Clinical and economical assessment of digital health innovations in Austria — an ecosystem view

Abstract

Digital health products are expected to disrupt healthcare by improving quality of care, efficiency and accessibility. The number of digital health products has grown rapidly, however there are just scarce examples of proven benefits of digital health solutions regarding their clinical outcome and cost effectiveness. Therefore, clinicians, regulatory bodies and insurance agencies often remain sceptical about new digital health innovations. In this thesis I explore the possibility to validate digital health solutions in Austria and compare these possibilities to international practices. First, a model of a digital health validation ecosystem was established based on the literature. To identify the elements of this model in Austria, literature search was performed, expert interviews were conducted and the publications on Austrian digital health clinical trials were reviewed. The challenges and barriers in the ecosystem were identified by expert interviews. The Austrian digital health validation ecosystem is strengthened by the national digitalization strategy, the presence of an electronic health record system, numerous public funding opportunities, an accelerator program for digital health and the high digital literacy of the citizens. However, there are gaps in the infrastructure and in private financing opportunities supporting digital health validation. Furthermore, resistance of clinicians towards digital health creates a barrier for developers. Based on international examples, the Austrian ecosystem could benefit from the development of real-world testbeds and from a national framework describing the necessary evidence for reimbursement. These elements could support the development of validated digital health solutions and position the country as a leader in digital health.