Digital Health Reality Check: Four Perspectives from HLTH Europe

The best healthcare conversations happen when the room is small and the trust is high. While nothing replaces being part of these intimate discussions, here's a taste of what emerges when the right people gather.

Healthcare loves talking about transformation while doing everything possible to avoid it. At HLTH Europe 2025, four roundtables hosted by and for the HLTH Community exposed this dynamic in vivid detail, revealing both genuine progress and stubborn systemic barriers.

The NHS Integration Dream 

The NHS is preparing its 10-Year Plan, and everyone agrees: integrated care powered by interoperable data will fix everything. The reality? GPs should anchor neighborhood care models, but local variations matter (for instance, what works in Harrow may not work in Hackney).

The killer insight: successful integration examples showed dramatic cost reductions, but scaling requires fixing misaligned commissioning structures. NHS leaders stressed that most hospital costs stem from a small patient percentage - prevention saves money, but the system still pays for sickness. Patient activation sounds great until you realize it requires answering "what's in it for me?" with something more compelling than "better health outcomes." The workforce is burned out, and solutions adding complexity will fail.

Technical barriers persist: interoperability across systems remains expensive and politically complex. The dream of a single patient record enabling anticipatory care faces the reality of competing vendors and data silos. Bottom line: the building blocks exist, but assembling them requires political will, money, and culture change - the healthcare trifecta of impossibility.

Injectable Therapies: When Assumptions Meet Reality 

Here's a $100 million mistake: healthcare providers think patients prefer hospital injections, but patients actually want to self-administer at home. This fundamental disconnect drives entire service models in the wrong direction

The incentive structure is backwards: providers earn more for facility-based injections, so moving care to a home setting would threaten revenue. COVID proved home care works, but systems reverted faster than you can say "prior authorization."

Digital solutions are emerging as differentiation tools, especially against biosimilar competition. There is a catch here though, as they can double injectable costs while health technology assessments slash prices for "insufficient evidence." One company's most popular connected device feature wasn't AI-powered insights - it was the automated reordering of …. Sometimes innovation means making boring stuff less annoying.

The adherence paradox crowned the discussion: despite massive investment in digital adherence tools, adoption remains low. We still build solutions for problems we assume patients have, not problems they'll pay to solve. Even marginal improvements in adherence matters greatly in some therapeutic areas, but first, tools need actual users.

Beyond the Pill: Pharma's Consumer Reality Check

Pharmaceutical companies are discovering what happens when patients become consumers. In this closed door session, the room mapped an idealized patient journey from assessment through long-term maintenance, revealing scalability challenges at every step. Online assessment needs safety measures; the "disembarkation journey" (maintaining outcomes post-treatment) remains largely ignored.

The monetization reality hit hard: patients want enhanced digital solutions but won't pay directly. Sustainable models require government or payer support tied to outcomes. A connected device company shared how they integrate passively into existing ecosystems rather than creating yet another app - radical thinking in healthcare.

Pharma's role sparked debate. Beyond ensuring drug availability, companies must adapt to consumer expectations. In markets like GLP-1 therapies, this means creating consumer health experiences, not traditional pharmaceutical approaches. Solution providers expressed frustration at pharma's data hoarding about patient needs, highlighting the ecosystem's fragmentation.

The consensus: patient-as-client models work best with integrated digital architecture supporting the entire care journey. But execution requires data sharing, aligned incentives, and acknowledging that in consumer-driven markets, patients have different expectations than traditional healthcare assumed.

Metabolic Health: The Prevention Paradox

Insurance companies operate on annual cycles. Preventive health benefits show returns over decades. Welcome to healthcare's most expensive mismatch.

Our diagnostics roundtable confronted an uncomfortable truth: preventive healthcare is explicitly excluded from most insurance coverage. This forces consumers to pay out-of-pocket or hope their employer cares enough to cover it, putting legitimate preventive care in direct competition with whatever wellness app is trending on TikTok.

The ROI problem is almost comical in its shortsightedness. Insurers need to show results within 12-month reporting cycles, while metabolic health improvements prevent costs 10-20 years down the line. We need "creativity" in making a business case - this is healthcare-speak for "good luck with that spreadsheet."

Some promising models emerged from the discussion. Starting small with demonstrated outcomes can build credibility. Bundling metabolic health with mental health and other services creates comprehensive packages that are easier to implement and adopt. More radical ideas included mandatory prevention spending requirements for insurers (a complex but not impossible path) or government tax credits for prevention investments.

The most pragmatic suggestions focused on integration by embedding risk screening into routine clinical visits rather than separate prevention appointments, and building coalitions across government, payers, employers, and providers to share both risks and rewards. Strategic investors and family offices were identified as better funding sources than traditional VCs, who typically want returns faster than preventive health can deliver them.

The product challenge remains significant. Prevention needs to be sticky and attention-grabbing in a world of infinite distractions. Participants emphasized that quality time with healthcare providers during prevention visits could be a selling point - though convincing people to show up for check-ups when they feel fine remains healthcare's eternal struggle.

The Uncomfortable Truth, But a Promising Path

Across all of our community roundtables, the pattern is clear: healthcare transformation requires changing entrenched incentive structures, not just adding technology. Whether it's NHS integration, injectable therapy delivery, pharma's digital evolution, or making prevention financially viable, success demands aligning what patients want with what the system rewards. Yet despite these challenges, the energy in these rooms was palpable - pharma companies, tech innovators, and healthcare leaders are increasingly working in lockstep, determined to crack the code on sustainable care models that actually serve patients. The solutions are emerging; now we just need the courage to implement them

Want a seat at the table for these candid conversations? HLTH Community hosts exclusive roundtables throughout the year. Visit our Events page to learn more about upcoming sessions and how to get involved.