OBJECTIVES

Digital health technologies (DHTs) have the ability to improve patient health by enabling real-time monitoring and treatment decision-making. This study aimed to assess potential value drivers of DHTs related to real-time treatment decision-making through the case study of point-of-care technologies (POCT), as both can facilitate immediate treatment and disease-management decision making, compared to standards of care.

METHODS

We conducted a targeted literature review of economic model approaches for POCT, as well as economic evaluations of POCT for cardiovascular disease (CVD) and diabetes, two conditions targeted by DHT interventions. Studies were included if they were peer-reviewed and published after 2009.

RESULTS

A total of 235 article titles were screened, and 17 were included. Health system perspectives included the United States, Europe, Canada, and Australia. Several review articles have assessed economic model approaches for POCT and found that current models often do not include the impact of faster testing and test results on patient outcomes. Economic evaluations (i.e. five cost-effectiveness analyses, one budget impact model, two decision analytic models and two observational studies) of POCT for diabetes and CVD are limited and revealed mixed results. Two studies in CVD and three in diabetes found POCT was associated with reductions in healthcare visits (inpatient, emergency department and office), especially in populations with advanced disease. Provider time associated with POCT may increase costs in the short-term due to the educational and service requirements of the devices but reduce costs in the long-term, as providers may be able to make faster treatment-related decisions. Other elements not typically captured in economic evaluations included patient and provider satisfaction and workflow improvements.

CONCLUSIONS

This case study of POCT highlights the need for economic evaluations of DHTs to incorporate changes in the patient pathway attributable to real-time monitoring and decision-making, including improvements in long-term patient outcomes and potential cost savings.