solution is by the sustainability of its outcomes — primarily through adopting healthier behaviors. Intensive behavioral therapy is crucial to obesity treatment and can reduce the risk of type 2 diabetes. Support from expert dietitians and coaches can help promote a healthy relationship with food for optimal weight loss.

Through medical nutrition therapy, dietitians create personalized calorie and macronutrient goals to foster weight loss in a healthy, sustainable way. Also, self-directed cognitive behavioral therapy can help people become more aware of underlying thoughts and behavior patterns around food.

Step therapy approach to treatment

Some obesity management solutions avoid medications entirely while others rely solely on expensive GLP-1s. But both of those methods fall short of providing the best care to the most people at the lowest cost possible.

The best obesity management solutions take a clinically rigorous step-therapy approach to treatment. This way, they carefully manage access to expensive anti-obesity medications while achieving meaningful outcomes. Many of their members will achieve clinically significant weight loss through behavior change alone. Some may need a boost from lower-intensity, lower-cost anti-obesity medications to reach their goals. Others, with severe obesity or multiple cardio-metabolic conditions, may require higher-intensity anti-obesity medications like GLP-1s. Treatment levels can be safely tried in succession with needs and costs in mind.

It’s likely only 5-10% of a given population would end up using GLP-1s with this step-therapy approach, while the majority of people would still get clinically meaningful results without such intensive treatment.

Address SDOH to personalize care

One-size-fits-all solutions — like those that insist on a highly restrictive diet — miss the mark on health equity. Not everyone can afford expensive meat-heavy diets and they don’t always line up with people’s cultural preferences. Similarly, a program that simply doles out GLP-1s without helping people manage side effects doesn’t work and will only drain budgets.

The key to unlock improved outcomes is by helping people address SDOH challenges like food insecurity, language barriers, cultural factors, physical environment, and more. A good obesity solution should expand access to bilingual registered dietitians who are trained in dietary considerations and eating patterns for many different cultures and ethnic groups. They can help folks plan meals around limited budgets and specific dietary needs.

Conclusion

Organizations have much to consider when evaluating obesity solutions for their population. It’s easy to be swayed by simple metrics that seem indisputable. But, in the end, outcomes like 5% weight loss and reductions in HbA1c for the majority of an eligible population are what counts. Sustainable outcomes rely on real behavior change, a careful step-therapy approach to medication, and personalized care when it comes to social determinants of health.

Caitlyn Edwards, PhD, RDN, is a Senior Clinical Research Specialist at Vida Health

Obesity is crippling the US, but there are solutions

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By STEPHANIE TILENIUS

Well over a third of Americans are obese — and the percentage keeps growing at a staggering rate. Over the last twenty years, obesity prevalence grew from 30% to 42% of the US population and rates of severe obesity nearly doubled. If we don’t make serious changes to our healthcare system, it’s scary to think where we’re headed in a few short years.

The fact is, obesity is far from a cosmetic condition. It can be a devastating disease and was classified as such by the American Medical Association in 2013. Obesity is the leading risk factor for deadly diseases like type 2 diabetes, heart disease, stroke, and at least 13 types of cancer.

If we don’t stop the obesity epidemic in its tracks now, we’re in for a world of hurt. People’s lives, the healthcare system, and, by extension, the US economy could be headed for collapse if we continue to ignore it. Cardiometabolic conditions like obesity, heart disease, stroke, and diabetes cost the US healthcare system upwards of $500 billion a year in healthcare costs and another $147 billion in lost workforce productivity for heart disease and stroke alone.

And yet private and government-sponsored health plans are dragging their feet to address obesity head on. They know most people jump from health plan to health plan every few years, so they’re willing to take the chance that their members with obesity won’t develop high-cost complications soon enough to justify treatment now. And yet treatment could reverse the effects of obesity and downstream chronic disease, saving lives and billions of dollars in the long run.

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Inside Vida Health’s Move Into Musculoskeletal Care

By JESSICA DaMASSA, WTF HEALTH

In the ‘point solution versus platform’ debate, mark another score for integration as Vida Health jumps into the musculoskeletal (MSK) care space. This is a move we’ve seen before among the digital health chronic condition management set (remember when Omada acquired Physera, Dario Health acquired Upright, and everyone was waiting to see if Livongo would make a play for Sword or Hinge?) so why is Vida just jumping in now?

Dr. Patrick Carroll, Vida Health’s Chief Medical Officer, lets us in on the strategy behind the startup’s move into the MSK space and what it signals about how employers (and their employees) are starting to view digital health and virtual care within the larger scope of available care options out there.

As for Vida’s MSK program, it’s different than what you might expect. According to Pat, the program is strictly focused on lower back pain and helping members quickly find the physical therapy and, if needed, mental health care that can make a real difference to their overall health in a manner of weeks. If something more complex is discovered, Pat says Vida is working with partners – including those digital-first MSK clinics – to refer out. Is this the long-term play or will Vida eventually build out or buy its way further into MSK? We find out what’s ahead for the cardiometabolic care company as it launches yet another new offering to improve access to care.

Vida Health Starts Prescribing: Meds, Labs, Devices, & More for Mental Health & Diabetes

By JESSICA DaMASSA, WTF HEALTH

Big news coming out of Vida Health today as the chronic condition care startup announces that it will now be able to prescribe meds, med devices, lab tests, and more to its members. This puts Vida Health among the first of the digital health chronic care companies to evolve its offerings beyond apps-and-coaching, leading on this trend to take digital health chronic care into a more full expression of virtual care.

Vida Health’s Chief Medical Officer, Dr. Patrick Carroll, introduces us to the new offering which he tipped us off about when we met him a few months ago, new to his role at Vida and coming in hot from Hims & Hers where he built similar services as he took that company public as CMO.

The new prescribing services will cover both sides of Vida Health’s integrated model: mental health and cardiometabolic health, but in different ways. On the mental health side, Pat says members will be able to receive prescription meds for anxiety and depression ONLY at this time; on the cardiometabolic side, members working with Vida Health will NOT be able to get prescription drugs to help with diabetes or heart health, but would instead be able to get continuous glucose monitors (CGMs) prescribed, specialized diets, and labs, like A1C testing, that require a script.

Do these prescribing services begin to turn Vida Health into a primary care provider? If not, how do these new prescribing and medication management roles integrate with whatever other primary care offering is in place through a member’s plan or employer without adding cost or confusion to the patient experience? We talk through the evolution of both care model and business model as Vida Health adds another layer to its full-stack chronic condition management platform.

Vida Health Hires New Chief Medical Officer from Hims & Hers: A Sign ‘Scripts’ Are Coming Soon?

By JESSICA DaMASSA, WTF Health

Vida Health’s new Chief Medical Officer, Dr. Patrick Carroll is bringing a very unique expertise to the chronic condition management startup’s C-suite: pharmacy. Pat just left virtual pharmacy co, Hims & Hers, where he helped take the company public as CMO after building-out their virtual primary care practice. Before that, he was CMO at Walgreens…

We get to know Pat – brand-new in his role as Vida Health’s first-ever CMO – and catch glimpses of how his years of experience as a primary care doc and executive leader at leading consumer-focused pharmacy businesses will likely be shaping Vida’s future delivering care to poly-chronic patients.

Vida Health’s current approach to diabetes management and mental health care has stood apart for being fully-integrated from the get-go, tackling the mind-body connection through digitally-based coaching and counseling. While Pat acknowledges that this approach has thus far yielded “remarkable outcomes,” he definitely seems interested in finding out if those outcomes could be even better if a virtual prescriber group were involved as well.

Will this be a partnership with a medical group? Or something Pat sees Vida Health building out itself to fully support its 100% at-risk-on-outcomes model? A compelling set of questions, particularly when you consider Vida Health’s investor-and-client relationship with the largest managed Medicaid plan in the U.S. (Centene participated in their $110 million Series D round in May 2021), the prevalence of complex diabetes cases (30% are multi-chronic), and the interesting data point Pat shares about Vida’s ability to get more people to see their primary care docs, increasing PCP visit rates by 10%. Interesting opportunity for Vida Health to further compete with Teladoc-Livongo and other virtual-first primary care providers aiming to deliver on the chronic condition care spectrum.

Rumor Check with Vida Health’s CEO: Buyer Sentiment on Virtual Care, At-Risk Models, Mental Health

By JESSICA DaMASSA, WTF Health

To hear Vida Health’s CEO Stephanie Tilenius talk about what she’s hearing from payers, providers, and employers about at-risk value-based models, the shift to virtual care, and the growing importance of mental health services as a culture-builder for businesses forced into a part-virtual-part-in-office world, you get a sense of how her past work leading the various payments and commerce businesses of Google, eBay, and PayPal probably comes in handy. For example, the shift to virtual care, she says, is, “like the Internet in 1999…It’s happening.”

We get an update on exactly how Vida Health is making it happen themselves, and how they expect their newly expanded at-risk model will help. Vida’s always been fees-at-risk on physical outcomes related to diabetes management, hypertension, etc. BUT the mental health side of their offering (which experienced 6000% growth year-over-year during the pandemic) is now at-risk on outcomes too. With so much happening across the industry to move to value-based models, we deep-dive with Stephanie to hear what she’s hearing from her clients, including client-and-investor Centene and hear about growth in the employer market where she sees a major shift in how employers are thinking about healthcare as the new sexy job perk. “Instead of snacks or transportation or other benefits,” says Stephanie. “It’s all about healthcare.”

#Healthin2Point00, Episode 204 | Vida, Headway, & Neuroelectrics, plus RCM acquires VisitPay

Today on Health in 2 Point 00, I am over the moon excited about Chelsea’s Champion’s League semi-final win. But on Episode 204, we have some big deals to cover too. First, Vida Health gets $110 million in a Series D bringing their total to $188 million. Next, R1 RCM acquires VisitPay for $300 million, integrating patient financial engagement into their revenue cycle management offerings. It’s Mental Health Awareness Month, and mental health startup Headway raises $70 million – do they have a chance in that crowded space? Finally, Neuroelectrics gets $17.5 million for their neurostimulation cap helping with epilepsy and depression. —Matthew Holt

Inside Vida Health’s $110M Series D & Big Push into Digital Mental Health

By JESSICA DaMASSA, WTF HEALTH

It’s another mega-round for a digital health chronic condition management startup, as Vida Health closes its $110M Series D – AND adds a pair of big-name insurers to their cap table. Vida’s Founder & CEO, Stephanie Tilenius, gets into the good news about the funding round, which was led by growth equity fund, General Atlantic, and brought managed care giant Centene (a Vida customer) and multinational insurer AXA into the mix.

Beyond the funding – and the extra “insurance side” endorsement it gives to the virtual chronic condition care space – what’s interesting about Vida now is how its “whole person” approach, which integrates physical health care and mental health care, is very much tilting to mental health these days.

While overall revenue has tripled since last year, Stephanie talks about how the 6000% year-over-year growth for her mental health services has played into that rise, and how the new funding will be used to further expand those offerings.

Does this mean we need to start naming Vida as a competitor to digital mental health companies like Ginger, Modern Health, and Talkspace? And, how does this impact their positioning among the field of other health tech chronic care co’s? For those who may have forgotten, Vida went out the gate with a platform that was designed to treat both the mental-and-physical aspects of chronic disease, while others like Omada and Livongo-now-Teladoc acquired-and-integrated behavioral health providers to augment their physical-first offerings and satisfy customer demands. Will it now prove easier for Vida to scale-up and scale-out, having been built for both “mind and body” from the very beginning? Stephanie’s got her opinion, big plans, and now a treasury to rival those key competitors across both fields of care. Tune in for all the details!

Vida Health’s CEO on Scaling Up in the Highly Competitive Chronic Condition Virtual Care Space

By JESSICA DaMASSA, WTF HEALTH

Even before Covid19, virtual care for chronic conditions was a hot and competitive area, with the heat turned up by Livongo Health’s IPO last year and big funding rounds for companies like Omada Health, Virta Health, and One Drop. Another contender in the space, Vida Health, has been best known for taking a “platform” approach to chronic condition management before “platforming out” became the-move-to-make for scaling health tech companies. Their digital health biz actually started out with a “whole health approach” to helping patients manage all their conditions at once, integrating care for diabetes, hypertension, COPD, high cholesterol, mental health conditions, and more from the get-go. Contrast that to some of their biggest competitors, who have adapted to that approach by adding on treatments for co-morbidities as their core businesses evolved.

Is there a benefit to starting out with a holistic care model that those who build it along the way can’t capture? We caught up with Vida Health’s founder & CEO, Stephanie Tilenius, to find out what advantage starting out as a platform play has brought to her business, which just closed a $25M funding round in April and is now available to more than 1.5 million people through employers and health plans.

How will the company scale from here? How will they remain competitive in such a crowded space? Stephanie talks through some of Vida Health’s post-pandemic plans AND how lessons learned from her “previous life” as an exec in Big Tech during that industry’s growth era of the 2000s & 2010s has shaped her thinking about the uptake of technology in healthcare. Not only did Stephanie work at eBay, PayPal, and Google during the birth of the online payment era, BUT she also helped take an online pharmacy company (Planet Rx) public during the dotcom boom.

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