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The growth in business cases for new models of healthcare delivery and integration of digital health technology is reaching the point of convergence — creating powerful synergies where there was once only data silos and skepticism.
We have not quite achieved this synergy yet, but opportunities emerging in 2015 will move the industry much closer to the long-awaited initiatives in connected, value-based care.
Individuals are constantly hyper-connected to a variety of technology networks and devices. Wearables will continue to enter the market, but their features and focus will go well beyond fitness. Even the devices entering the market now are more sophisticated than ever before. Some are now equipped with tools like muscle activity tracking, EEG, breath monitoring, and UV light measurement.
It will be fascinating to watch how consumer electronics, wearables, and clinical devices continue to merge and take new forms. Some particularly interesting examples will be in the categories of digital tattoos, implantable devices, and smart lenses.
As the adoption of wearables continues to grow, we will continue to see more value placed on accessing digital health data by healthcare and wellness organizations. This will be especially important as healthcare shifts towards value-based models of care. The need to gain access to the actionable data on connected devices will only grow as innovation creates more complex technologies in the market.
This is the year the promise of telehealth will be realized. It is projected that by 2018, 65 percent of interactions with health organizations will take place via mobile devices. Those statistics speak to the need of satisfying the growing demands being placed on providers, along with the growing discernment among patients when it comes to selecting affordable and convenient medical services. The continued adoption of telehealth will extend the point of care for providers and provide ubiquitous access to medical professionals for patients.
A number of entities are already putting this into practice: Walgreens, in partnership with MDLIVE, recently expanded their mobile platform to offer virtual doctors visits for acutely-ill patients; Google is testing a HIPAA-compliant medicine platform for video chats with doctors; and, digital urgent care solutions, like Doctor on Demand, are growing in popularity due to their convenience and low cost.
Telemedicine will not only extend the point of care, but will also be critical in better combatting chronic disease. Managing chronic health conditions will become the focus of many healthcare providers, as models of reimbursement and population health management (PHM) continue to replace fee-for-service models. One issue with chronic disease management is that it is difficult to monitor at-risk patients outside of the hospital. This is where telemedicine comes in.
Prescribed devices and applications to better handle chronic conditions will increase in pervasiveness. This idea of prescribing mobile health to better manage disease states translates to a host of chronic conditions – obesity, diabetes, heart disease, arthritis, cancer.
For example, our client UCSF uses devices like step trackers, sleep trackers, scales and blood pressure monitors to track patients at-risk for heart disease or cardiac readmissions. Another client, UNC is creating a Gastro-Intestinal tracking application (GI Buddy) that leverages fitness devices and scales to monitor Chron’s disease. There are thousands of studies pioneering innovations to improve the efficiency and effectiveness of healthcare. And, they are making serious strides.
The automatic transmission of pertinent patient data from these mobile health technologies is propelling forward capabilities for cost-effective, efficient and successful remote patient monitoring, population management and patient engagement programs.
However, as telehealth and telemedicine capabilities continue to develop, the major hurdle for most providers is integrating and the mobile health data collected outside of the hospital back into the clinical story for use in the provision of care. In a value-based healthcare system, the key to better outcomes lies in data, and specifically, obtaining access to data generated outside of the provider setting.
Platform services will continue to be vital partnerships as healthcare systems are expected to quickly execute on all these initiatives simultaneously and successfully. Bottom line: The industry is transforming, and if you have not started talking about how to connect to those external data sources, then you need to start.
These emerging trends will continue to bind the landscapes of technology, healthcare, and business. The road set upon long ago by medical professionals and legislators is finally coming to fruition. The walls of interoperability are beginning to come down, investments are growing, partnerships are forming, and consumers are starting to take notice. We are moving towards a digital health revolution. We have the opportunity, the responsibility, and the honor, to align healthcare and technology innovation to exponentially improve our care system. It is a tall task, but we are off to a promising start.
With news that Richard Branson sees telemedicine as a decent investment opportunity, it raises the question of whether a dominant telemedicine model will emerge. That was one of the observations shared by Katerina Fialkovskaya, co-founder and managing partner at Boston-based OKM Capital.
She welcomed Branson’s entrance into the market last week and noted:
“The flow of investment into the space will certainly accelerate the process and help to figure out the winning model. Whoever is the winner, the benefits for the society, that mobile technology is to bring by disrupting the health care, are incomparable to the social network revolution.”
It’s too early to say which model will win, since familiarity with telemedicine will take some time before it works its way into the mainstream awareness. But here’s a sense of how some companies are approaching telemedicine models.
Web-based and mobile companies like Doctor on Demand, in which Branson invested, provide feedback to patients based on the symptoms they give. They tend to generate revenue from employers interested in whittling down healthcare expenses and whose employees tend to have high out-of-pocket costs. Users tend to get whoever is qualified to provide medical advice in their community. Some also offer the services to consumers for a flat fee, such as $50-$60.
What’s interesting is the scope for specialty medicine in this area such as dermatology. Dermatologist on Call is a direct to consumer mobile platform that lets users take a picture of a rash or mole and send it to the company and receive a response from a dermatologist in three business days. Second opinions are also another part of the model. MDLive recently partnered with Children’s Hospital of Pittsburgh to offer second opinions in pediatric cases. For $3,000 2ndMD customers can speak with two to five specialists, depending on their condition, after providing lab, test results and a physician’s assessment or recommendation for treatment a few days before.
The healthcare kiosk has the feel of stepping into some futuristic pod. HealthSpot and SoloHealth are the dominant companies in this space. HealthSpot users connect with a physician online and tend to play an active role in the exam by using one of a handful of electronic medical devices such as a thermometer, stethoscope, an otoscope to get a better view of an ear and a dermascope to get a better view of a rash or skin problem. Non emergency medicine tends to dominate in telemedicine and kiosks are no exception. Each of the devices transmits an image or reading to the physician on the other side of the screen. It’s formed a joint venture with Cleveland Clinic after doing a pilot of the service for one year which raises some interesting questions about which directions it could go in. It’s also providing it kiosk service through an employer wellness plan by Kaiser Permanente to one of its company clients.
With healthcare kiosks and many of the online models, the physician tends to be someone the patient hasn’t previously met. But the founders of these businesses take the view that access triumphs familiarity. SoloHealth has kiosks in retail sites and lets consumers in high-traffic retail locations monitor their blood pressure, central vision and weight, as well as get a health-risk assessment. Users can identify and contact local physicians. WellPoint and Coinstar are among its investors.
The highest profile national drugstores are still experimenting with how they approach telemedicine through in-store clinics. The furthest along appears to be Rite Aid. It embraces both telemedicine through the in-store clinic and the online experience. Its NowClinic is available at 58 of its stores through a collaboration with UnitedHealthcare’s Optum Health Solutions. It started with nine stores in Detroit in 2011, but now has a presence in stores around Baltimore, Philadelphia and Pittsburgh. In some states providers — doctors or nurse practitioners can prescribe medication based on their diagnosis. But it also offers 24/7 access to providers online. Users log in and complete their contact details and health history. They can also get a copy of the physician’s summary sent to their primary care provider and integrated into their health record.
CVS uses nurse practitioners to provide telemedicine services to patients in the presence of a nurse. Although its initial focus has been rural communities where Medicare tends to reimburse for telehealth care, an increasing number of states require private insurers to cover telemedicine, including California. That’s where CVS is piloting telehealth in 28 states. Walmart is collaborating with Humana to provide telemedicine access in a handful of stores at Humana Health and Well Being Centers.
On March 12, the Center for Technology Innovation at Brookings examined mHealth applications in Africa, with a particular emphasis on mHealth innovations in Nigeria, Liberia and Sierra Leone paying specific attention to child and maternal health.
Telemedicine is already alive and well across medical institutions spanning every corner of the globe. Let’s take a look at a few examples of how telemedicine implementations are improving the delivery of care as we know it.
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