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March 5, 2021

The Telehealth [R]evolution

Commentary
Ramzy Ross (DrDoctor) | Alette Brinth (HealthXL)
&

The world has undeniably experienced an explosive upward trend in telehealth adoption over the last 12 months, fuelled by a global pandemic. In the US, the CDC reported a 50 % increase in telehealth visits in the first quarter of 2020 alone. Across the pond in the UK, Deloitte recently reported that 80% of healthcare providers increased the adoption of digital technologies to provide virtual support and engage more effectively with patients. A rare opportunity to innovate and reimagine the delivery of medicine has been created in the eye of the storm, and stakeholders across the healthcare industry have been thrust into alignment on a common goal: how do we continue to deliver high-quality patient care in an era of social distancing? 

The fact is, telehealth is so much more than seeing your doctor on a screen - it’s not just an evolution of care-delivery, it’s a revolution! Here are some of the big disruptions happening, and some of the opportunities that await.

Going Green & Going Global: The Social and Environmental Impact of Telehealth

In a world enabled by telemedicine, patients in vulnerable communities have greater access to quality of care that would otherwise be restricted by cost, time and travel considerations. Can telehealth bring us one step closer to bridging the gaps in global health inequality? It is estimated that in developing countries like Malawi, there is only 1 physician available for every 62,500 people - 150X lower than in the US. These gaps can now be addressed by initiatives such as the World Telehealth Initiative partnership with Teladoc to connect physicians with patients in developing countries. A growing network of physicians are volunteering their time, and it is projected that an additional 24-36 million patients could be treated annually if every US physician currently using televisits (estimated at 0.5 million) volunteered just 1 hour a month. 

It goes without saying that a rise in telehealth will significantly reduce the medical industry’s carbon footprint. The green impact of the reduction in travel of patients and healthcare workers is significant, with a swedish study estimating a 40-70 fold reduction in carbon emissions by pivoting from physical to virtual appointments alone. Furthermore, it has also been demonstrated that converting to digital ways of working can not only help healthcare organisations reduce administrative related hours but also contribute to reducing their carbon footprint with reports of up to 70% reductions in paper use for activities such as printed appointment letters.

(Source: DrDoctor)

The Connected Patient: Putting the Patient Center-Stage

There is growing evidence supporting the necessity of increasingly putting patients at the core of evolving, and new, healthcare models. Healthcare governing bodies, providers and health technology organisations, across the globe, are continually evaluating how to enhance patient-centred care. They are increasingly pivoting towards digital opportunities to better incorporate patient profiling, and tailored feedback, with the view to deliver bespoke, patient-centric communications and care management. NHS England is one example of this where they refer to patient centred care planning incorporating personal health budgets and supporting patient preferences.  

The case for change is primarily driven by healthcare supply and demand. One example of increasing demand is outpatient hospital services, which have almost doubled in England over the last 12 years. Currently valued at 120 million a year, this increase in demand for outpatient services in the UK has called for radical change in outpatient care services by esteemed organisations such as the Royal College of Physicians.

Breaking this down further, the evidence often points to follow-up related appointments as being a significant contributor to the increase. To add to the problem, statistics often also show that the proportion of non-attended appointments is also on the rise - inevitably adding to waitlist delays and contributing to poor patient experiences.

In attempts to counter such challenges, digital health technology organisations are continually scoping opportunities to tackle the problem and improve healthcare delivery. One solution that is gaining a lot of interest from HCPs and patients is patient-initiated follow-up, aka PIFU, allowing patients to become more in control of their care including the self-scheduling of appointments. Organisations, such as DrDoctor, believe that PIFU oriented models are key to not only solving challenges such as the patient waitlist backlog (which the current pandemic has only exacerbated), but can go further in terms of making patients feel like responsible partners in their personal care journey and lending to improved patient satisfaction.

Reimagining Medicine: The connected doctor

The increased adoption of video calling by clinicians has undoubtedly helped overcome some of the health and safety challenges associated with the delivery of care - particularly during the Covid-19 pandemic. However, video calling is only one solution that forms part of a wider tool-kit of remote engagement and monitoring capabilities. Innovators are increasingly working to develop both passive (such as wearable technologies) and active tools (such as digital questionnaires or assessments) in view of creating remote models of care that allow patients to be monitored more closely and in the convenience of their own home. Remote patient monitoring solutions are also gaining increasing traction in the marketplace, which were reported to attract an estimated USD $642 million in investments in 2020, up 13 % since 2019.

(Source: HealthXL platform)

From the clinicians’ perspectives, this provides key advantages including enabling clinicians to identify potential patient health deterioration sooner leading to better patient health outcomes. From a healthcare management perspective, this also enables ‘asynchronous capacity’ - in other words - an increase in capacity of clinician availability so more patients can be seen within a given timeframe. Such methods are continually gaining recognition for their abilities to benefit both patients, and healthcare providers alike, and projects such as ‘My Online Care’ are a testament to such developments.

A second opinion: AI real-time decision-support

As healthcare systems struggle to handle overloaded hospitals, clinical decision support systems (CDSS) provide physicians with a way to deliver diagnoses remotely. Astronauts in space have relied on CDSS like VisualDX for years to stay informed on their symptoms in the remotest of settings. NASA’s human research program has actively funded research in CDSS to ensure that even on a space mission to Mars (where the time-delay to a doctor is 20 minutes), astronauts can stay in control of their symptoms and risk factors. Back on Earth, the benefits of AI-powered triaging and CDSS are being felt not only in the physician's office, but also in the emergency room workflow. The Scandinavian startup Corti teamed up with Sweden’s SOS Alarm emergency service to utilize Audia (an audio-based AI platform) to help emergency workers detect out-of-hospital cardiac arrests. The results demonstrated a whopping 50 % reduction in undetected out-of-hospital cardiac arrest cases, a 30 % increase in time saved with call protocols and 25 % faster detection rates.

(Source: Corti)

Medical Device companies are also seeing the benefits of CDSS, and last month Ipsen announced a partnership with Mendelian to speed up rare disease diagnosis by integrating MendelScan software into NHS systems to scan EHR records for symptoms and risk factors. Partnerships like these are paving the way for a preventative care model, where data analytics give doctors a 360° patient view to help more efficiently predict risk and enable early intervention. In a recent survey, PWC reported 74 % of health executives saying their organizations would invest more in predictive modelling in 2021.

Keeping the momentum

The reality is, telehealth experienced two breakthroughs during the pandemic: an uptake in adoption and a permanent place in the overall strategy of healthcare organizations. However, the challenge now is not to lose the momentum that has been gained. The current climate provides a real opportunity to further lay foundations and accelerate progress that, not only, addresses current pressures but is also ready for the future and the exciting new innovations it will undoubtedly reveal.

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