To better understand how the HealthXL Members currently evaluate digital health solutions for their organizations, as a customer rather than investor, we spoke to a number of the different stakeholders within the community. We interviewed representatives from J&J, Children’s Hospital Los Angeles, Imperial College Health Partners and BTG. That allowed us to identify the key attributes and create a scoresheet that allows easier evaluation. Note: the scoresheet doesn't replace due diligence!

10 attributes when evaluating digital health solutions:

  • Relevant Outcomes
  • Financial Model
  • Flexibility
  • Data Requirements
  • Changes to Operation
  • Plan for Pilot
  • Internal Buy-in
  • Team
  • Complimentary not Competitive
  • Readiness

Scoresheet (see template below)

To illustrate how it works in practice, see the brief case study about Aetna's partnership with Wildflower Health's app. It's followed by the scoresheet where we've scored their pregnancy health tracking app for each of the attributes based on Aetna's strategic objective for the partnership.

Case Study: Aetna and Wildflower Health

Aetna had a strong maternity program, but would have to wait until a medical claim was made to offer it, which in most cases was half way through a pregnancy, when many of the most critical preventative measures delivered through the program were no longer as effective. Why was this important to Aetna? The late adoption led to a reduction in potential medical cost savings. For its commercial health plans, Aetna used Wildflower Health’s DueDatePlus app, a pregnancy health tracker. It was so popular among their customers so that Aetna partnered with Wildflower Health who customized the app to encourage enrollment into Aetna’s maternity program ‘BeginningRight’. When a user downloaded DueDatePlus they were asked if the were an Aetna customer, a simple yes or no. If yes, the users were offered the Due Date Plus for Aetna app, from which Aetna could administer their maternity program at a much earlier date than they ever could previously when relying on being informed by a medical claim. As a pregnancy health tracker, DueDatePlus delivers a program to help track pregnancy milestones, deliver reminders and personalize actions. The customized version of the app also connects to Aetna's services such as 24/7 nurse support and the BeginningRight maternity program. It also allows customers to look up health issues related to pregnancy, get weekly updates such as ultrasound videos showing what babies look like at each stage. Wildflower Health allowed Aetna to increase the adoption rate of their maternity program at an earlier stage of pregnancy, improve medical cost savings, all by leveraging existing infrastructure, resources and content through a new mobile delivery channel. Meanwhile, apart from being a new customer for Wildflower Health, Aetna were driving customers from their maternity program straight to DueDatePlus. Even from an outsider's perspective there are a number of attributes which clearly shine through as scoring 5/5, but let's go through each of the attributes individually to score them --

Scoresheet: Wildflower Health

**Attributes** **Score** **(1-5)** **Reason for Score**
**Relevant Outcomes** Outcome data from previous commercial relationships with organisations similar to that of the member. These outcomes should relate to how the member measures success i.e. improved medical cost savings by 2% in 1 year. **5** High volume of existing downloads, strong levels of engagement and excellent program completion rates. These were the outcomes relevant to increase enrolment of their maternity program, as well as achieve improved medical cost savings.
**Financial Model** Clear and precise understanding of how the customer will be reimbursed for the company’s product, or how the cost of the product/service relates tightly to outcomes.


They operated at a PEPM (per employee per month) fee for employers, which aligned precisely with the goal of reaching more users to enrol in their maternity program.
**Flexibility** Flexible to the unique nature of each healthcare system, adapting the commercial model to ensure strategic fit.


Wildflower Health met the users at the right place and right time, while using apps and searching for resources to help with pregnancy, instead of presuming they would come to find help off Aetna.
**Data Requirements** Do not require large amounts of existing data from the member to successfully initiate the relationship. **5** No data requirements from Aetna to begin the relationship, only content from their Beginning Right program.
**Changes to Operations** Little to no change to the existing IT workflow, existing operations and a small amount of time needed to integrate with the member. **5** No obvious major changes to operations or IT workflow apart from providing an alternative content delivery mechanism.
**Plan for Pilot** Pilot planned to suit the member, and prove value to them, not just the objective outcome of the company. Routes beyond the initial pilot also established. **N/A** N/A
**Internal Buy-in** Understand the approval process, and prove value for each key stakeholder within the approval chain. **5** Aetna’s maternity program was already effective, so getting more people to enrol in the program was the primary goal, and that is exactly what DueDatePlus gave them access to.
**Complimentary ****not Competitive** Does not cannibalise or compete with existing internal business units or programs, but further enhances the performance of existing assets and infrastructure. **5** Using largely existing content, as well as additional services from Wildflower Health, Aetna were able to bolster the strength of their resources by partnering with a new delivery channel.
**Team** Understand how the clinical and financial systems work within healthcare and have an excellent technical team, an area which is not considered high performing within typical healthcare incumbents. **5** Strong mix of industry experience and technical talent.
**Readiness** Is the technology ready to do all of the things the company's management team are proposing? **5** Their technology was already in the market fulfilling a similar offering.
**Total Score** **45/45**

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