COVID Tailwinds for Digital Health Trends
In the United States and abroad, the COVID-19 global pandemic has both rocked the economy and tested the limits of already-stretched healthcare systems. Large corporations and startups alike have sprung into action to alleviate the shortage of personal protective equipment (PPE), hand sanitizer and ventilators, as well as to support the heroic efforts of frontline healthcare workers.
Headlines abound of the new partnerships and innovative technology solutions aimed at fighting the current crisis, but fewer stories detail the deep (and in my opinion, durable) impacts that the pandemic will have on the digital health industry. A number of major trends in consumer and enterprise healthcare IT have developed in the past decade, and I believe the current crisis will serve as a strong tailwind, accelerating the uptake of novel and nascent modalities and technologies that support the “Triple Aim” of:
- Improving patient experience
- Reducing the per capita costs of health care
- Improving the health of populations overall
Telemedicine
Telemedicine is arguably the most covered healthcare trend that’s experiencing a massive expansion during the current crisis. It’s a no-brainer why patients would flock to telehealth solutions in a time when many physical doctors offices are closed, and hospitals/urgent care clinics are considered high-risk for transmitting infection. Many patients and physicians are trying virtual visits and consultations for the first time, both for COVID-associated symptoms as well as unrelated healthcare needs, such as mental/behavioral health and maternal/pregnancy care.
HHS recently relaxed HIPAA guidelines to support the utilization of telemedicine solutions during this time of unprecedented demand. Congress’ Coronavirus Preparedness and Response Supplemental Appropriations Act earmarks $500M to expand coverage for telehealth services in Medicare. Leading payers have responded by expanding coverage and offering zero co-pays for virtual visits. Teladoc Health, a market leader in telehealth, recently reported massive increases in patient volume, as many as 15,000 visits requested per day.
It’s unknown whether this surge in demand will last beyond the current crisis. However, the flood of new patients and clinicians using telemedicine for the first time and the expansion of coverage/reimbursement will indubitably accelerate the pace of adoption for virtual care.
Remote Patient Monitoring and Virtual Clinical Trials
Hand-in-hand with telemedicine, the remote monitoring of patient vitals and other clinical markers is experiencing a groundswell of uptake. Hardware developers like Tyto Care and Kinsa Health have found new use cases for their devices, augmenting telehealth consultations and helping epidemiologists track the virus’s spread. During a time when in-person medical consultations are reserved for high-risk and advanced cases of COVID-19, doctors and researchers are eager to explore *validated* technologies that can *securely* transmit important clinical data from the comfort of a patient’s home.
In the life sciences industry, clinical research for new therapeutics (not treating COVID-19) has been massively delayed. The FDA recently issued guidance, encouraging virtual visits and remote monitoring to support patient safety and trial integrity during the pandemic. Pharmaceutical sponsors have begun to prioritize and pool resources towards core, late-stage programs. The Phase I/II, Phase IV post-marketing and longitudinal observational studies that will see the greatest support in the coming months will be those with existing protocols that leverage virtual visits and/or home visits and remote data collection via sensors and wearables.
I anticipate this shift will make a durable impact on future clinical trial designs, lending preferential bias to studies where patients do not need to visit hospitals/clinics, and where both traditional and digital biomarkers can be gathered outside of a trial site. Further, I expect accelerated market penetration of “eClinical” technologies, including eConsent, ePRO, and eCOA solutions. These trends will also support the added benefits of expanded access and participant diversity in clinical trials.
Next-Generation Staffing Solutions
Healthcare facilities are being hit hard in the crisis, with both physical (i.e. ventilators, beds) and labor resources stretched thin. Managing appropriate staffing levels has long been a central pain point for providers, and current circumstances have exacerbated the problem. Hospitals and elder care facilities are struggling to share staffing resources, monitor those staff quarantined/exposed to the virus, and track the movements of staff to prevent further spread of infection. I anticipate that following this crisis, companies like Nomad Health and BookJane will experience increased demand for their solutions which help facilities to better allocate and coordinate staffing.
Patient Engagement
The global market for patient engagement was estimated to be $9.1B in 2017, with 20%+ annual growth. Maintaining direct lines of communication between patients and providers, both before and after healthcare interactions is a critical necessity. A plethora of research has demonstrated how patient engagement can help improve medication adherence, healthcare outcomes, and value-based care programs.
The COVID-19 pandemic has helped emphasize the need for fast and simple patient communications for provider groups and health systems. In vulnerable populations, such as low income communities and foreign-born immigrants, people aren’t receiving critical information regarding the virus’s symptoms, vectors of transmission, and best-practices for seeking medical care. Some startups are responding to the call, such as ConsejoSano, which has developed multi-lingual communication offerings in 20+ languages to connect with patients about coronavirus.
EMR Interoperability, Portability, and Patient Access
Coincidentally, HHS issued two final rules on interoperability just weeks before this pandemic began its spread in the US. These rules help lay the groundwork and set a firm timeline for the implementation of key developments that support interoperability and secure sharing of electronic medical records (EMR), while instituting harsh penalties for information-blocking and anti-competitive behavior.
This pandemic demonstrates the urgency for interoperable and portable EMR, as well as the need for patients to access their medical records. Patients and their physicians need fast and easy access to EMR to understand their risk-levels. With an abundance of new triage and screening apps, it’s more important than ever that these new sources of clinical data be quickly integrated into a patient’s centralized healthcare record. Furthermore, because clinical guidelines are rapidly changing, fast and accurate data exchange is necessary to “push” updates across the continuum of EMR, screening tools, remote monitoring and telemedicine platforms.
