The End of Digital Health
2020 ended with a global sigh of relief as one of the most difficult years in the 21st century ended. A global pandemic, climate disaster, political upheaval, the list goes on. The year inspired the song ‘Fuck 2020’ by German artist, Scooter, and Netflix released a mockumentary called ‘Death to 2020’. Its not too difficult to guess the worlds sentiment for this particular year.
With 2021, the world will be addressing the ramifications of the past year with the distribution of the vaccine, the economic challenges of lockdown, and much more. 2021 will be challenging, however, in these difficult moments its best to take a page out of Monty Python’s Life of Brian and ‘always look on the bright side of life’.
On that note, there is one thing we can be grateful for in 2020 and 2021. That is how start-ups, digital tech corporations, along with healthcare providers are working hard to improve delivery of healthcare, broadening the scope of what wellbeing means, all via digitalisation.
In fact, an exciting development of 2021 is as digitalisation of healthcare continues to exponentially grow, what we will witness is the end of digital health. The end of digital health does not entail the sudden disappearance of digitalisation of healthcare but rather a paradigm shift. Today’s healthcare system is seeing widespread adoption of digitalisation to overcome today’s health challenges. Over the following years we will see as healthcare becomes inseparable from digital health, becoming one and the same.
Patient Journey from A to Z
The digitalisation of the patient journey will begin with the digitisation of our patient files. This brings about strong patient empowerment, as patients gain control over their own medical files. Along with this innovation, sharing of patient info will increase efficiency, reducing redundant testing and improved patient experience with the healthcare system.
Healthcare encompasses many aspects including prevention, diagnosis, and treatment all of which will be digitalised and tailored for many of our growing health issues like chronic disease, infectious (like COVID), and mental health.
In todays current healthcare system, we see a framework that is largely reactive, focusing on treatment. However, with digitalisation we will see our system transition into a preventative approach. This is largely due to the novel digital techniques being introduced in the field of preventive care.
Prevention
Today’s patients in Europe are equipped with smartphones, tablets, emails, instant messaging, wearable health devices and telemedicine, some of which will further be equipped with digital biomarkers. The aim of these is to detect and even predict health issues, such as heart conditions, panic attacks, falls, and much more.
Diagnosis
Patients will see improved diagnostics in the coming years. With their electronic health record, doctors and labs will have a lot more data on the patient than they could access before. The current system is currently inefficient and reductive, it focuses on a combination of analytical and medical interpretation contextualised to the patient’s medical record. Traditional medical records usually have a fraction of relevant information available. With patient’s electronic health records, they will find more extensive information that can lead to a more personalised diagnostic. This is further paired with improved software that can categorise, organise, and deduce relevant information for the lab technician and physician. The future of diagnostics will see researchers/laboratorians less defined by their analytical skills in diagnostic testing but rather their ability to integrate and interpret data with the clinical context data in an efficient manner.
Treatment
Patients will find that digitalisation will provide them with an improved and efficient treatment experience. With AI and access to big data, algorithms can be created to learn how the biological system behaves and can further be used to predict whether a drug treatment will be effective or not. New companies that focus on this are beginning to pop up like Accelerator cohorts Cyclica and Turbine that can predict drug candidates significantly quicker than traditional methods.
The process of clinical trials will also be greatly affected. Clinical trials are lengthy, high risk and costly process of drug discovery and development, often taking up to 10 to 15 years. Patient recruitment can be rapidly expedited thanks to electronic health records. Along with improved timing, decentralization of clinical trials to patient’s own homes with novel technology will further improve patient experience.
Physicians will also have access to more information and support too through digitalisation. Over the years we will see improved communication both locally, regionally, and perhaps globally as secure communication is improved across the healthcare workforce, allowing to share tips, data, and experiences on different treatments. Also, many companies are working to develop apps and support tools for different disorders and diseases for physicians. OncoAssist is a smartphone application that allows oncologists to make more informed decisions on available treatments for the individual patient!
Revolutionary Changes
Digitisation is the conversion of information or data into a digital format, like our patient files transforming into electronic health records. Digitalisation, on the other hand, refers more to the organisational and cultural transformation that occurs through digitisation. One of these especially relevant changes from digitalisation is our changing approach to primary healthcare with services and delivery. This will be one of the first and most visible transformation of our healthcare system.
Around the world, digital healthcare providers are changing society interaction with healthcare, like Ada Health in Germany or Babylon in the UK. Babylon Health was launched in the UK in 2013 and has since expanded internationally, offering subscriptions to their online health services to Canada, Rwanda, United stated and Saudi Arabia. The platform offers online consultations with nurses, GPs, therapists and even specialists. There is also a symptom checker that can inform you on what might be your possible diagnosis and suggests who to speak to next and what steps to take. They also provide users with a health check tool that allows you to build your own report of your health and further identify risk factors and improve overall health.
The app is flexible, and services are matched with what your health insurance covers. In the UK, its connected with the NHS and provides access to several primary health services. Physicians are able to give prescriptions to patients that can be directly delivered to their home. Babylon provides access to consultations 24/7, allowing users to have constant assurance of getting help the moment they need it. Primary healthcare will see a transition from the office to the screen for the majority of cases.
Health Challenges
Digitalisation does not stem solely because of advancing technology, but rather out of absolute necessity. The world faces a growing, ageing population. With this transition in demographic, we also see a growing burden of chronic disease as people live longer. Cancer, heart disease, ALS, Alzheimer, Parkinson, diabetes the list goes on and on.
As we stand, chronic disease represents 77% of the total burden of disease. Chronic disease is costly as it requires constant monitoring along with treatment and possibly additional support from care givers. Furthermore, it is often an illness that stays with the patients for several years or until the end of their life, potentially dramatically reducing their quality of life simultaneously. Our current healthcare system is ill-equipped, it lacks the efficiency, money, healthcare providers, and space to deal with such a problem.
Digitalisation offers a lot of promise to reducing this growing burden. Improved efficiency, cost-effectiveness, and furthermore treating patients from their homes could ease the strain on our healthcare systems. However, transitioning into a digital healthcare system comes with its own challenges…
Key Factors to Transition into the Digital Era
To see widespread acceptance of digital health, there are a few key factors that must be addressed. This can be broken down into a few parts including; patient and physician acceptance, staff, and finally business strategy.
Patient, Physician, and Regulatory Acceptance
Patient and physician acceptance comes with its own challenges and factors. Patient acceptance has seen steady growth over the past few years as the image below illustrates. From 2016 there is already a big difference in patient requesting digital options from electronic prescription refills to online physician consultations. However, for those who are not so familiar with the digital alternatives a few key strategies should be implemented. To begin, digital understanding must be pushed through education and guides for both physician and patients. An additional educational program must also be combined for the patient focusing on health literacy so that they may make the best-informed decisions regarding their health, and further have fruitful conversations with their physicians. A final key driver for both physicians and patients is ensuring patient privacy, regulatory approval, and proven effectiveness. Health-Tech companies must demonstrate an effective and safe digital alternative.
Staffing
Deloitte published an insightful article arguing for the need to create an office and team that focus specifically on digital transformation. While the article focuses rather on industrial players, a similar strategy should be applied in the healthcare system for hospitals, clinics, and other healthcare providers. Digitalisation will be a multifaceted and overwhelming transition that requires continuous monitoring and change. Having a team of experts on digital transitions can make sure that implementation is done correctly and efficiently. Besides implementing digital systems, they could further aid the hospital staff on understanding and applying these changes. Further, as mentioned before in diagnosis, more staff will need to be able to work with and integrate various modern digital systems and identify relevant information. Staffing will experience a shift; however, it is absolutely crucial to aid in the transition to the ‘digital age’.
Business
To sustain the transition, digital health companies must throw their own weight in and make sure they have an effective product and robust market strategy. Heal Capital has published a few articles looking at particular marketing options for various health tech innovations like digital therapeutics and telemedicine. As digital health companies receive regulatory approval, they still have a long way to go before hospitals, physicians and patients accept their product. Healthcare providers are looking for products that will effectively aid patients, keep them engaged, and simplify the physician’s life.
Having an amazing product is only half the story. Entering the market requires a robust, strategic, and flexible approach. Christian Weiss, Heal Capital’s managing partner, noted that telemedicine as a standalone product could be short-sighted as it fails to capture a wide enough market to make it profitable. His suggestion was to widen the scope, to develop a Vertically Integrated Micro-Provider (VIMPRO), giving the user end-to-end coverage. This would entail a telemedicine platform that could further provide prescriptions, digital therapeutics, coupled with online consultations, perhaps focused on a particular issue like acne or diabetes.
Partnerships will be another key strategy in successfully entering the market and becoming widely adopted. Already a few legendary partnerships have taken place. Teledoc, a massive telemedicine and virtual healthcare company has merged with Livongo, which provides a virtual chronic condition management platform. Teledoc paid $18.5 billion for the acquisition of Livongo. Selecting a partnership is a risk, so making sure the two companies align on values and goals is critical. Heal Capital will be writing more about these big digital health platform partnerships in the coming weeks!
Future
Should the healthcare system raise up and overcome these challenges, we will see further progression of this digital transformation. Currently, we are witnessing a systems level adoption as various health centres, hospitals and clinics implement digitisation. However, should things continue to progress, the following step of the digital transformation will be to implement digital health to improve population-level monitoring and prevention along with a general lifestyle change as health awareness and literacy improves. With electronic health records, researchers can witness large-scale trends and predict outcomes like raise of chronic illness or other issues.
The paradigm shift into digital health or rather just ‘healthcare’ will see widespread societal impact as patients go from being passive to empowered, knowledgeable and active patients. Through digital health, patients have been given more access to their health file and decisions in their prevention, diagnosis, and treatment. Physicians will also receive more support in their daily tasks as big data, healthcare apps, and improved technology allows them to be more time efficient and have access to valuable information/data as they go about their tasks of aiding patients. Hospitals will also see improved results as they are able to triage patients first in their homes with symptom checkers, improve their scheduling and communication across departments and healthcare providers, and further use big data to come up with cost-effective health strategies.
