Why do Incentives Matter? The Role of Incentives in Driving Digital Health Adoption Worldwide

Author: Deepali Kausshik, National Health Authority. Deepali is a dedicated public health and policy professional with experience in public health research, monitoring & evaluation, and digital health. With expertise in public health and a passion for driving positive change, she has collaborated with various organizations to drive innovation and develop effective healthcare policies aimed at enhancing public health outcomes. Currently, she is working with the National Health Authority under the ABDM Scheme.

The global healthcare landscape is experiencing a real transformation, driven by the integration of digital technologies into patient care and healthcare management. From electronic health records (EHRs) and telemedicine to mobile health apps and wearable devices, digital health has the potential to improve patient outcomes, enhance the efficiency of healthcare delivery, and reduce costs. However, despite the promise of these technologies, achieving widespread adoption among healthcare providers and stakeholders has been a complex challenge. With time, incentivization has emerged as a powerful tool to overcome these obstacles and drive the digital transformation of healthcare. To address the persistent issues, many countries have devised incentivization schemes to promote the adoption of digital health technologies.

The Role of Incentives in Healthcare:

Incentives play a pivotal role in motivating stakeholders to embrace and adopt digital healthcare technologies. These incentives can take various forms, including financial rewards, recognition, regulatory compliance, and improved workflow efficiency. By aligning the interests of different stakeholders, incentives create a sustainable environment for digital adoption in the following ways-

Provider Adoption: Healthcare providers are essential actors in the adoption of digital technologies. Incentives such as financial rewards, training opportunities, and simplified documentation processes can encourage providers to integrate electronic health records (EHRs), telemedicine platforms, and other digital tools into their practice. These incentives not only streamline workflows but also improve the quality of care and patient outcomes.

Patient Engagement: Patients are increasingly becoming active participants in their healthcare journey. Incentives such as access to personalized health data, remote monitoring capabilities, and telehealth services empower patients to take charge of their health. By incentivizing patient engagement, healthcare organizations can enhance patient satisfaction, adherence to treatment plans, and overall health outcomes.

Interoperability and Data Sharing: Interoperability remains a significant challenge in the digital healthcare landscape. Incentives that promote data standardization, interoperability frameworks, and secure data exchange protocols incentivize healthcare organizations to share data seamlessly. This fosters collaboration, improves care coordination, and enables holistic patient management across different healthcare settings.

Innovation and Research: Incentives stimulate innovation and research in digital healthcare technologies. Funding opportunities, grants, and recognition programs encourage researchers, startups, and healthcare organizations to develop and implement cutting-edge solutions. These incentives drive continuous improvement, foster collaboration between academia and industry, and catalyse the development of breakthrough technologies.

Regulatory Compliance: Regulatory requirements often serve as both barriers and incentives for digital adoption in healthcare. Compliance with regulatory standards such as HIPAA in the United States or GDPR in Europe incentivizes healthcare organizations to prioritize data security, privacy, and ethical use of technology. Meeting regulatory requirements not only mitigates legal risks but also builds trust among patients and stakeholders.

The comprehensive review of digital health incentive programs in several countries showcases examples of incentivization in different forms (the United States, the United Kingdom, Australia, Singapore, Canada, and India). By examining these programs, we aim to gain insights into their objectives, implementation, and impact on healthcare delivery.

Various forms of Incentives in Healthcare Technology Adoption:

United States: Medicare and Medicaid EHR Incentive Program – The Medicare and Medicaid EHR Incentive Program, also known as the “Meaningful Use” program, was launched to encourage healthcare providers to adopt and effectively use certified EHR technology. [1] By meeting specific criteria, providers could qualify for financial incentives. This program played a pivotal role in accelerating EHR adoption across the United States, driving improvements in healthcare data exchange and patient care.

United Kingdom: Quality and Outcomes Framework (QOF) – In the United Kingdom, the Quality and Outcomes Framework (QOF) incentivizes general practitioners to achieve certain quality and outcome targets in patient care. While not solely focused on digital health, the QOF includes digital health-related metrics. [2] This program has spurred innovation in primary care and incentivized the use of digital tools to improve patient management and health outcomes. [2]

Australia: Practice Incentives Program (PIP) Digital Health Incentive – Australia’s PIP Digital Health Incentive encourages general practices to embrace digital health solutions, including electronic prescribing and My Health Record integration. By participating in this program, practices receive financial incentives, driving the adoption of digital health technologies and improving patient data accessibility. [3]

Singapore: National Electronic Health Record (NEHR) Incentive Program – Singapore’s NEHR Incentive Program aims to create a comprehensive national electronic health record system. Healthcare institutions are incentivized to contribute data to the NEHR and adopt digital health systems. This initiative has fostered data sharing and improved healthcare coordination, ultimately benefiting patient care. [4]

Canada: Digital Health Investment Review Program (iHRP) – Canada’s iHRP supports healthcare providers and organizations in adopting digital health solutions. It provides funding and resources for innovative digital health projects. By investing in digital health initiatives, Canada has enhanced healthcare access and improved patient outcomes. [5]

India: Ayushman Bharat Digital Mission (ABDM) – The Ayushman Bharat Digital Mission (ABDM) in India seeks to create a digital health ecosystem. It incentivizes healthcare providers and other relevant stakeholders through its Digital Health Incentive Scheme (DHIS) [6] to participate in ABDM initiatives, such as the creation of Health IDs and linking the patients’ health records. Such incentivization would help in building a patient-centric digital health ecosystem in the long run. This program holds the potential to transform India’s healthcare landscape, fostering patient-centric care and data interoperability.

Challenges and Opportunities

While digital health incentive programs have made significant progress, they face common challenges, including concerns about data privacy and security, interoperability issues, and resistance to change. Overcoming these challenges requires concerted efforts and innovative solutions. However, there are opportunities to enhance these schemes further:

• Data Standardization: Establishing global data standards can facilitate seamless data exchange and interoperability among digital health systems.
• Patient Engagement: Incentivizing patient participation and engagement in digital health can lead to better health outcomes and improved data accuracy.
• Emerging Technologies: Leveraging emerging technologies such as artificial intelligence, blockchain, and the Internet of Things can revolutionize healthcare delivery and data management.

Future Directions

• International Collaboration: Encouraging international collaboration and knowledge sharing to learn from each other’s successes and challenges can prove beneficial.
• Policy Innovation: There is a need to continuously adapt and refine incentive schemes to keep pace with evolving digital health technologies and emerging healthcare needs.
• Research and Innovation: By embracing new ideas, we can help in increasing research and innovation in digital health to uncover new ways to incentivize stakeholders and providers effectively.

Conclusion

Incentivization plays a pivotal role in driving the adoption of digital health technologies, ultimately benefiting patient care and healthcare delivery. The global digital health landscape is evolving rapidly, and incentive programs are adapting to meet new challenges and opportunities. By aligning incentives with stakeholders’ interests, healthcare organizations can overcome barriers, stimulate innovation, and improve patient outcomes. As the healthcare landscape continues to evolve, effective incentivization strategies will play a crucial role in shaping the future of digital healthcare delivery. By reviewing the experiences of different countries, we gain valuable insights into what works and where improvements are needed. Policymakers, healthcare leaders, and industry stakeholders must recognize the importance of incentives and utilize their power to drive meaningful changes in healthcare. As we look to the future, international collaboration, policy innovation, and continued research and innovation will shape the future of incentivization in the digital health ecosystem, ultimately improving healthcare for individuals worldwide.

References

1. https://www.healthit.gov/sites/default/files/pdf/privacy/privacy-and-security-guide-chapter-5.pdf– Medicare and Medicaid HER Incentives Programs Meaningful use of Core objectives that address privacy and security
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880106/– What drives general practitioners in UK to improve the quality of care?- A systematic review
3. https://www.servicesaustralia.gov.au/sites/default/files/ehealth-incentive-pip-guidelines.docx#:~:text=The%20Practice%20Incentives%20Program%20(PIP,administration%20processes%20and%20patient%20care.- Practice Incentives Program eHealth- Services Australia
4. https://opengovasia.com/support-initiatives-introduced-to-encourage-healthcare-licensees-to-contribute-data-to-the-national-electronic-health-record-nehr-in-singapore/– Support initiatives introduced to encourage healthcare licensees to contribute data to the National Electronic Health Record (NEHR) in Singapore
5. https://www.grandchallenges.ca/digital-health/– Digital Health- Canada
6. https://abdm.gov.in/DHIS– Digital Health Incentive Scheme for ABDM Adoption