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The Rise And Fall And Long-Term Rise of Digitally-Enabled Health Care

The Rise And Fall And Long-Term Rise of Digitally-Enabled Health Care

Source : Medtech Insight

The tailwind behind the increasing adoption of telehealth during the first wave of the coronavirus was put into perspective during a Deloitte-hosted panel at AdvaMed’s 2020 MedTech Conference.

The virtual panel, chaired by Deloitte’s head of global medtech practice Glenn Snyder, addressed the theme of the provider environment in times of COVID-19-induced change. It sought to place a current and future value on telehealth as a tool to deliver health care across the care settings.

Mayo Clinic’s Clark Otley observed that, in adapting to the daily challenges thrown up by the pandemic, the clinic’s use of telemedicine rose from under 1% to 60% within two months. “Had that been 10 years ago, it would have been the old playbook,” he told the panel. However, in September, it was back down to 10%.

That fall is because certain things need to happen to make the change more permanent, said Teladoc Health’s president of health and hospital systems, Joe DeVivo. The fast rise and fall in use of telehealth this year was based on doctor-patient consultations in a climate of COVID-19 lockdown. “It didn’t stick because it wasn’t part of the patient workflow or the normal practice of medicine,” he said.

Switching to virtual care entails many steps on the part of the physician and other clinic staff who are called on to contact patients, set up a virtual consultation, confirm it, and finally carry out the consultation. Those are new challenges for clinicians, but so too are billing for these services and maybe even proving that a virtual consultation has taken place.

In order to make this shift to telehealth more permanent, these capabilities must be embedded into the core systems of health care, said DeVivo. And they have to be made easy, with automatic reminders, for instance, being sent to patients.

“[Telehealth] is not yet built into the normal practice of medicine. When reimbursement has firmed up, the technology has become part of the normal workflow and people have been educated into how to use it properly, people will demand it,” he asserted. Telehealth can make health care “more friendly.” Moreover, providers will see this, and employ it for competitive advantage.

Abbott Laboratories Ltd ’ Andrea Wainer stressed the need to secure appropriate reimbursement for new technologies once they have been proven to be more effective in enabling people to be cared for at home. New COVID-19 tests have given governments more options. Test reimbursement should also cover point of care testing, which is often not at the same level as for core lab tests, said Wainer, who is Abbott's executive VP of rapid and molecular diagnostics.

Some health systems, like Mayo Clinic, are already ahead of the game. Five years ago, the over 150-year-old hospital decided to create a virtual form of the clinic, the Mayo Clinic Platform, in parallel to the bricks-and-mortar entity. It was powered by big data and data sciences, Otley explained. People “attending” did not have to travel.

“We wish we’d started that five years ago,” said Otley, who is the clinic’s business development medical director, as well as CMO of Mayo Clinic Platform.

Mayo Clinic has also developed an advanced care at home program, which provides hospital-level care in the home setting. It teamed up with Boston-based technology services company Medically Home to implement the program. Shifting advanced medical care into the uncontrolled environment of a patient's home might seem be hard to do, said Otley, “but it works, and is based on advanced analytics.”

The next step must be to move from concept awareness to institutionalizing telehealth in the workflow, said DeVivo.

The concept includes testing at the point of care, digitized data intake, data management and virtual interactions. Like telehealth, former InTouch Health CEO DeVivo has been fast-tracked into the health care industry spotlight this year: InTouch Health was acquired by Teladoc Health, Inc. in early 2020, which in August went on to do the industry’s largest merger agreement of the year, the $18.5bn acquisition of Livongo Health, Inc.. ()

As to telehealth use now, Mayo’s is still ten times higher than it was pre-COVID, but the clinic also knows that this level is at one sixth of what it could be. As Otley suspected, higher recent use has confirmed to the clinic that telehealth works very well for some consultations and has pleasantly surprised in certain other areas, and has shown clearly questionable value for some other uses.

Still, there are ways of integrating remote/virtual care on a partial basis for prospective patients. Virtual care for a skin cancer patient, for example, could involve kits being sent to patients at home for them to do a minimally invasive diagnostic test or tape stripping. The results might prevent a patient from having to attend the clinic; and if it didn’t, the clinician would already know how to prepare for the consultation and care.

Otley was impressed by the possibilities on offer. The sudden broadscale ability to access digitized personal care pathways and the convenience and personalization they offer is a major shift in care and “a wake-up call for us,” he said.

“It’s a positive innovation that is unlike anything we’ve seen before,” he added, echoing Snyder’s contention that the increasing use of telehealth was indeed the implausible “silver lining” of the pandemic.

Telemedicine was recently only on the fringes of health care, neither reimbursed nor part of the normal delivery of care. “We’ve tapped into something that can truly be a solution in health care,” DeVivo said. Traditional medtechs are now thinking more about their digital footprint and where they can reduce costs.

“If I was a brick-and-mortar medtech company now, all I would be thinking about is the coming digital age, how I can manage my outcomes, deliver a premium service and not get commoditized,”he said.

By Ashley Yeo