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The case for a digital health "hope index"

Illustration of a ladder made out of syringes.

Illustration: Aïda Amer/Axios

Since his last trip to Las Vegas, Adam Pellegrini has been mulling the idea of using a "hope index" to track the progress of people using his cancer support app.

Why it matters: Throughout his career at both startups and health behemoths, the Jasper Health CEO has recognized a common problem: Digital health companies lack reliable means of measuring their programs' impact on patients.

  • This led Pellegrini to wonder whether positive outcomes — such as healthy days or even hope — could serve as more helpful indicators.

Driving the news: As the digital health sector rightsizes amid tough market realities, entrepreneurs and investors are beginning to prioritize clinical rigor above a growth-at-all-costs mindset.

Zoom in: The idea of a hope index first occurred to Pellegrini at the HLTH conference in Las Vegas in November, when he was thinking about how people's perception of how lucky they are — the "luck index" — varies based on random external factors, such as whether they damaged their car or spilled a drink.

Between the lines: Almost every digital health company has a means of measuring negative outcomes, such as depression or high blood pressure, but the industry still lacks a standardized way to determine impact of their interventions on patients.

  • Worse still, many digital health companies aren't universally tracking or quantifying outcomes at all — positive or negative — meaning there's little hard data on whether their offerings are helping or hurting patients.
  • Per a June 2022 study in JMIR, in which Rock Health researchers assessed 224 companies, nearly half had a clinical robustness score of zero out of five, with five representing businesses that had the highest number of clinical trials and regulatory filings.

What they're saying: Several entrepreneurs and clinicians at the J.P. Morgan Healthcare Conference told Axios they were experimenting with more closely tracking the beneficial results of their interventions. For example:

  • DispatchHealth CEO Mark Prather said his company takes into account the "I love you score," or when a patient tells one of the companies' care team members that they love them.
  • A benefit of treating patients at home instead of the hospital is being able to view positive indicators like a balanced gait, healthy food in the kitchen and solid relationships with neighbors, he added.
  • Included Health chief medical officer Ami Parekh says her company has been using the CDC's "healthy days" metric, a series of questions designed to assess someone's quality of life.
  • Town Hall Ventures general partner Andy Slavitt says his firm is "obsessed with NPS, properly measured," referring to net promoter score, a metric that asks respondents to rate the likelihood they'd recommend a product to a friend or family member.

The bottom line: Difficult macroeconomic conditions are prompting digital health movers to focus on creative ways of demonstrating evidence and outcomes.

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