Success factors and measures for scaling patient-facing digital health technologies from leaders' insights.

Background: Europe's healthcare systems face a triple burden: the rise of non-communicable diseases (NCDs), an aging population, and a shortage of healthcare professionals. NCDs, the leading causes of death, disproportionately affect older adults, placing significant pressure on healthcare services. By 2050, nearly 30% of Europe's population will be aged 65 or older, up from 20% in 2023. These challenges demand urgent solutions to sustain healthcare systems. Patient-facing digital health technologies (DHTs), such as Digital Diagnostics and Digital Therapeutics, offer promising tools to address this burden by empowering patient self-management, reducing strain on healthcare professionals, and enhancing system efficiency. Despite their potential, the scaling and adoption of DHTs remain limited. This study investigates: (RQ1) What key factors drive success across different patient-facing DHT categories? and (RQ2) How can companies implement these factors?

Methods: Following COREQ guidelines, we conducted semi-structured interviews with 29 executives and founders of European DHT companies targeting NCDs. Participants were identified using PitchBook, focusing on revenue-generating companies with over 20 employees. Virtual interviews were conducted in English between May and September 2024, lasting an average of 28 min (range: 21-40). Data saturation determined the sample size. Thematic analysis was performed, with two researchers independently coding the data to ensure reliability. Success factors were categorized as internal (e.g., employees) or external (e.g., partnerships). Ethical approval was obtained, and data was anonymized. A follow-up survey (n = 27) was conducted to confirm our findings.

Results: We identified 18 success factors for scaling patient-facing DHTs. Health & Wellness companies prioritized business model flexibility, while Digital Therapeutics relied on regulatory compliance. Validation of health impact was critical across categories, emphasized by all respondents in Digital Diagnostics and Digital Therapeutics. Other key factors included customer awareness, strategic partnerships, and investor alignment, highlighting the importance of tailored growth strategies.

Conclusion: This study provides structured guidance for scaling patient-facing DHTs, emphasizing category-specific strategies aligned with operational, regulatory, and consumer demands. It offers actionable recommendations for founders and executives to allocate resources effectively and adapt to diverse market contexts. By addressing the unique challenges of scaling DHTs, this work contributes to advancing digital health research and improving healthcare system resilience.