The Big Digital Recovery - How health went digital overnight

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21 May 2020

Our second Big Digital Recovery webinar panel comprising Dr. Ansgar Lange (Chief Product Officer,  Cera Care), Dr. Jack Kreindler (Founder & Medical Director, CHHP & Mosaic Ventures), Tobias Alpsten (CEO, iPlato & myGP), Benedict Ireland (Head of UX, Splendid Unlimited) and Nick Chiarelli (Head of Trends, Unlimited Group) discussed how the transition to digital healthcare provision had been accelerated by the COVID-19 outbreak. You can listen to the whole discussion below.

COVID-19 has massively accelerated the adoption of digital health

COVID-19 represents an unprecedented challenge to individuals, global governments and health services alike. Of course, COVID-19 did not create the concept of digital health delivery. Over the past five to ten years we’ve seen an explosion in the use of technology in all areas of healthcare, including but not limited to telemedicine, the dematerialisation of diagnostics, the exchange of digital healthcare records, digital therapeutics, and others. However, the sheer scale, reach and severity of the global COVID-19 outbreak have forced lifestyle changes on citizens and placed an extraordinary degree of pressure on healthcare systems. So, despite the huge and tragic personal cost of this disease, we have also seen positive changes to the health and care system that have been expedited by it. People have (had to) become much more comfortable with video interfaces with their doctors. Far fewer patients have been going to A&E for situations that are not an emergency and we’ve seen them turning in ever greater numbers to remote support mechanisms such as phone consultations with their GPs, high usage of the NHS 111 platform, and in some cases adoption of newer video- and app-driven healthcare solutions.

Within this context is perfectly possible to view COVID-19 as a time of crisis in the true, original meaning of the word, as a time of great difficulty when decisions must be made and as a potential turning point, where those in the industry either embrace tech-first solutions and change the way things are done, for good, or potentially suffer the consequences.

We are seeing something that was played around with for a while and everyone thought was a nice idea and suddenly this forcing function [of COVID-19] has truly pushed medicine in the digital era.”

Dr. Jack Kreindler, CHHP & Mosaic Ventures

There has definitely been significant innovation in the how technology can be applied to various aspects of healthcare. Both citizens and providers have been interacting more freely with digital applications, in part because the situation has been thrust upon them by their enforced isolation, but also because the records, capabilities and resources that they need are increasingly available within the digital space: Here are just a few examples of areas where digital approaches have been successfully adopted:

  • More streamlined recruitment and training of healthcare staff
  • Usage of remote sensors to identify circumstances where care staff need to intervene to support vulnerable patients
  • Accessing repeat prescriptions
  • Accessing personal patient records
  • Remote and online/video consultations
  • Patient diagnostics

Before this, doctors and healthcare systems around the world were extremely reluctant to trust diagnostics in the hands of patients. Now that is happening and it could be the beginning of what we in healthcare had been waiting for – a diagnostics revolution.”

Tobias Alpsten, iPlato & myGP

Patient experiences are streamlined and enriched

Before COVID-19 it was clear that the NHS was under pressure. Without seeking to politicise the issue, it seemed that, patients experienced fragmented services, administrative hurdles and unreliable lines of communication. The “patient experience” often remained an afterthought in the NHS, leading to worse health outcomes, and costing the NHS dearly.

Under COVID-19, the role of the NHS within our society has been thrown into sharp relief. Each Thursday we now congregate to show our deeply-felt appreciation for the massive efforts healthcare workers are going to on behalf of all of us, and for their dedication, passion, selflessness and sacrifice.

Digital solutions are being applied to both streamline and enrich the patient experience. Early on in the outbreak there was a huge role for the ability of digital solutions to provide scale and volume of engagement, enabling healthcare professionals to allay fears, pass on information and, where necessary, leverage digital technologies to get kit to individuals or to get care and treatment implemented as quickly as possible.

Before, being allowed to discuss clinical cases with a dispersed group of ICU consultants before sending one of your patients off to their nearest emergency room without many of the usual barriers, would have been unheard of.”

Dr. Jack Kreindler, CHHP & Mosaic Ventures

It is also important not to overlook some of the more peripheral benefits of healthtech. Simply by streamlining the bureaucratic processes associated with healthcare, such as record keeping, they allow caregivers to spend more time with patients, both delivering care but also fulfilling a more pastoral role:

Care workers are doing more than just using digital tech. They are both an enabler for older people to use digital services and also a link between their elderly and vulnerable patients and the families that are currently prevented from visiting them in person.”

Ansgar Lange, Cera Care

There is, of course, a recognition that more can be done. It is tempting to imagine, for example, that video consultations are more widedly adopted than is really the case and it is also true that many elements of the patient journey currently exist in separate silos with different solutions for each.  Nevertheless, significant progress has already been made, and will continue to be made in making the typical patient experience both easier to arrange and manage, and for it to be better integrated, for the benefit of all:

Ideally, joining these services end to end is where we want to get to but, primarily this is about access to each of those individual services which requires havingt the right app and the right platform. Ultimately it will also be about the right kind of integration between them.”

Benedict Ireland, Splendid Unlimited

The capabilities of providers are being transformed

COVID-19 has focused placed deserved attention on frontline health staff, recognising the danger they place themselves in on behalf of society. Because of the burdens caused by the volume of patients it has also forced changes in working practice (GPs moving to phone or online consultations).

Technology is being used to create efficiencies, allow care-givers to spend more time with patients and less with administration or bureaucracy and encouraged legislators to take a more relaxed view towards enforcement of certain regulations (e.g. ICO not actively fining people right now if they are seen to be working towards helping patients, solving real-world problems, etc).

Digital is helping in all kinds of ways, from on-site compliance checking to criminal background checks for careworkers that are required in our industry, to better ordering and procurement processes for necessary equipment, such as PPE

Ansgar Lange, Cera Care

One of the issues for the future will be the ability of healthcare professionals, administrators and legislators to successfully and collaboratively tradeoff considerations of patient confidentiality, data privacy and rising demands for instantaneous service, with the pressure to deliver quality service/care at scale.

The system may struggle to cope with the increased demand that will come from digital and we may have to see contractual obligations for shorter and more responsive timelines.”

Tobias Alpsten, iPlato & myGP

What patients and clinicians regard as a fulfilling experience has flipped. Availability now trumps experience. I think we’’ll see a massive dematerialisation or decentralisation of care as a result

Dr. Jack Kreindler, CHHP & Mosaic Ventures

2020: Year Zero for digital healthcare?

As countries around Europe emerge tentatively from lockdown, the UK both watches on with interest and is taking its own, slower steps towards easing the restrictions on movement and interaction.

Aside from specific health-related discussions, much of the conversation around COVID-19 has centred on societal change (e.g. we’re getting good at WFH, we’re being kinder, we’re drinking more, some are exercising more, while others are putting on the pounds, etc). Understandably there is considerable debate about whether the changes we’ve seen and experienced will “stick”. Will we emerge into a “new normal” or will it be back to “business as usual”? And, there is, of course, a parallel conversation within the healthcare world about whether the expanded role for digital healthcare that we have seen under COVID-19 will continue once (the worst of) the outbreak is over. Perhaps not too surprisingly, our panel were firmly of the opinion that coronavirus will prove to have been transformative in driving a permanent change in the way that healthcare is delivered:

We will look back at 2020 and it will be a bit like BC and AD for medicine – Before Computers and After Digital.”

Dr. Jack Kreindler, CHHP & Mosaic Ventures

They also went further to, recognise the so far partial nature of adoption and innovation and to stress the need for continued effort on all fronts: from investors and entrepreneurs to continue to identify and respond to changing needs; from legislators and DPOs to enable the vital centralisation of patient data in common formats; from the comms industry to partner with healthcare providers in getting strong, proactive messaging out to the public about the changing nature of healthcare; from analysts and modellers to increase the sophistication of predictive, and preventative algorithms derived from democratic diagnostics; and from the industry as a whole to collect, study and publish as many forms of outcomes data (including economic outcomes) that will prove the efficiency of digital approaches as a springboard to their more widespread future adoption:

Despite the rapid acceleration of digital in healthcare, we need to recognise that we are still way behind other sectors, sush as financial services. We need to focus on digitalising more and more of the transactions and entrepreneurs are still needed to step up and continue to innovate.”

Tobias Alpsten, iPlato & myGP

Two things have fundamentally changed. One is the mindset of the public towards digital healthcare. And the second is a greater openness amongst the relevant government bodies to adopting digital solutions and the data exchange they need.I’m sure we’ll see these things living longer than the crisis and therefore the appetite for digital health will surely grow

Ansgar Lange, Cera Care

The NHS intent to empower the person is a stated aim in its published Personalised Health & Care Strategy from 2016, still being implemented now and showing us how far along that curve we really aren’t. The intent is there but in reality we are just at the start of that digitisation of care.”

Benedict Ireland, Splendid Unlimited

This article was written by Nick Chiarelli, Head of Trends at Unlimited Group.

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