Elena Torrente interview – Digital Health Development Deputy Director DKV

Elena Torrente (DKV Innolab): “In one year, the equivalent of ten years progress has been achieved in digital health”

Elena Torrente has been working in the field of innovation and digital health for 15 years, in both the public and private sectors. She is currently deputy director of digital health development at DKV, in addition to being in charge of the DKV Innolab project: a space to promote research and innovation to provide effective solutions in digital health and improve people’s well-being. She is also part of the WHO Roster of Experts in Digital Health.

After 15 years in the field of innovation and digital health, has the outbreak of COVID accelerated the field of digital health?

It has indeed; there is no doubt about it. In one year, the equivalent of ten years progress has been advanced because there has been a before and after with respect to Covid.Telemedicine has been perhaps the most relevant during these months because it made it possible to offer healthcare remote assistance to people who decided to stay at home for fear of contagion or because of the strategies put in place by health authorities to avoid collapsing the system. This has permitted the validation of the usefulness of telemedicine in many cases (there are studies that state that three out of four outpatient consultations are either unnecessary or could be carried out virtually). And the best thing is that it has been seen both on the side of professionals and the patients themselves (convenience, savings in travel time…). But beyond telemedicine (whether synchronous or asynchronous) digital health encompasses much more: it is the application of technology to improve people’s health and there we find digital tools for the optimisation of diagnosis, for self-care, prevention or health education, for the improvements of treatments, for early detection and remote monitoring, etc.

The question now is to see if this trend continues post-pandemic, but everything points to that it will do so. We have data from the first quarter of 2021 where investment in start-ups worldwide has broken historical records and this points to the trend continuing over time.

At DKV you have developed a digital tool called “Quiero cuidarme más” (I want to take better care of myself) that gives the patient a platform to access medical reports, to schedule medical appointments and even virtual consultations. What degree of acceptance has this tool received by both people and doctors?

As in the whole sector, there is a before and after the pandemic. Before COVID fortunately, we had already made an effort, we had already been building this entire platform for 6 or 7 years, therefore, we already had our homework “done” in digital health and then what allowed us to have the platform up and running was to provide solutions and customer care for our clients. Therefore, the acceptance has been very good. There was a moment in time during the crisis where over 50% of all our company’s activity was carried out virtually, that is a record for the company and we were able to do it because we were prepared and had the technology in place for it.

Quiero Cuidarme Más is designed in a modular form; therefore it can be customised according to the needs of our clients. It is receiving a very good degree of acceptance, especially with regard to virtual consultations (24-hour general medicine and 10 specialties) and other services such as the online coach or the digital midwife. Doctors also perceive it very positively: during the pandemic it allowed them to carry on with their work without which, they would not have been able to carry out, and now they have seen that for many types of consultations (chronic patients follow-up, …) virtual care is very suitable.

Self-care tools are more difficult to adopt and for this reason, through the Lab we work among other things, on elements of behavioural change and smart positive health.

The GDPR (General Data Protection Regulation) currently in force will be expanded with new legislation resulting from initiatives, both by the European Commission and the FDA, to ensure the protection of patient clinical data. Could this new regulation mean a slowdown for Digital Health?

During the pandemic, the level of security requirements has been relaxed in general quite a lot, because of the need for medical care due to the situation we were experiencing and there have been solutions that did not exactly comply with all the security guarantees that are required in the health field. So, I believe that a legislation reform can thus increase the awareness that not everything goes, things have to be done with all the security guarantees, technology has to adapt to the standards that are already defined to meet those levels of security and in some way it will also serve to value the things that are being carried out correctly.

Many digital health apps are free, could this be counterproductive for the commercial development of more comprehensive apps?

I don’t think so, and I doubt that all apps are free because although there may be a series of services that might be free in a first version, there are updates or additional services that do have a cost. We are also going towards a subscription economy: citizens are used to paying subscriptions to services (eg Netflix, Spotify…), that is, for services that provide us with “value”. This will be the main issue. Solutions that want to be marketed under the SaaS model must have a clear and relevant value proposition for the end user, who will increasingly have more and more to choose from. Here, elements such as usability and user experience will be key, but also interoperability and the ability to integrate solutions with any system.

With regards to another business model, Data as a Service (DaaS), what do you think of this model?

In the digital health sector we see more and more solutions marketed as Software as a Service (SaaS), and what Data as a Service (DaaS) offers are multiple services related to this data that is in the cloud (processing, data analytics…). The business model is usually based on a subscription model and in the digital health sector, where the solutions are APIfied, this model of “payment for consumption” of data is interesting, whilst maintaining all the required security guarantees. And, the most important thing from my point of view: is that we can offer the end user multiple value services where back-end integration is produced (between systems) without the need to change the application or solution.

Why did DKV decide to create DKV Innolab?

We have been working on digital health and building a person-centred ecosystem for six years. A series of services are created from the Personal Health Record, ranging from the field of health promotion to the field of virtual care. In some way, with Innolab we want to take a further step in this commitment to health promotion that we are leading and we want to do so with this innovation environment. It is a highly relevant commitment to the health innovation ecosystem in Barcelona and we want to take it to two main areas: open innovation and research. Open innovation because we want to stay up-to-date in terms of trends and detect those solutions to incorporate into our value chain. To this end, we have different activities in place such as scouting, calls for ideas, hackathons and acceleration and incubation programs where our Living Lab setting is made available for testing and validation of solutions in simulated scenarios. We have also created our own S + i Certificate that gives access to different levels of integration in the ecosystem.

On the other hand, the research area aims to generate evidence on the effectiveness of digital health solutions under the Smart Positive Health approach. To do this, we participate in R&D projects at a national and international level and carry out market analyses on new trends and opinions and preferences of the population through surveys, interviews and workshops (Innolab Friends Community).

Can digital applications help improve global health?

Yes, under the Smart Positive Health concept we refer to how to achieve optimal health through the proper use of health assets that can be enabled by new ubiquitous technologies (IoT, artificial intelligence, big data and robotics). Health assets are any factor (or resource) that enhances the ability of individuals, groups, communities, populations, social systems, and/or institutions to maintain and sustain health and well-being. Positive health is the scientific study of these health assets and by “smart” we mean how technology can support it.

Another issue is prevention, how does DKV contribute in this regard?

It is an important issue for DKV: everything that has to do with prevention and improvement of health, such as detecting symptoms, preventing diseases and promoting healthy habits.

At DKV Innolab, the validation of a Digital Health product can be validated in two contexts: controlled facilities that emulate different scenarios (such as those available in the DKV Innolab facilities) and a real environment (hospitals, patients’ homes, etc). How does one validation complement the other?

It depends on the solution and functionalities that you want to validate. In some cases the simulated context will be sufficient and in others we will be able to count on our own network of centres and the involvement of patients from the Innolab Friends network who wish to validate, for example, home monitoring devices.

An agreement with GENESIS Biomed has just been signed, how could GENESIS Biomed contribute to DKV Innolab?

GENESIS Biomed has a wealth of expertise in entrepreneurship and business development in the sector. It also has an extensive knowledge of the sector. Furthermore, we will be able to carry out education activities with workshops for entrepreneurs and other Innolab activities. We believe that alliances of this type serve to strengthen the ecosystem and the relationships between the actors that are dedicated to the health innovation sector.

What expectations do you have with DKV Innolab? Could it help develop digital health applications?

We have high expectations since we launched it, despite the COVID hiatus. We are very confident in undertaking innovation projects and contributing to the improvement of the design and commercialisation of applications in the digital health sector.