A recent article published in the Journal of Medical Internet Research challenges the current research model that has shaped the digital health industry for years. The article titled “From Efficacy to Scale: Addressing Digital Health’s Original Sin” argues that the traditional approach of treating digital interventions like pharmaceuticals has hindered their widespread adoption and scalability.
The author of the article, Trevor van Mierlo, DBA, who is a seasoned digital health researcher and the Founder of Evolution Health, with more than 25 years of experience in the field, sheds light on the inherent flaws in the industry’s research methodology. He points out that the focus on disruption and the application of the Randomized Clinical Trial (RCT) gold standard, commonly used in pharmaceutical research, has limited the potential of digital interventions to reach a broader audience.
Van Mierlo highlights the issue of attrition in digital interventions, where dropping out of a trial is often viewed as a failure, rather than a valuable insight into user engagement patterns. He argues that the approach to trials needs to shift from a clinical focus to a more controlled and user-centric design, akin to software development practices.
The article specifically examines digital Cognitive Behavioral Therapy (CBT) as a case study, showcasing how the rigid trial design fails to account for real-world variables that can influence outcomes. Van Mierlo emphasizes the need for a new path to scale digital health interventions, which includes normalizing dropout data, optimizing user engagement, and adopting software economics principles.
In order to transition digital health from a niche tool to a globally accessible platform, the article suggests embracing attrition as a signal, conducting controlled trials that prioritize user engagement, and aligning business models with software economics. By shifting the industry’s mindset and practices, researchers, developers, and investors can turn efficacy into tangible real-world impact at scale.
Dr. van Mierlo’s analysis offers a critical perspective on the current state of digital health research and provides a roadmap for stakeholders to navigate the path towards scalability. By addressing the “original sin” of misapplied pharmaceutical models in digital health, the industry can unlock its full potential and realize the global vision of improving healthcare through technology.
For more information, the article “From Efficacy to Scale: Addressing Digital Health’s Original Sin” by Trevor van Mierlo can be accessed in the Journal of Medical Internet Research. The DOI for the article is 10.2196/85878.
This content has been provided by JMIR Publications and offers valuable insights into the evolution of digital health research and the necessary steps to achieve scalability in the industry.
