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The categorization of COVID-19 as a global pandemic is turbo-charging traditional health care firms' efforts toward the provisioning of digital and virtual healthcare in an attempt to treat the masses while minimizing risk to the limited pool of care providers.
Far too often in life, it takes a crisis or elevated pain threshold to effect dramatic change. In this case, the highly contagious nature of the coronavirus is the catalyst for rapid and dramatic adoption and deployment of digital health solutions in the areas of telemedicine, remote patient monitoring, and real-time notification systems.
According to a recent telehealth consumer survey, Sixty-six percent of consumers expressed a willingness to use telehealth solutions, yet only 8% have tried it. As the coronavirus outbreak continues to sweep the globe and quarantines move from cinematic fantasy to our stark new reality, health care providers are ramping up telehealth solutions at a blistering pace. The CDC is encouraging an expansion of telemedicine to manage the potential onslaught of patients and to maximize the isolation of at-risk patient groups such as the elderly. In fact, many older patients are unable to physically get to a medical care setting and telemedicine is bridging that gap.
Other benefits of telemedicine include the positive impacts of limited community exposure, lower patient-to-patient interaction, and minimization of contact between patients and health care workers. This latter point is of acute importance as qualified doctors and nurses were already in low supply and high demand. Telemedicine interactions also allow the health care system to scale up the ability, via the use of triage procedures to screen many more patients than in-person visits can accommodate efficiently.
While telemedicine solutions create an efficient one-to-many treatment option between the practitioner and patient, it goes farther than that. An often-under-appreciated use case for telemedicine is the transformational ability to link rare, in-demand specialists with other doctors in outlying medical centers, often in rural areas. As I wrote about here over a year ago, Intermountain Healthcare provides a shining example of how this technology can extend rare and expensive diagnostic and treatment options to those currently out of reach or that can only access care via expensive emergency trips to specialist locations.
As evidence of this trend, one digital health provider, PlushCare, told Business Intelligence Insider that it had seen a 40% increase in appointment volume as a result of the coronavirus and the traditional flu season. This compares to an average 10% increase in volumes during a regular flu season. PlushCare CEO Ryan McQuaid chalks the rising adoption of telemedicine up to three primary drivers:
- Increasing patient awareness that virtual care is an option, with the coronavirus making this awareness even higher due to CDC recommendations.
- Consumer behavior changes with patients becoming more comfortable with a virtual doctor visit.
- Regulatory and legislative changes such as increased insurance reimbursements for virtual care, lower copays, and the recent expansion of telehealth agreements between insurance companies and digital health provider firms (e.g. PlushCare, Teledocs).
Mr. McQuaid predicts that telehealth will grow at a 100% annual rate with virtual care visits outnumbering physical visits within ten years.
Remote Patient Monitoring
AI-powered remote patient monitoring (RPM) solutions are an effective means of tracking patients from afar. Not nearly as far along as telemedicine and virtual care visits yet, this emerging care path promises to deliver many benefits that should far outweigh the costs of the requisite hardware and software solutions needed to build this "patient monitoring supply chain."
We are all familiar with our fitness tracking devices such as the Fitbit or Apple Watch. These devices are being transformed into medical-grade tracking devices (see more here), which are then integrated into the Electronic Medical Record (EMR) systems in ways that enable patient data access from their mobile devices while simultaneously empowering physicians to collect monitoring data in real-time.
There are also several digital health firms with solutions in the field and in the R&D pipeline that are already being prescribed to patients. These solutions collect real-time telemetry data and send the data back via cellular/ethernet/Wi-Fi connections to the providers’ EMR systems for analysis and subsequent treatment. RPM solutions are also able to act as early warning systems that alert care providers to patient data that moves outside of established ranges for various conditions and can be tailored to the patient.
Closer to the current crisis, Boston-based Biofourmis is teaming up with researchers from the University of Hong Kong to implement RPM solutions for the monitoring of quarantined patients as a result of the coronavirus. The Biofourmis solution gathers biological data (temperature, heart rate, respiration rate) via physical sensors worn on the arm of patients. The bio-data is then analyzed, through the use of AI-based solutions, to monitor and spot changes in health. Anomalies result in alerts, allowing targeted responses by care providers. The solution also incorporates a smartphone app from which patients answer questions about symptoms. This data is monitored via a physician dashboard. Biofourmis hopes to outfit between 500 and 1,000 quarantined patients with this solution.
Healthcare Alert Systems
Health care providers are in short supply in the best of times. Add in the current coronavirus pandemic and the healthcare systems in most countries are instantly stretched beyond maximum capacity. The ability to keep physicians, nurses, and other essential personnel informed about changes to the crisis in real-time, without requiring them to deviate from their standard workflows reduces stress. It increases time-on-task, allowing more effective patient care. With AHA high-end estimates projecting a staggering 4.8M hospitalizations, 96M total US cases, and up to 480k deaths, every second saved is potentially life-saving time. It is important to note that these are high-water mark estimates, and they do not incorporate changing environment dynamics and additional measures taken to limit the spread of the coronavirus, such as self-imposed quarantines, mass school closures, cancellation of public events, and remote work mandates/options.
OptimizeRx is taking a proactive approach to enabling information provisioning to health care providers. It has embedded coronavirus updates as released from the Centers for Disease Control and Prevention (CDC) into its cloud-based health information network, which is used by many electronic health record (EHR) providers. This ensures that health care practitioners have access to the latest coronavirus information via their EHR dashboards in real-time. EHR vendors will undoubtedly seek to contract with additional data providers that can provide actionable informatics and analytics data from both external and internal sources to enhance their offerings.
Telehealth initiatives have slowly been gaining momentum over the past few years. However, as impressive as the technical capabilities are, cultural resistance and regulatory barriers have impeded the rapid adoption needed to shift the current healthcare infrastructure enough to help during this crisis materially. The sad reality of our current state is that:
- One percent of US consumers over 65 have used telehealth, with 50% of this demographic unwilling to try it as an alternative care delivery option (this does not include the challenges seniors have with modern technology).
- Consumers overall are generally oblivious and unaware that telehealth options may exist for them already. Twenty-three percent of providers have conducted telehealth patient visits, but 6% of consumers surveyed stated they have telehealth options available. This is a serious disconnect!
- Uninsured individuals are unlikely to have telehealth access and are forced into ER visits, further spreading the virus. In fact, 13% of US adults are underinsured as of 2018 per the CDC.
On a positive note, the US government has recently approved $8.5B in emergency funding to combat the coronavirus pandemic, with $500M earmarked for telehealth programs. The goal is to reduce the existing regulatory barriers currently restricting Medicare beneficiaries from accessing virtual care. Trends also indicate that overall attitudes towards telehealth are positive; we simply have an information and learning gap to overcome.
Repost from Daniel E. Lewis, PhD with permission:
Research by Scott Bickley, Info-Tech Research Group