Some may believe that the COVID ’19 pandemic is a harbinger of a digital health rising tide, while others may believe that the pandemic has only accelerated the process of its evolution and adoption. I, for one, support the latter. The Digital Health market size is approximately US$ 195.1 billion in 2021, and is expected to grow substantially to around US$ 780.05 billion by 2030¹. Spending on digital health solutions is expected to reach US$244 billion by 2025². Digital Health Companies are slowly boiling, brewing, adapting and growing, and have captured the market when the time was ripe.
When a pandemic requires the need for mitigation in the midst of disruption and chaos, Health Technology companies are ready to offer them maturely Plug and play solutions that make adoption seamless and important. In addition, several countries are quickly recognizing the need to change privacy policies and data protection regulations to enable remote consultations and virtual health interventions³. This is driven by a lack of physical resources, and coupled with an alarming need for accessible and quality health services. But more importantly, there is a realization and a clear label for administering this new type of treatment no need be personal- virtually, virtual.
Objectively, virtual care can be divided into those that make you feel better, and those that keep you better… alternatively, curative and preventive. While the former takes care of patients during the necessity of the moment, the latter emerges as the new unsung hero; Unexploited solutions to global and ancient opportunities. The Center for Medicare/Medicaid Services (CMS) intention to incentivize improvements and care management can/can fly fast on the wings of such a software platform HealthViewX. Solutions such as Remote Physiological Monitoring (RPM), Transitional Care Management (TCM), Chronic Care Management (CCM), among others, help care teams monitor, manage and engage patients right from their homes. This in turn has been shown to reduce costs and accept returns, mitigate risk, improve yields and increase reimbursement⁴. Win-win-win!?
But, wait! While all of this sounds bright and comfortable, I wonder if there’s any resistance in adoption among doctors and patients… end users, in the end. I found an enlightening adaptation strategy matrix in an article by Ande De. In a matrix outlining the level of behavior change required of clinicians, versus the rate of patient resistance to adopting new technologies, TeleHealth, RPM, and COVID screening, response and monitoring, emerged victorious with least resistance from both stakeholders⁴. Although cloud-based web portals and health apps that record patient data met with some resistance, it was a pleasant surprise to note that there were no digital health ‘failures’, which met with high resistance⁴. The data also shows that Artificial Intelligence (AI), Prescriptive Analytics and Predictive are here for the ‘long haul’, facing high resistance among clinicians and low resistance among patients⁴…all predictable, yet surprising at the same time!
While there may be several intuitive and understandable reasons for rejection, I’m forced to boil them down to,
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Change management:
Willingness to embrace change and take time to get used to it. Technological evolution throws up some unknowns, mostly in terms of who should be involved, when and how. While an internally developed digital health infrastructure may make the unknown less bleak, it is unlikely that health systems will have the time, resources, and bandwidth to continue troubleshooting and improving. While these drawbacks are mooted with third-party digital health vendors, challenges arise with seamless interoperability, integration, and complete customization to organizational needs.
Encouragingly, more and more companies like HealthViewX are working to tackle this problem at the grassroots level. This platform requires seamless integration with its own custom interoperability engine, and the ability to fully customize the platform. -
Burden:
The fear and risk associated with the unknown. Some doctors may not be sufficiently trained in the use of digital tools, in addition to problems with seamless integration… resulting in potential medical malpractice and related legal claims. There is some open concern – are these malpractice claims attributed to doctors, technologists or those responsible for training⁵? Are there clear and well-established legal norms/protocols for how digital care needs to be provided and documented⁵? Most importantly, is the patient’s confidential data safe and secure?
In a survey conducted among 242 doctors in Pakistan, 69% ‘agreed’ or ‘strongly agreed’ with the sentiment of a lack of regulation to avoid medical malpractice. Only 29% believe their medical compensation will include telehealth consultations⁵. Another study found that doctors lack confidence in prescribing controlled drugs through TeleHealth.
On the other hand, research has shown that some malpractice, misdiagnosis, or mistakes can be avoided with AI and digital health interventions. This with the help of real time alerts, diagnostic decision support, tracking, reporting etc. More and more laws have been restructured to free up AI/digital health in dealing with accidents, in some circumstances. -
Proof:
A natural barrier to adoption in general is a lack of evidence-based results. Emerging Digital Health solutions may not be mature enough to deliver a historic laundry list of problem solving and adaptability to evolving user needs. However, the more external digital health solutions that healthcare entities adopt, the more their peers have a track record to witness and long for.
A valuable metric lies in achieving Quadruple Aim, i.e. focusing on Population Health, improving the experience of end users, and care providers/clinical staff, and reducing per capita health care costs⁶. There are some intangible results like, provider fatigue, time saving, patient outcomes, and patient satisfaction⁶. Externally developed tools also often provide case studies or scientific evidence demonstrating them meaningful results. -
Access:
While digital health has redefined care at the click of a button, socio-demographic barriers to access can result in health inequalities and digital disparities. These can be separated into technological barriers (eg, lack of smart devices and internet connection, prevalence of digital health in their region/community) and, digital literacy barriers involving ease of use of technology depending on age, literacy, income and technological acumen, etc.
While the digital divide can be narrowed by subsidizing the inherent access fees, and possibly by installing public access kiosks, ultimately, utopian visions must go beyond digital literacy to digital mastery and autonomy⁷.
My sassy but clever answer to these four points is, Time.
Time to move. It’s time to take the plunge. It’s time to embrace. Time to get and assess results. It’s time to move on. Time to revolutionize.
Time to be Almost perfect.
Reference:
- “Digital Health Market Size To Reach USD 780.05 Billion By 2030 Growing 16.1% CAGR – Exclusive Report based on Facts & Factors,” February 2023, Facts and Factors, https://www.globenewswire.com/en/news-release/2023/02/01/2599148/0/en/Digital-Health-Market-Size-Will-Attain-USD-780-05-Billion-by- 2030-Growing-at-16-1-CAGR-Exclusive-Report-by-Facts-Factors.html
- “Use of Digital Health Platforms During the COVID-19 Pandemic: A Consumer Perspective,” Alharbi. F, March 2021, PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116074/
- “Health and digital care during a pandemic: the impact of COVID-19,” Peek. N, Susan. M, Scott. P, 2020, BMJ Journal, https://informatika.bmj.com/content/27/1/e100166
- Adoption rate chart, “Five ways Digital Health Innovations grow + thrive post-pandemic,” Ande De, April 2020, Alteryx, https://www.alteryx.com/input/blog/5-ways-digital-health-innovation-will-grow-evolve-post-pandemic
- “Digital health technology risks specific to medical malpractice liability” S. Rowland, E. Fitzgerald, et al, October 2022, https://www.nature.com/articles/s41746-022-00698-3
- “Assessing the impact of digital transformation of health services,” PANEL OF EXPERTS ON HOW TO INVEST EFFECTIVELY IN HEALTH, Barros, P et al, November 2018, https://health.ec.europa.eu/system/files/2019-11/022_digitaltransformation_en_0.pdf
- “The Determinants of Digital Health: How to Narrow the Gap,” K. VIgilante, Feb 2023, https://www.forbes.com/sites/forbestechcouncil/2023/02/02/the-digital-determinants-of-health-how-to-narrow-the-gap/?sh=384def8c59ba
