Digital Health's 2025 Crossroad: Prescription vs. Platform
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Access Takes Time
In the early 1800s scientists started to understand the connection between contaminated water and disease. In 1854, Dr. John Snow used a dot map to trace a cholera outbreak to a public well. Epidemiology was born. Lives could be saved.?
Word spread, and by the late 1880s, it was pretty much accepted that clean water prevented disease. The problem was infrastructure; access to clean water was limited to wealthy people in populated areas. Everyone else had to wait.
Chlorination started in North America around 1910, but it wasn’t until the 1940s that mortality from waterborne disease declined. In order to make clean water accessible to the general population it took time to find the right delivery mechanism.
Cognitive Behavioral Therapy
In the 1920s the first clinical trials for mental health treatments began, but in the 1970s, Cognitive Behavioral Therapy (CBT) started to be recognized as efficacious. CBT’s John Snow is Dr. Aaron Beck, who developed the initial protocol in the 1960s.
However, similar to access to clean water, CBT was initially (and in many cases, still is) only available to wealthy, insured individuals living in populated areas with adequate numbers of trained professionals. Although CBT is widely regarded as a gold-standard in evidence-based therapy, access remains a problem.??
Pandemic: Stigma & Help Seeking
While we sat at home in 2020, a global understanding of the pervasiveness of mental health and addiction issues emerged. Stigma decreased and help seeking was normalized. Most likely due to our children attending class virtually, and doctor appointments taking place the same way, we realized it was convenient to attend therapy sessions online.??
An aggressive market followed suit. Zoom went public in April. In February of 2021 Teladoc's stock peaked at $293.66. Although both company’s stock prices have adjusted from the hype,? the telemedicine market is forecast to grow to a staggering $286 billion by 2030. Online therapy, a subset of telemedicine, is estimated to grow to $70 billion by 2032.
But once again, we have an access problem. I’ve written about this previously: the shortage of trained psychologists is predicted to last for years, if not decades. Basic economics can illustrate how it will become more difficult, rather than easier, for millions of people to get help.
What can we do for the millions of people who cannot access therapy? From a business perspective, why are we leaving money on the table?
Self-Guided Digital Therapy
A stop-gap - and for those stuck on waiting lists - is self-guided digital therapy. But generally, because of the rules of economics, the average person cannot access self-guided therapy because we haven’t figured out access. The solutions exist, but they are behind complicated paywalls.
Globally, millions of people can benefit from self-guided solutions. How can there be such intense demand for a product with such limited supply??
While self-guided digital health solutions are far less costly than telehealth, they still have substantial cost centers - especially if they go global. Growth capital is essential. And while demand is vast, digital health companies continue to struggle to develop scalable, accessible solutions. Most importantly: what is the revenue model?
2024 Digital Health Year of Reckoning
In 2024, the digital health industry faced what some have called “A Year of Reckoning”, a result of several well-funded companies declaring bankruptcy in 2023.?
As we enter 2025, digital health is at a crossroad. Some believe the rebirth of digital health will be led by:
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But are any of these approaches equipped to handle the global scale and diversity of need that will be required to generate profit?
Monetizing Behavioral Health
These business models have been seen in the past, and here are the shortcomings:
Platform-Based Models
Platform-based models, capable of delivering support across multiple languages and demographics, can reach users directly, leverage AI to tailor treatment, and rapidly scale.?
But despite broad accessibility, can they offer the scientific rigor necessary to deliver truly effective care? Will end-users trust them? Can they evolve to match the sophistication of prescription therapeutics? How will they be funded? What is the revenue model?
A Path Forward
In Power and Prediction, the authors anticipate systems change for the healthcare industry, and the power dynamic will change.?
亚马逊 ’s platform started as an online bookseller while I was a History & English undergrad at Western University. I loved the stacks, bookstores were magic, and I rolled my eyes at the thought of digital usurping print.?While I was surrounded by books, many others weren’t. What I didn't realize was what the Amazon platform did: enable access.
My perspective is certainly influenced by my work with Evolution Health and my other digital health ventures (all run on AWS). But, my experiences lead me to believe that an open, multi-faceted approach to digital health will offer the greatest potential for addressing the access problem.
The faster we find digital Health’s John Snow, Aaron Beck, or Jeff Bezos - the better life will be for millions of people across the globe. It’s going to happen, we just need to know where to look.
Evolution Health offers white-label instances of our interactive, self-guided digital health courses to organizations aiming to facilitate transformative change. Please reach out to us if we can assist you.
If you or a loved one are struggling with mental health or addiction issues, explore our free interactive tools at https://EvolutionHealth.care for immediate support and guidance. No waiting list.