Large-scale MSK study

Cutting Through the Hype: Does Digital Health Actually Work?

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With all the hype around digital health, many employers and health plans might be wondering: Do digital health solutions actually solve chronic back or joint pain and reduce medical spend? Musculoskeletal (MSK) issues are the number one cost driver for medical spend—outpacing other conditions such as diabetes and cancer. However, new research has proven digital health solutions offer better outcomes at lower costs. This white paper highlights the results of the world’s first large-scale digital MSK study conducted by researchers at Stanford University, University of California San Francisco, and Vanderbilt University.

The Rise of Digital Health

The convergence of new technologies like wearables, sensors, and AI combined with smartphones and tablets are rapidly redefining the healthcare landscape. Moreover, these consumer-friendly digital health apps result in better patient outcomes at a fraction of the cost.

This doubling of MSK spend was driven by two main trends. First, there was a 40% increase in per-member costs from 2010 to 2019. Second, the number of health plan members in our dataset grew by 42% in this same time period, although the number of members filing MSK medical claims remained roughly constant. As patients avoid doctor and hospital visits during COVID-19, digital health is currently experiencing a sharp uptick in demand.

Moreover, the new remote workplace is also creating new workforce health issues. With employees working in makeshift home offices and enduring long hours of videoconferencing with minimal physical activity, musculoskeletal (MSK) issues like back and neck pain are exacerbated. Post-COVID-19, remote healthcare is likely here to stay. Businesses and governments will continue to shift to innovative, remote models of delivering health care to offer better care at lower spend. Employer benefit leaders play an important role in redefining healthcare benefits to support employee well-being at home during COVID-19 and beyond.

MSK surgery is costly & ineffective. For chronic or long-term musculoskeletal issues like backor joint pain, surgery and opioids are not recommended as initial treatment options and are often unsuccessful. Research has shown back and joint surgeries can be unnecessary and ineffective, despite the hefty price tag of up to $100,000 per patient. A randomized control trial published in the New England Journal of Medicine showed that real and placebo knee surgeries showed no difference in clinical outcomes.1 In fact, a peer-reviewed study in Spine demonstrated patients who did not have back surgery had better outcomes than those who did have back surgery.2

  1. Sihvonen R, M.D, et al. “Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear.” New England Journal of Medicine, 2013.
  2. Nguyen TH, Randolph DC, et al. “Long-term outcomes of lumbar fusion among workers’ compensation subjects: an historical cohort study.” Spine, 2011.

Key Takeaways

Study demographics
Number of participants= 10,264
Pain reduction
69% on average per participant
Depression & anxiety
58% reduction

Clinical Effectiveness

Adherence and outcomes

In-person physical therapy has low adherence rates. In short, exercise therapy generally can be more effective and less costly than surgery at reducing joint pain. However, in-person physical therapy (PT) has low adherence rates as patients fail to do their exercises or find time in their busy lives for PT appointments. The therapy route requires a more concerted effort to ensure patients stay on track and achieve positive outcomes.

At-home digital health solution can reduce pain & medical spend. Helping people achieve significant behavior change requires sustained coaching at a time and place that conveniently fits into their lives. Remote coaching with emotional support via phone and frequent text reminders plays an important role in achieving positive outcomes for patients.

In fact, new research demonstrates sensor-guided exercise therapy paired with remote 1-on-1 health coaching and personalized education results in significant chronic pain reduction. With chronic pain resolved, expensive surgery is avoided—cutting medical spend for employers and health plans.

Key Takeaways
In-person PT adherence
7/10 patients can't adhere to physical therapy
Key Takeaways
In-person PT adherence
7/10 patients can't adhere to physical therapy

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