Implementation Strategy for a Digital Health Tool Influences User Engagement

Background and Aims: Digital health tools not only should be effective in clinical trials, but should be implemented into the healthcare ecosystem without adding undue burden for patient and the care team. We hypothesized that different modes of implementation may be associated with differences in engagement.

Method: In the first model, users received a prescription for a FDA-cleared digital tool from their healthcare providers. In the second model, certified diabetes educators provided the digital tool to their patients. In the third model, the digital tool was distributed via a direct-to-patient email from a large, national health plan for Medicare enrollees. The user data was collected electronically and de-identified according to data policies.

Results: 3,141 users were identified as part of the provider prescription model. Of note, 30.7% of users did not enter their diabetes medications into the system. 136 users were identified in the educator-driven model. Again, a significant minority (25.3%) did not enter their diabetes medications. In the health plan model, of the 11,000 enrollees who were invited to participate by email, 161 individuals activated accounts. Interestingly 67% of these users engaged with the digital tool via the web, not on mobile devices.

Conclusions: In the provider prescription and the educator models, individuals were provided the digital tool during a face-to-face visits. Though overall engagement with the system was good, a significant minority of users still did not enter their medications into the system. In the health plan driven model, only a small proportion of recipients of the emails activated their accounts. Surprisingly, those users were more likely to use the web portal vs. the mobile app. These insights can be used to guide the effective integration of digital tools into clinical practice.