In an environment changed forever by COVID-19, telehealth is just the start of rapid digital transformation in healthcare
After graduation from University in 1996 I went backpacking around the world - I would find myself queuing at the post office when I reached a major city to collect mail from home! Despite email being invented in 1980, it wasn’t accessible - there were no internet cafes or smartphones. It took the advent of ISPs (AOL, then Hotmail, then Yahoo!) followed by the birth of Blackberry to make email truly available for the first time. In the period from 1980 to 1993, email staggered from just 50 (yes, five-zero) to 7m users globally... By 1999, that had climbed to 400m… and by the turn of the millennium there was no looking back.
Just because the tech existed, it took a complex chain of events, enabling technologies, societal changes, plus the creation of consumer demand for a whole new way of communicating to happen.
No matter how good any new technological breakthrough may be, no matter how much sense it makes to the innovators, evangelists and early adopters, a paradigm shift like this, needs all the stars to be perfectly aligned for lift-off to happen. And sometimes, something extraordinary comes from nowhere, that unleashes the big-bang.
Healthcare has been one of the last bastions for widespread digital disruption - a sector absolutely ripe for tech to deliver so many transformative benefits for healthcare providers, clinicians, payers and patients alike.
Significant change and rapid adoption of tech often takes outside influence to coax industries into changing their behaviour and embracing a new way of working.
For those of us that have worked in health-tech for some time, it’s been apparent that momentum has been building and the doors to digital adoption have been opening. However, sales cycles can be long with plenty of red tape thrown in for good measure. It’s fair to say that the floodgates had not opened… yet.
Waiting in the wings has been a multitude of incredible health-tech ventures, who have invested heavily in creating truly transformative technology.
Today’s patients are consumers who expect user-centric tech in every area of their lives.
They, and I can tell you from personal experience, have grown frustrated by a lack of enabling technology to help them once diagnosed with something that they’d prefer to have dodged.
Coronavirus - [Enter Stage Right] - has created the perfect storm.
We are seeing ‘supply push’ from health-tech innovators, ‘demand pull’ from patients and clinicians, and a game changing environmental stimulus from a virus that has rewritten the rule book.
The healthcare industry is being forced to review and reimagine how healthcare is delivered safely, scalably and efficiently, at a rate of knots nobody ever thought possible. Balancing the utmost need to triage and treat people at home, whilst reducing clinical risk for our healthcare professionals.
Right before our eyes, healthcare is seeing its own paradigm shift.
Technology won’t solve all of the challenges this global pandemic has presented, but it can help solve a great many of them, particularly when it comes to health. But what does it mean for the patient experience?
“The future is already here – it's just not evenly distributed.” - William Gibson, The Economist in 2003.
Coronavirus has removed the luxury of time - ‘dither and delay’ is no longer an option. As has been widely reported, since early March we have seen a decade’s worth of change in a matter of weeks. Patients, healthcare professionals and hospitals have all been forced to adapt quickly, to keep people - especially those classified as ‘vulnerable’ - away from clinics to avoid exposure to COVID-19 and perhaps controversially, to ensure capacity for those infected.
The most obvious example of rapid adoption has been Telehealth. Before this pandemic, video appointments made up only 1 percent of the 340 million annual visits to NHS primary care. Now everyone affected has quickly come to expect that a video call will be their first interaction with their healthcare professional. Video consultations provide a level of convenience and safety for patients and clinicians. But this is just the start.
The innovation to support this new form of doctor-patient interaction however, must be underpinned by data. Video consultations alone rely on visual observations and patient recall - this is not enough.
Technology that helps patients to effectively manage key elements of complex conditions such as cancer at home, combined with remote access to data and monitoring tools by clinicians, plus the ability to hold video consultations, will deliver significantly enhanced outcomes and efficiencies. Accessing this ‘360° view’ will reduce clinical risk for healthcare providers and enable the patient to experience first rate care outside of the surgery or hospital, in the comfort of their own home. Whist video is incredibly helpful, alone it only provides insight as to how that individual looks at that precise moment in time - it lacks all important context.
We’ve seen this digital transformation happen in other sectors, most notably within banking and financial services. Our adoption of technology has moved the consumer experience from tellers in high street banks, to web portals for online-banking and now to mobile-only banks like Monzo and Starling. The traditional banking experience has been taken outside of the branch and into people’s homes. Easily accessible 24/7 and truly multi-channel, with routine transactions executed digitally, and more consultative complex transactions still performed in person. How we engage with our bank has changed dramatically, as have our expectations about the level of convenience and service we demand. Healthcare is no different.
The genie is out of the bottle. Our relationship with managing our own health has been steadily evolving since the introduction of pioneering consumer health portals and the ability to self track through the advent of wearables that I played a small part in establishing over the last decade.
Using platforms like Careology, for digital cancer care, we now have ready access to accurate physiological insights using connected devices, that can be blended with other data such as symptoms, side effects, medication adherence etc... and viewed side by side with video.
How we interact with and share this information with those who care for us will now also change. Data driven healthcare must now deliver a highly personalised experience for patients. One that begins to match our consumer expectations. This shift cannot be ignored and will not be reversed post pandemic.
As Secretary of State for Health and Social Care, Matt Hancock stated: “We won’t ever go back, where there have been advancements amongst these huge challenges, we must not lose them.”
As absurd as it seems today that I stood in a sweaty queue in the centre of Mumbai to pick up a letter that had been mailed from London weeks earlier, we are on the brink of looking back at huge change in the provision of healthcare.
We have known, for a long time, that the delivery of care and the doctor-patient relationship has become unscalable and is inefficient. The technology big-bang brought about by Coronavirus will drive efficiencies and help us tackle the growing burden of complex diseases and long-term conditions.
In an environment changed by a COVID-19 catalyst, health systems around the world need to learn quickly how to scale the provision of care in a safe and cost effective manner that delivers better care and outcomes to the patient, and protects patients and clinicians from this pandemic.
Patient-clinician interfaces must be reimagined and previous care models reinvented for today’s digital era. The advancements we are making today will propel us forward and deliver a raft of benefits for all. There is no looking back.