We're at a major inflection point for digital health. The pandemic has created a unique set of factors that are accelerating existing trends in digital health and forcing change. While digital transformation in healthcare has happened slowly compared to other industries — the fax is making its last stand supporting healthcare communications — there's no turning back now.
The ongoing COVID pandemic has nearly exhausted the American healthcare system. Healthcare workers are leaving the industry in droves — down by 298,000 since February 2020, according to the Bureau of Labor Statistics March 2022 report.
The U.S. already has a significant shortage of doctors and nurses — a problem that is not going away anytime soon. A report from the AAMC (Association of American Medical Colleges) indicates that by 2033, the U.S. could see a projected shortfall of 54,100 - 139,000 doctors in primary and specialty care.
Add to this an aging population — by 2030, 1 of 5 Americans will be at retirement age, according to the U.S. Census Bureau — and a lack of options for primary care, especially in rural areas, and you have the potential for a healthcare crisis of epic proportions.
The possibility for digital health solutions to mitigate some of these problems, among many other healthcare issues, is significant and much needed. These five digital health trends are patient-centric, including but not focused solely on a particular set of digital health technologies — mobile applications, telehealth, artificial intelligence, embedded sensors, connected medical devices, and the like. These trends are in many ways related and connected, but they do not encompass the entirety of digital health. They all speak, in different ways, to the future of care delivery and emerging models for delivering care at home via a virtual environment or outpatient care in a local, non-traditional setting. These digital health solutions hold the promise of better quality of care — increased accessibility, cost efficiency, and perhaps most importantly, improved patient experience and better outcomes.
Possibly the most exciting digital health trend is one that's still very early in the adoption curve. Digital health in the home will continue its bumpy progression towards adoption in 2022 onward as more companies attempt to leverage and expand their existing, connected footprint in your home with new software and service layers focused on healthcare.
Every company making products for the home — from bathroom fixtures to kitchen appliances to televisions — is now potentially a digital health company or aspires to be a part of the IoT (Internet of Things) network supporting your health. LG, for instance, has added a health platform to its smart TV models to enable telehealth visits and health education.
The COVID pandemic has changed what people expect of their homes, accelerating the trend towards multi-functional connected spaces that support a variety of living and working activities within them. In particular, the vision of the bathroom of the future is continually evolving. Already equipped with advanced devices to create a spa-like atmosphere, the modern bathroom is well on its way to fully transforming into a "health room" with the integration of more sophisticated, sensor-driven, connected devices that monitor our daily health metrics status.
There will be increasing competition to be the home health hub, or at least one of many, as telehealth, fitness, and connected medical devices converge on a health-focused lifestyle integrated into your residence. In addition, adoption of these technologies will be driven by the need for healthcare as more Americans desire to age in place, remaining in their homes rather than moving elsewhere.
Advances in remote patient monitoring will make it not only possible, but routine to connect the hospital to at-home care. Services for remote care and monitoring will overlay and enhance digital health at home, collecting data from a patient via sensors and other digital technologies, like smart watches, connected medical devices, and on-body sensors, and transmitting it securely to a provider for assessment and recommendations. This can help families and health providers monitor chronic conditions or symptoms.
Additionally, remote monitoring allows patients to more easily participate in clinical trials, opening up recruitment to more diverse patient populations. Digital platforms improve management and communication with patients in the home, enabling better patient engagement and retention for clinical trials. However, adoption is limited so far.
We can already see the strong connection between those companies that will supply the infrastructure for digital health at home and patient monitoring. For instance, technology retailer Best Buy recently acquired a UK company specializing in remote patient monitoring. Best Buy Health will partner with providers to customize end-to-end care delivery solutions.
Alexa Together is Amazon's endeavor into remote monitoring and assistance for the family caring for their elderly relatives. Amazon incorporates AI-driven remote healthcare monitoring — particularly fall detection — care team tools to support the person aging in place, and an urgent response team to assist when needed.
Remote patient care and monitoring have many benefits, including deep personalization for each patient. These tools can reduce the use of hospital resources, and be used for both outpatient recovery and proactive management of patients dealing with long-term conditions. For chronic disease monitoring for conditions such as diabetes, remote patient monitoring will integrate with personalized health plans — recommendations for diet, exercise, etc.
We're at the start of a significant systemic shift to new care delivery models. Telehealth adoption took a big step forward during the pandemic, enabling virtual visits when in-person interactions were difficult, if not impossible, due to COVID. According to a research report from the HHS Office of the Assistant Secretary for Planning and Evaluation, Medicare Beneficiaries' Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location, "the number of Medicare fee-for-service (FFS) beneficiary telehealth visits increased 63-fold in 2020, from approximately 840,000 in 2019 to nearly 52.7 million in 2020."
Virtual primary care is convenient and saves time for patients and providers. You no longer need to see a doctor in person for many types of interactions. In fact, half of face-to-face clinical office visits can be conducted virtually.
As patients adopt the technology and integrate it into their lives, telemedicine can reduce barriers and increase access, especially important for chronic disease management. With a lack of healthcare options, especially in rural areas of the U.S., virtualizing primary care will make a significant difference in overall health. Telehealth providers like WellVia are pioneering virtualized primary care while companies like One Medical take a hybrid approach, with offerings that combine telehealth and in-person care.
However, integrating telehealth visits into regular, replicable outpatient routines as a mainstay of primary care interactions will be a journey that progresses in fits and starts. As the pandemic begins to wane and in-person visits are more feasible, the longevity of telehealth as a regular service for healthcare will be tested.
Much has been made of the need to shift the "front door to health". Healthcare is no longer confined to the doctor's office, hospital, or urgent care clinics, but has expanded into non-traditional settings like retail and pharmacy. As we’ve seen, the overstressed American healthcare system, further taxed by the COVID pandemic, lacks options for primary care, especially in rural areas. In response, retail outlets and pharmacies have begun to incorporate health services into their offerings for basic healthcare consultations and immunizations. CVS Health, Walgreens, RiteAid, and Walmart are leveraging their existing footprint in communities to provide access to local, convenient care through a combination of in-person services and telehealth.
Walmart, for instance, is investing heavily in building its network of clinics that offer primary care services and operate within the company's existing stores, with 105 locations currently available and more in development.
These clinics, co-located with retail and pharmacy, are particularly helpful for patients managing chronic conditions, who can benefit from more frequent visits with a healthcare provider and regular tracking and analysis of their health data. It's local and less expensive. Further, these retail-based primary care clinics can combine in-person services and lower-cost telehealth consultations to deliver care at value to patients when and where they need it.
Our health data is growing at a remarkable rate. With the increased prevalence of digital health services — from telehealth to connected medical devices to remote patient monitoring to sensors embedded in the home — and the ongoing usage of digital health records, EHRs, PHRs, etc., the amount of health data contained in silos across hospital records, primary care, and personal devices, is unprecedented.
Ironically, we're simultaneously experiencing a data glut and yet have limited access to that information — with patient data stranded in various places and no one way to retrieve and manage it. Realizing the promise of digital health requires that we address this issue. The slow march to solve this problem of managing patient data across multiple sources will influence and shape the digital health landscape for years to come.
The healthcare industry struggles with data. We throw out or abandon too much of our health data, whether it be stored readings from an at-home blood pressure cuff, heart rate data from our smart watch, or test results we get from an urgent care clinic. The stored data is often owned by someone else and not parseable when we receive it. The promise of digital transformation has been hindered by siloed, hoarded, and ultimately stranded data, limiting the use of patient data for prevention, early diagnosis, and research.
And the healthcare data deluge will only continue. As social determinants of health integrate into healthcare evaluation and decision making, our day-to-day life data — from our food purchases to our leisure activities — will increasingly be considered a part of our health data.
Universally accepted and adopted data standards supporting interoperability between electronic health records, patient data use agreements that facilitate personal access and control, and patient-centric software that allows for patient data management, are all examples of ways in which we'll move along the path, a trend that is often under-appreciated.
There is a massive opportunity in patient data management of their own medical records and health data. We'll begin seeing the potential, for instance, in the emergence of new digital services, allowing patients to more easily move medical records from one hospital to another.
But, it will be a long road to travel before we can manage our health data with confidence and ease.