Digital Healthcare UN-explained? or MIS-percieved?

Our life has changed. A lot. A pandemic like COVID-19 did a lot of difference in our daily lives and changed the way how we do things for sure. Because we were unable to "physically" access to goods, food, services, and anything we needed, we all "realized" that there was a "digital" way of accessing those services, and it was in deed quite convenient.

Some time ago I had written an article about "new normal" and had talked about how digitized services had already been available but we did not understand the value of it, or did not give enough credit. This one is particularly about the digital / virtual healthcare, and I believe there is a big gap in the interpretation / understanding of digital healthcare / virtual healthcare delivery.

The Problem

Transforming healthcare delivery into digital and how to effectively make it utilized is still an area that some efforts need to be spent.

The problem in the adoption of such is a multi-dimensional and multi-stakeholder one.

Even though the maturity of technology and digital solutions and tools in every aspect of our lives reached to a significant level, still there is a big trust issue to such solutions in healthcare area, especially if they touch to the patients and the HCPs. When we are talking about Artificial Intelligence, even though we are all using the benefits of AI in various ways in our daily lives, we are so hesitant to rely on it when it comes to our health.

The Conflict and the battle

Governments want their communities to be healthier, and want to implement all possible preventive healthcare measures to reduce not only the cost of treatment for the citizens, but make healthier living for their citizens. This requires implementation of national level healthcare information systems, electronic medical records, KPIs, guidelines. Eventually, they want to spend government budgets for "health" care, rather than "sick" care.

Healthcare providers wants to see more patients, and they want them to come to the facilities. Where they are willing to reduce their operational costs to the minimum level possible, yet, they are not very much willing to implement digital tools to possible take patients away from visiting their facilities. Besides, the government and payor policies for especially tele-consultations and any sort of supportive digital healthcare tools are not to the advantage of the providers and in a way causing them to thing that they are losing revenue.

Insurers want many members to pay premiums but does not want to pay too much back to the providers. They keep their packages limited to a certain number of visits, does not want to cover preventive healthcare tools, and does not offer policies to cover digital therapeutics, remote patient monitoring.

Patients / community members want immediate access to doctors, hospitals, at their own convenient time, mostly don't want to pay anything (as they are already covered by insurance policies), and be healthy.

The point missed in the overall loop is, if there is something that we can prevent it from happening today at a cost, it will help everybody to avoid from much more costs in the future for treating the condition.

A post-op bypass patient is very less likely to show up in the ER in the middle of the night with a critical acute condition, if he is monitored and his vitals are continuously evaluated, and any possible developing complication could be fore-seen.

A diabetes patient could be prevented from developing diabetic retinopathy and having a surgery/expensive medication/implant use in the future, if he is referred to an ophthalmologist and covered with periodic checks.

Examples could be more. The idea is, from the financial perspective, it shall be considered that, even though it may seem that the "cost" of implementing digital healthcare tools a bit too much for today, in the mid to long term, the benefits to all stakeholders will be much more.

Wait! Are you telling me that I can't talk to my doctor in his room, but need to see him on a screen?

We "patients" always had, have, and will always have the right and the chance to go and visit our doctors at the hospitals, clinics.

Digital healthcare solutions will not act like a magic wand and treat us no matter what conditions we would have, and/or they are not meant to restrict us physically accessing to healthcare services and treatments we need.

Not only because there are yet so many things that the technology is not capable of for the time being, but also because of critical and emergency cases must be intervened (heart attack, stroke, falls, ...) in the soonest time and in person.

None of the digital healthcare solutions are designed to restrict us from accessing to healthcare services, but it's just the other way around, they are designed for us, patients, to access healthcare services independent from location, time. They enhance and broaden the way and the variety of services that the patients can avail, even without checking in at a healthcare facility.

So, does this "thing" know better (than me) ?

We always and will rely on our respected doctors, nurses, care givers, and nobody and no technology will ever "replace" them. They will always be the ones who says the final words, they will always be the ones who cures their patients.

Medicine is way more completely different than anything with straight and solid strict logic and mathematics. That's why, they say "it's not the disease, but it's the patient". It's only doctors to know what is going on in what conditions for which patient.

Digital healthcare solutions, whether they are patient facing or HCP facing, are only designed and here to help HCPs for quicker diagnosis, for better treatment planning, for better understanding the patients' conditions, and for keeping an eye on the patients so that they won't completely be unaware of what happened to the patient between the two visits. They remove the burden of paperwork (at the simplest) and also remove them from "personally" monitoring and evaluating everything with their own personal efforts and time. Doctors need rest and sleep to refresh, and be ready for their next tough day, see and help many more patients. Digital tools keep their patients safe and monitored 24x7 and helps the doctors by giving them a more peaceful personal time, and alerting them when a condition change occurs.

Are you cannibalizing my revenue?

This is one of the biggest challenges to address. Healthcare providers are afraid that enabling digital healthcare, especially tele-consultations would affect their revenues because they think that they are "likely" to receive less patients, meaning that there is less revenue coming in. They want patients to come to the hospitals, clinics, and they want more patients to come.

The question for the providers is, if patients can access to their doctors remotely with a couple of clicks and solve their health problems without coming to the hospital, doing lab tests, X-Rays, MRIs, BT-Scans, additional consultations, then how are we going to earn money?

It may seem to be a valid point, especially considering that the payors are paying much lower rates for teleconsultations compared to in-person visits, and this is a very major point that needs to be addressed.

On the other hand, providers also "save" on their costs, which may reach to a point that their savings is more than the loss, and let's them stay on the positive side of the curve.

• Reduced No-show rates: A booked slot for a doctor leads to loss when the patient doesn't show up. Patients might just feel lazy to go to the hospital at the scheduled time, or may feel the need to avoid from the cost (time and money) of travel/transportation to the hospital. Tele-consultation will remove the burden of such expenses from the patient.
• Time optimization: Tele-consultations require less time to be spent per patient because there is no need for paperwork, waiting room management, and doing the examinations done in a more focused manner. The delay occurring when a patient leaves the doctor's room and the next comes in is also removed. That leads, providers can receive more patients in the same time interval compared to in-person visits.
• Less consumables and resources: In-person visits means use of examination gloves, disinfection materials, increased A/C use, electricity, water, cleaning materials and use of disposables. Virtual healthcare reduces the use of such resources to the level of essence, which saves cost for the providers
• Reduced ER Visits: Studies show tele-consultations have a significant effect on reducing the unnecessary ER visits. Virtual consultations can handle minor health issues, follow-up consultations, and especially reduces the ER visits occurring after-hours because the patient has not been able to come to the hospital during the operational hours for several reasons (occupied with work, can't take time off from the office, weather conditions, ...) but still needed to consult to a clinician.

From the patient side, access to healthcare on digital/virtual channels bring advantages as well.

• Reduced time and money cost: Patient does not need to travel to the facility, and most likely they would not travel alone but be accompanied by someone in the case of in-person visits.
• Less exposure to infectious diseases and conditions: Whether a simple flu or a very serious and/or contagious disease, when at the hospital, there is always a risk of exposure to diseases, viruses. Remember the days of COVID measures, avoidance of touching to any surfaces, social distancing
• Access to health care at any time at any place: What could be better than having some service available at all times regardless of where you are? Tele-consultation can be done using mobile phone, tablet, PC, and in some cases via devices that are specially designed to provide with virtual primary healthcare, equipped with bio-sensors to also send instant measurements to the doctor at the time of consultation.

Digital Healthcare is not just a video call

Even though it's the very first thing that comes to mind when talking about digital healthcare, it is much more than that. Variety of digital healthcare solutions brings hundreds of advantages and benefits to the physicians, governments, patients, pharma companies, insurance companies.

Patient-facing digital healthcare tools and solutions help improve the engagement between the doctor and the patient, lets the patient receive all the information required instantly and with accuracy, helps coping with chronic diseases, makes them stay safe at all times by monitoring vitals at all times and alerting care-givers in the event of an emergency. It helps reducing the cost of access to healthcare, and removes the barriers of distance.

HCP-facing digital healthcare solutions brings all the information available in the world to the fingertips of doctors, nurses, helps them make better decisions with the help of clinical decision support systems, make it much easier to access to patients' history of records, diseases and any sort of information that will help designing better clinical pathways. AI-supported solutions give physicians the chance of early intervention, and prevent adverse conditions, leading to improved quality of care.

Industry-facing solutions help pharma companies design more effective medicine, reduce cost of research, help providers automate their workflows, monitor utilization of their assets and equipment, optimize patient throughput, connect them to the national HIEs and exchange medical records instantly.

Digital healthcare solutions are the building blocks of digital healthcare ecosystems, which contributes to better quality of care, better monitoring, better population health management, and applies to various use cases. Here are some of them.

• Chronic Disease Management: Digital healthcare tools help patients with medication reminders, educational materials (e.g. a video showing how to do insulin shots, or a guide showing how to measure the blood pressure), a large database of answers to frequently asked questions, and also becomes a companion for the patients.
• Remote Patient Monitoring tools are used to effective post-operative care, chronic conditions management and preventative healthcare, making sure that the patients are doing well enough and the risk of a patient ending up in a critical condition is much lesser, and also gives a chance to the provider to early intervene, and proactively calling the patient in for a visit (or a tele-consultation) to better assess his condition when an alarm is raised.
• Virtual Primary Healthcare platforms help patients to access to first-level health care at the comfort of their homes, and removes the need of them traveling to hospitals at late night hours, congested times. Parents can easily ask for an initial assessment of their child's condition with the help of digital tools, and be advised to visit the healthcare facility or just be comfortable and apply some measures as the condition is not likely to be critical.
• Preventive Healthcare on public level can be implemented effectively with the help of analytics platforms, AI and predictive tools, implementation of national clinical KPIs and guidelines and monitoring the compliance on real-time. It also helps governments to keep the nation-wide healthcare expenditures under control and identify the areas of need for additional resources, or areas of preventable conditions and reducing the burden on the government budgets.

Patient journey is life-time, and starts when we are just at home, and not even having a single sign of sickness, but when we receive vaccine shots, use some vitamins, or even take care of our daily nutrition. Sometimes we feel the need to get a consultation which could be a very minor health issue, or at times we go to the hospital and have operations done. When we are back home, there comes a list of things to do to take care of our health and heal, and keep our health at the maximum level. Then comes chronic conditions, like diabetes, cardio-vascular conditions, metabolic syndrome and diseases, that requires close monitoring and attention at all times to stay as healthy as possible, without developing adverse conditions, and cope better with those kind of diseases.

Digital healthcare tools connect all the milestones of such journey, makes it smooth, improves the quality of care and quality of life.

We at Diginova Healthcare Solutions bring and present solutions to build the most efficient healthcare delivery ecosystems and help providers build and execute digital healthcare transformation strategies.