MacDougall Musings

Digital Health Transformed by a Pandemic

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In this edition of #MacDougallMusings, the MacDougall Team, discusses the impact the COVID-19 pandemic has had on the acceleration, innovation and deployment of patient-facing digital health.

As COVID-19, the disease caused by infection of the SARS-CoV-2 coronavirus, hit the scene in the U.S. in January 2020, with it came altered relationships – occupationally, socially and medically. Over fear of contracting and transmitting the virus, workplaces shuttered and employees began to work from home. Families and friends stopped getting together, dining out and remained in their own houses. People avoided the doctor’s office for preventive and routine screenings, and chronic care patients failed to seek necessary medical attention. The urgent need for digital health was here.

Digital Health is Not New

Digital health isn’t new. Since the arrival more than 40 years ago of portable electronic blood pressure monitors and digital glucose monitoring kits to allow patients to track key vital signs at home, to the emergence of networked Electronic Medical Records (EMRs) to improve communications between care providers, to the integration of online portals to allow patients ready access to test results, digital health has been a part of everyday care.

But the public health emergency triggered an immediate and greater need for a digital response. The initial focus was on infection data collection. Who has contracted the virus? Who have they been exposed to? How can they be traced and notified? How can we track the spread? As positive patient counts grew, personal protective equipment (PPE) ran short, overcrowded hospitals were all but closed save for the most critically ill – and innovation exploded.

Emergent Needs

It was no longer safe for nurses to go from room to room to assess the often unstable and unpredictable vital signs of COVID-19 patients, not to mention that the demand for even routine monitoring equipment exceeded supply. Enter – more remote multi-function monitoring devices and apps installed on the laptops at nurses’ stations to track each patient’s vitals outside of patient rooms. Increased production and some FDA-leeway regarding marketing claims made these readily available, operating much like the consumer-grade wearables such as Apple Watches and Fitbit bands, and they were quick to deploy.[1]

Viral spread potential made it unsafe for COVID-19 patients to be transferred to ultrasound suites for the essential respiration and cardiac function assessments they required. Enter – hand-held ultrasounds that display on a compatible smart device like the Philips Lumify that received expedited FDA clearance just 5 months into the pandemic.[2] These were compact, portable, affordably priced and importantly, easily disinfected.

Nurses lacked the necessary PPE to physically “look in” on their patients. Enter – tablet devices for real-time, two-way bedside video via Zoom or FaceTime-type apps to allow patients to communicate with their nurse if able, and for the nurse to visually observe any changes in their medical status without utilizing the limited and cherished PPE. Unlike the sophisticated high-definition videoconferencing “tele-ICU” systems, tablet devices can be purchased at any electronics store or online for a fraction of the cost. And, we’ve all seen the hundreds of faces of families only allowed to see their loved ones via tablet and phone during hospital lock-down conditions.

Health and General Welfare

The rapid expansion of digital health was borne of the COVID-19 crisis, but where do we go from here?

In the midst of the crisis, Congress was called on to implement emergency telehealth payment policies for Medicare and Medicaid and to encourage commercial health plans to follow suit. Attempts in 2020 to make the reforms permanent fell short, but with the new administration, a bipartisan group of lawmakers has re-introduced the Protecting Access to Post-COVID-19 Telehealth Act, in hopes of making the policy changes permanent.[5]

Achieving true equity in virtual care must come next. Technological access limitations lead to telehealth disparities in underserved rural communities and continued neglect here will only deepen the healthcare divide for those already disproportionately affected by the crisis itself.

Where to Now?

With the slow roll-out of the global vaccination programs and new and rampant virus variants, 2021 is already looking like more of the same, for a while, anyway. So, patients and healthcare professionals alike, are turning more often to safer physically distant means for necessary medical treatment via “virtual office visits,” which were virtually unheard of until COVID.

According to a press release dated February 2, 2021 from FAIR Health, a national, independent nonprofit gatherer of health insurance claims data, telehealth medical claims in November 2019 represented just 0.20 percent of claims, but by November 2020, they made up more than six percent of claims. This digital health trend skyrocketed by nearly 3,000 percent in one year.[3] Yet 3,000 percent still isn’t enough.

In a recent article, Dr. Wayne A. I. Frederick (2021) discusses the “aftershocks,” as he calls them, that we’re already seeing from this ongoing public health emergency, due to the disruption in healthcare and disease that has gone undiagnosed and untreated since March 2020. He cites a statistic published in December by the Prevent Cancer Foundation which reported that 43 percent of Americans missed preventive care appointments during the pandemic.[4]

Innovative Prospects

There is some good news! If this year’s Consumer Electronics Show (CES 2021) in Las Vegas is a benchmark, the explosion of new exciting digital health and wellness products continues. The virtual crowd was wowed by the unveiling of the Philips BioIntellisSense BioSticker, a wearable disposable patch sensor that, in addition to the usual monitors for temperature and heart and respiration rates, also tracks body position and cough frequency for at-risk COVID-19 patients at home. HD Medical featured its HealthyU, an at-home 7-lead ECG and stethoscope, and FallCall Solutions debuted an Apple Watch app to detect the likelihood of an injury based on the degree of the impact of a fall that can automatically dispatch emergency services to those in need at home.[6]

The accelerated pace of digital solutions in healthcare and the promise to positively impact patient outcomes is an exciting trend! In keeping with the new normal closing salutation, stay safe.

Are you involved in digital health technology? Do you need strategic communications, IR or PR counsel? Contact our team to learn more about how MacDougall might be able to help.

References

[1] Hale, Conor. (2020, March 20). FDA looks to expand remote monitoring to free up hospital space. Fierce Biotech.
https://www.fiercebiotech.com/medtech/fda-looks-to-expand-remote-monitoring-to-free-up-hospital-space

[2] USA Philips. (2020, May 13). Philips receives FDA clearance for the use of its ultrasound portfolio to manage COVID-19-related lung and cardiac complications. [Press release].
https://www.usa.philips.com/a-w/about/news/archive/standard/news/press/2020/20200513-philips-receives-fda-clearance-for-the-use-of-its-ultrasound-portfolio-to-manage-covid-19-related-lung-and-cardiac-complications.html

[3] FAIR Health. (2021, February 2). Telehealth Claim Lines Increase 2,938 Percent Nationally When Comparing November 2019 to November 2020. [Press release].
https://www.fairhealth.org/press-release/telehealth-claim-lines-increase-2-938-percent-nationally-when-comparing-november-2019-to-november-2020

[4] Frederick, Wayne A.I. (2021, February 22). What Happens When People Stop Going to the Doctor? We’re About to Find Out. The New York Times.
https://www.nytimes.com/2021/02/22/opinion/medical-care-coronavirus.html

[5] Wicklund, Eric. (2021, January 26). Lawmakers Reintroduce Post-COVID-19 Telehealth Bill, Hoping for a Better Outcome. mHealthIntelligence.
https://mhealthintelligence.com/news/lawmakers-reintroduce-post-covid-19-telehealth-bill-hoping-for-a-better-outcome

[6] Landi, Heather. (2021, January 11). At all-virtual CES, the spotlight is on touchless tech, robot companions – and smart bathrooms. Fierce Healthcare.
https://www.fiercehealthcare.com/tech/at-all-virtual-ces-spotlight-health-monitoring-robotics-and-smart-devices-home