(Authored by Mr. Sanjay Pathak – Head Healthcare and Insurance Solutions, 3i Infotech)
While ‘Telemedicine’ has been there for a while, it did not become mainstream the way it was expected mostly due to lack of right technology and business objectives. In the current context, virtual care would mean remote health monitoring, home health management, telemedicine, kiosk and self-diagnosis based systems, wearables and the likes. Ideally, a collaborative environment leverages video, audio, mobile/portals, sensors/kiosk from where consumers can receive care with no constraints of location, time & in-person touch. The current virtual care drive is fueled by digital consumers, technology advancements, high cost of care, regulation driven better care mandates, and sparse density of physicians to name a few.
Let’s explore some of these in the current context –
Technology advancements: IoT, AI/Voice and Block chain could pave the way forward for the connected health/virtual care. These technologies have disrupted many industries operating today and healthcare is no exception.
IOT: Evolution of sensor technology has made it possible to connect many passive devices with internet. Cost & size of many healthcare sensors have drastically reduced, providing opportunities and options for a connected ecosystem. Wearables and mobile phones of today are good examples of instruments that have enabled measuring & streaming of personal vital data. Voice: Alexa, Siri, Google voice and many similar voice intelligent solutions ease the consumer interaction to more conversational rather than a complex system interface. Blockchain: While it has lot of promise and is yet to gain mainstream status, there are good chances that distributed and secured health records will be a plus for virtual care, where the information will not be restricted to one hospital and will also be immutable and secured at the same time.
High cost: Global healthcare spend is projected to reach $8.7 trillion by 2020 which will be approximately 10.5% of GDP. Virtual health if done correctly could be an answer to this rising cost, specifically for non-emergency, minor cases, rural care and post-surgical care which lead to hospital re-admissions. Substantial cost reduction can be achieved if virtual care can replace redundant physician & ER visits for trivial situations.
Regulatory compliance: Around the globe there is constant effort by regulators to enhance the care outcomes. US started value based care initiatives under Obama Care and even levies penalties on hospitals for readmissions. Prime reason for readmissions is confusion after discharge and lack of post-operative care. Virtual care and remote monitoring can drastically reduce potential readmission cases.
Vertical and horizontal consolidation: Healthcare sector has seen a global consolidation and there are recent cases where retail giants like Walmart are trying to acquire healthcare companies. While this is less of a driver & more of an outcome, this could result in better reach to population leveraging virtual care and tele-health kiosks even in the rural and remote areas via the retail outlets.
Density of physicians: Finally, the physician density is a big factor when it comes to virtual care. As per WHO, currently there is 1 physician for every 1000 people for over 45% of member states. This gap is bound to grow and even advanced countries like US, Canada etc. will have acute shortage of physicians, specialists and surgeons.
So now that we understand that virtual care is one of potential solutions to care reach, better outcome and cost reduction, let’s explore newer challenges it may pose:
First and foremost, a lack of comfort and confidence to adopt to this change is foreseen. Both physicians and consumers will have initial hiccups to adopt to the virtual care when both sides are used to in-person experience. A push from millennial population could be a key driver to overcome this situation. Next, when data is not limited to the boundaries of a clinic and/or hospital, security would be an added concern. The value of Electronic Health Records (EHR) combined with financial transactions data is very high in the grey market. While separating the two may be hard, digital technology and Block chain adoption can be an answer to some of the security concerns. Privacy has always been a key factor when it comes to health. This would continue to be an added challenge in a digital and connected healthcare world. Conflicts and legality could be another challenge as we adopt virtual care. The virtual ecosystem will need regulation and compliance support to run successfully. Reimbursements for services will be another factor and hospitals and insurance companies will have to come up with innovative ways to reimburse for such virtual care. Finally, fraud and abuse would continue to be a challenge. While technology advancements can be an answer to some, there will always be concerns arising from ill-intended practices from both consumers and practitioners.
So, how will an ideal virtual care system look like? No doubt, it will be an ecosystem of well-lubed entities. The system would comprise of a partner network to maintain the remote systems and kiosks; robust technology infrastructure; reimbursement system backed by Insurance (Payers); serve as a good knowledge base to educate the population; provide in-person help to assist mass on how to use the systems; and finally a network of participating hospitals, doctors, clinics etc.
Many Health-tech startups are coming up with innovative business models which will soon disrupt how healthcare is provided and even how we reimburse it. Gone will be the days where healthcare system only looked at generating profit. As the global healthcare system evolves, it will be virtual care that will be disrupting and re-composing healthcare ecosystem into its new and improved avatar.