INTRODUCTION: The need for cost-effective innovative eHealth solutions utilising AI technology is greater than ever and is increasing due to an ageing population and the rise of chronic conditions, whilst in parallel health systems look to shift care from the in-patient hospital setting into the outpatient and primary care setting. Despite the overwhelming need, access and uptake has been relatively stunted.

OBJECTIVES: The research aims to identify the market access barriers and adoption hurdles for an AI powered eHealth solution, capable of diagnosing and monitoring heart failure in real time.

METHODS: Between April and September 2018, sixteen 1-hour qualitative telephone interviews were conducted with cardiologists (n=10) and payers (n=6) from the EU5 and US. Questionnaires were developed for both payers and cardiologists. Using a mix of open-ended questions and scoring systems, the questionnaires tested barriers to access, reimbursement and uptake, and proposed approaches to overcome them in payers and cardiologists, of the AI powered eHealth solution.

RESULTS: Analysis of the 16 responses identified 6 key barriers to access and adoption by both payers and cardiologists. Inadequate methods of HTA linking to the need for substantial clinical testing and consequently the lack of adequate funding and reimbursement models were the greatest hurdles for payers. A lack of trust and awareness coupled with a reluctance to disrupt traditional methods of patient management were identified as the primary barriers to adoption by cardiologists.

CONCLUSIONS: A fundamental issue pertaining to the lack of access and adoption is that healthcare systems are not yet set up to approve or incorporate such solutions. New, more appropriate methods, that realise the additional benefits not captured by traditional evaluation methods are required by payers. Involving cardiologists in the development of new solutions will install trust and confidence in AI powered eHealth solutions and consequently improved likelihood of adoption.