Digital health is being touted as a progressive solution for some of healthcare's most intractable issues. Although at its infancy in healthcare, advocates claim that the digital future will bring more precise interventions, higher health outcomes, more efficiency, and eventually lower healthcare costs.
But how realistic is the promise of lower expenditures and enhanced health? We asked experts to share perspectives from a clinical, technological, and financial point of view.
Dr Steve Ommen is the Medical Director of Consumer Product and Platform Strategy at Mayo Clinic Center for Digital Health. When asked if digital medicine is facilitating efficiency through innovation and its impact on healthcare for physicians, here is what he had to say: “Digital healthcare solutions are improving efficiency in many health care systems. From a patient's perspective, the ability to get care without having to travel to a facility is much more efficient for their daily life. Provider teams are also finding that many of the video visits actually take less time than in-person visits and asynchronous activities such as secure messaging or online algorithmic care options improve efficiencies for those teams. Remote patient monitoring, the use of devices that the patient wears or has in their home to monitor physiologic parameters such as heart rate and blood pressure, allows a small team of nurses to monitor a large number of patients and look for deviations from the expected physiologic data that might indicate a patient is getting sicker. This allows an earlier less costly intervention in many cases. While tools like video visits have become commonplace and are quite familiar to most physicians, the newer solutions such as artificial intelligence or in-home remote monitoring do require teams to get more familiar and adopt some of their care pathways to fully take advantage of these solutions.”
While Majid Kaddoumi, President of Central & Eastern Europe, Middle East & Africa at Medtronic, shared its viewpoint as a leading global healthcare technology company.
“We believe that through developments in artificial intelligence (AI) and data analytics, medical devices are advancing disease management by empowering clinicians to personalise medicine like never before. These technologies provide revelatory insights into individual patients, in real time.
AI is becoming an integral part of healthcare because of advances in computing and sensing technologies, the expansion of available data, and the creation of better algorithms. As we continue to unlock the continuous data our devices and therapies generate, AI and machine learning are increasingly important tools at Medtronic. That's why we're actively adding innovative AI technologies to our research and design capabilities. Already, AI plays a pivotal role in the company's robotic-assisted surgery platforms, colonoscopy and endoscopy systems, and insulin pumps.
Recently, we launched the only FDA cleared “smart” insulin pen that integrates glucose sensor data, putting the power of AI to work for patients with Type 1 diabetes who rely on multiple daily injections. The future of healthcare has arrived.”
Furthermore, is there a possibility of innovation prompting cost reductions in the healthcare industry or will it increased costs?
Dr Steve reminds us that in the short term there are always start-up costs. However, when looked across a longer timeframe, these new digital solutions can add value, improve this efficiency and save money. “We have shown that the use of video telemedicine solutions to provide specialty services -- like stroke neurologists or neonatal intensive care specialists to rural hospital settings -- results in improved outcomes for the patients in health care expenditure savings. We have also seen with remote patient monitoring that hospital admissions or readmissions can be dramatically reduced. During the COVID public health emergency, sicker patients who were monitored had dramatically lower need for hospitalisation, dramatically lower intensive-care unit stays, and dramatically lower death rates because they were being monitored in their homes by skilled professionals. We have also shown that patients who were offered remote care options express high levels of satisfaction with these services and that we save patients money by offering these services to them. We have also shown in community care practices that allowing providers to have time on their calendar to address remote care in communications that the overall utilisation of the community care services and the cost per patient can be reduced,” he explained.
Majid added, “We can call it technology or innovation that delivers value: Better patient outcomes result in better economic value. Advances in technology can deliver profound benefits for global health systems. We see firsthand how medical technology is helping patients live healthier lives, creating value across the entire healthcare continuum. And when patients who have chronic, costly conditions like diabetes or hypertension successfully manage their illness, it can help reduce hospital stays and readmissions, allowing health systems to operate more efficiently. Medical devices with the power to analyse continuous streams of healthcare data — such as insulin pumps and certain cardiac devices — can help clinicians devise better treatment plans while helping patients live a healthier life.
Global healthcare costs are skyrocketing. Fragmented health systems focused on volume are buckling under the financial pressure of treating widespread chronic diseases such as diabetes, hypertension, and cancer. Patients don't always receive the care they need when they need it. And these issues have only been exacerbated by the COVID-19 pandemic's impact on people, health systems, and communities around the globe.
It's time for a new model of healthcare, one that uses the power of technology and data insights to deliver better outcomes.
We know the move to a value-based model of healthcare isn't easy. But through technology and innovation, we can address outcomes, costs, and access. There is no better time than now,” he emphasised.
So, what are the factors which cause constraints on resources to be integrated?
According to Dr Steve, there are several constraints on the adoption and implementation of digital health care solutions. “In the United States, health care providers are licensed individually in a state, and some of the states do not allow cross-state delivery of care using these tools. Reimbursement for digital health care solutions cross states, while facilitated during the public health emergency, is uncertain once the public health emergency is declared to be completed. These issues will, conceptually, apply globally, vary in the impact or complexity in each country. From a technology standpoint, many of these options are integrated into electronic health records. When this is the case, it can be part of the care team's standard workflows. However, some of these solutions are not integrated within the EHR and therefore creates some logistical or workflow inefficiencies as new teams are trying to integrate these solutions,” he said.
Majid highlighted that emerging markets face unique obstacles in their quest to stand up and establish sustainable, high-quality, and cost-effective health systems. “Access is typically impacted by location and proximity to quality health institutions, a few quality trained specialists and healthcare practitioners, and insufficient infrastructure or facilities. These restraints are specific to emerging markets. Developed markets have a set of different restraints that are more related to system connectivity and integration.”
Technology has facilitated integration of big data, telemedicine and blockchain. However, is the adaption challenging and are we still in a transition period, where training, and purchase of products have significant costs?
“We are still in a transition. Not only are the big data engines, and artificial intelligence machines just now starting to be trained on health care issues, but the health care teams are just beginning to get comfortable at utilizing these tools as part of the management of their patients. There are also some potential socio-economic disparities if these tools are not thoughtfully made available ubiquitously. As the question itself suggests, these new approaches do come with startup costs which may be difficult in some systems or geographies,” said Dr Steve.
“The technological and cultural revolutions are allowing technology and people to be better connected to one another, a network of connected, smart devices and objects that can communicate with each other and automate key tasks. Most patient interactions with the healthcare system involve the use of medical equipment and devices. The integration of technology and data brings together the digital and physical worlds to improve the speed and accuracy of diagnosis and treatments, and monitor and modify patient behavior and health status in real time. It also improves health care organisation's operational productivity and effectiveness by streamlining clinical processes, information and education, operations and workflows. During adaptation phase we expect better efficiencies and will provide better value for the technology and services provided,” mentioned Majid.
And what do insurance providers say?
"The pandemic has driven the conversation around utilising technology and affordability in a promising direction. We are already seeing innovative solutions and integration of reducing costs in the healthcare sector. It is also making overall procedures efficient and empowering people to manage their effectively. One such example is Cigna’s innovative solution, SmartCare, we developed this solution to make healthcare services more accessible to employees and alleviate the pressure on employers. The service offers access to a tiered network strategy encouraging access to lower cost facilities and driving affordability.
In fact, Digital Doctor’s, a study by Cigna Insurance Middle East, revealed that majority of doctors (85 per cent) agree that connected health devices and tools will provide patients with real-time data and knowledge about their health that will enable them to pro-actively manage their well-being and prevent diseases. Whether you're a relatively healthy individual who wants to track your fitness goals, an older adult who wants to maintain independence, or someone living with a chronic health condition, you can benefit from using connected health devices,” concludes Jerome Droesch, CEO of Cigna MEA and SEA.
