In the US, like elsewhere, the COVID-19 pandemic has impacted healthcare services by forcing the cancellation of elective procedures. This is hurting the margins of healthcare providers and putting pressure on managers to rein in costs. “Volumes for many elective procedures, especially in orthopaedics, have been reduced by an estimated 70%” according to Eric Chapman, Medical Analyst at GlobalData.
Patrick Allen is Principal, Healthcare Business Consulting at EPAM Continuum. The company works with healthcare providers and payors, and with both software and device developers. He points out that “the COVID-19 pandemic has accelerated the pre-existing situations and needs of the healthcare industry. It’s removed some irrational arguments against the use of technology. Telehealth, for example, was fringe before COVID, and not reimbursable.” But the need to continue providing care for patients while protecting themselves and fighting the spread of the virus pushed many healthcare systems and independent physician group practices to embrace telehealth.
Nemours is a children’s health system serving nearly 500,000 children across five states. As a result of COVID-19, it temporarily moved most outpatient appointments to its CareConnect telehealth program. For the month of April, it experienced 30,000 virtual visits, up from 800 in April 2019. Even as on-site appointments resume, telehealth has been embraced by many families and will remain an important mode of care delivery for Nemours.
Generally, patients have been very satisfied with telehealth, agrees Allen, both in the US and worldwide. And according to a recent report from Research and Markets, there are now expectations of rapid growth in the market. The telehealth market was worth $21.56 billion globally in 2017, and is now forecast to reach $200 billion by 2025.
But Allen sounds a note of caution. Many health plans don’t reimburse telehealth as well as in-person visits, so a structural shift is required in the business model to make it sustainable. “There are two parts to the solution,” says Allen, “the business part and the technology. For adoption to accelerate, we need to fix the incentives. Payment models need to change.”
Both telehealth and, especially, remote patient monitoring (RPM) were already on the rise before the arrival of COVID-19. Current Health, a British startup that has developed an AI-powered RPM platform, announced in June the appointment of a new CFO, John McLean, who will be based at the company’s Boston headquarters. In the past four months, the company has tripled its customer base and grown revenues tenfold. “Providers are looking to deliver care outside the four walls of the hospital,” said McLean.
Mindstrong, a mental health innovator, announced in May that it had raised $100 million in a Series C funding round. The company wants to improve care for people living with serious mental illness. The new investment will help it scale up its telehealth service and RPM solution. Users of Mindstrong’s service can arrange virtual appointments covered by their health insurance. Its smartphone app also monitors mental health symptoms and can trigger alerts to a member’s clinical team if there are signs of need or deterioration.
Other companies are exploring ways to tackle COVID-19 by monitoring for early signs of the disease. Nemaura, for example, is planning to repurpose its blood sugar monitor. The company’s sugarBEAT skin patch has an inbuilt temperature sensor that could be used to detect the onset of fever caused by many diseases. Continuous temperature monitoring has other potential uses such as tracking the fertility cycle and assisting in conception.
The coronavirus pandemic has highlighted structural challenges in US healthcare. There has to be a shift to value-based payments, a change in the payor-provider relationship that emphasises outcomes over activity. Simultaneously, COVID-19 has spurred innovations and accelerated the adoption of technologies that reduce costs, ease the patient experience, and improve outcomes.