The doctor will not see you now: How remote healthcare can improve outcomes

In early January, I waved a temporary goodbye to the U.K.’s winter chills and flew to sunny and warm Las Vegas, to attend the Consumer Electronics Show (CES), the largest consumer technology conference in the world. This was my first time at CES and—while I was there to immerse myself in as much as possible and try to breathe it all in—as a healthcare technologist, I was particularly interested in the Digital Health Summit talks and in learning about what’s next in healthcare technology. 

A phrase we hear a lot in this industry is “patient centricity,” which essentially means putting the patient at the center of the way in which healthcare is delivered, in order to improve the patient experience and therefore improve health outcomes.

One of the key ways in which the industry is putting the patient at the center of their healthcare is in a very literal sense: trying to center care delivery around the patient’s physical location, by serving them at their home as much as possible.

The upside for patients as a result of all this is clear: better care, and better health outcomes, without having to go to the doctor’s office or hospital every day... [T]he real excitement is that these tools allow [doctors] to be in two places at once.

Tim Sprinkle, Remote Healthcare Is the Future of Medicine

Of course the single most important enabler for that change is technology. And this isn’t a pipedream; it is already beginning to deliver real results. In his article Remote Healthcare Is the Future of Medicine, Tim Sprinkle states that “The upside for patients as a result of all this is clear: better care, and better health outcomes, without having to go to the doctor’s office or hospital every day.” But it’s not just patients who are benefitting. Sprinkle goes on to say that for doctors, “the real excitement is that these tools allow them to be in two places at once.”

In the same article, we learn that “Over the last two years, Medicare reimbursements for telemedicine services increased 25 percent to become a $2 billion annual market.” This change is real, and so it was great to be at CES to learn all about the latest technologies making remote healthcare a reality for patients—the healthcare consumers of today and tomorrow.


Voice Assistants

Let’s begin to look at some of the specific technological advances which are propelling us into the next age in healthcare. When we talk about remote healthcare, more often than not, we are referring to the patient’s home environment. In their Digital Health Summit talk on Big Changes Ahead: Hospitals, Pharma and Physicians, speakers from Philips and American Well stated that “The hospital of the future isn’t a hospital: it’s a network, and the home is part of that. More care is going to happen in the home.”

We cannot talk about technological advances in the home without focusing on voice assistants, for which 2017 was a big year. This explosion in voice assistant ownership is a relatively recent one. As recently as the previous year’s CES, Alexa didn’t even have its own booth, and 2017 is really when it all took off, with 20 million Alexa devices (and 8 million Google Home units) being sold in the US.

The hospital of the future isn’t a hospital: it’s a network, and the home is part of that. More care is going to happen in the home.

Philips and American Well, Big Changes Ahead: Hospitals, Pharma and Physicians

So if voice assistants are now a big deal in home tech, what do they mean for patients and for remote healthcare? Well at the last count, Alexa had 30,000 “skills” (installable device capabilities that enable a more personalized experience) available, a growing number of which relate to healthcare, fitness, and well-being. These skills mean that Alexa can turn her hand to everything from coaching a patient on how to inject their medicine (thereby improving effectiveness of the treatment) to fostering a wider sense of accountability to Alexa the personal trainer (“I stick to my treatment because Alex reminds me to”—a huge boost to adherence).

Additionally, we should of course not lose sight of two other important factors. Firstly, people want an Alexa in their home because of its many other desirable non-healthcare uses (it isn’t something “prescribed” or forced upon them). Secondly, once the device has been purchased, there are no additional costs to the consumer. Both of these factors increase adoption and “stickiness,” and this is really what makes these voice assistants such a huge opportunity in healthcare.


Telemedicine

If voice assistants, with their ability to connect you to the voice of a programmed bot, promise much for remote healthcare, then what about telemedicine, with its ability to connect you to the voice and image of a real-life, educated, experienced healthcare professional?

The ease with which these solutions put you in touch with a doctor means that they are becoming more and more popular (remember that stat from earlier: a 25% increase in the past two years has taken telemedicine to a $2 billion industry). Unsurprisingly, then, the Digital Health Summit and the wider CES event were not short of success stories in this area, with representation from companies such as Doctor on Demand, Teladoc, American Well, and iHealth.

So how is telemedicine positively impacting patients? Well, the obvious ease of access that these solutions bring means that more conditions can be detected sooner.

So how is telemedicine positively impacting patients? Well, the obvious ease of access that these solutions bring means that more conditions can be detected sooner. That in turn means the cost of healthcare is reduced, since virtual appointments like these are much lower cost than the now less frequently required emergency room visits.

This is not just about cost though. What matters are the outcomes. The majority of episodes of care can be very successfully completed virtually, and this makes the doctor more efficient (recall that “being in two places at once” comment). In turn, the patient experience is improved, since we can now discuss conditions or symptoms with a doctor from the comfort of our own homes.


Home Visits

However, we should stress that of course telemedicine is only a first line of defense and that sometimes, yes, you will still need in-person care. But even when your care plan requires face-to-face interactions, these don’t always need to be in a doctor’s surgery, clinic, or hospital.

More and more these days, we hear of healthcare organizations who are investing in home healthcare visits, especially in areas such as patient education. After all, being taught at home how to (for example) inject yourself with a drug brings two clear benefits: the patient is more at-ease in their surroundings and therefore more receptive to learning new information; and the environment in which you’ll be carrying out the injection yourself in the days, weeks, and months to come is the very same environment in which you learned how to do so.

Those two benefits bring real results in terms of outcomes. The improved patient experience from being in a relaxed environment, and the improved familiarity with the treatment administration, mean higher rates of adherence to therapies. And higher adherence means reduced readmission costs and, most importantly, better health outcomes.

As the company Medically Home put it during their Digital Health Summit talk, home is “the center of gravity for care.” The trouble is, it’s distant from the experts.

As the company Medically Home put it during their Digital Health Summit talk, home is “the center of gravity for care.” The trouble is, it’s distant from the experts. So what can we do when care providers need to come to the patient, rather than the other way around? Well, again, technology can help make this achievable and efficient.

Here at Mavens, one of the technologies we most often work with is the Salesforce platform. Products like Salesforce’s Field Service Lightning application allow healthcare organizations to make the most of their field-based staff by using technology to intelligently optimize those resources’ schedules (and even their routes, in order to help them beat the traffic) and to allow them to update patient care records from their cell phone (even if there’s no mobile reception in the patient’s home).


Medical Devices

At its heart, CES is of course an electronics event, and while what was most interesting for me was seeing how technology is enabling better healthcare services—both in the ways covered above, and in wider applications of existing technologies, such as using Uber to deliver medicines to new moms stuck at home—many people were at the event to see the latest products. So what are the latest medical devices and products that are going to allow patients to better detect and manage their conditions themselves at home?

We saw everything from physical robots that deliver your pills right to your armchair to blood sugar sensors which beam minute-by-minute data to your smartphone. And those pills the robot delivers to you might well be smart pills, too. That means they contain sensors which detect when they have been taken, and they can feed that information back to your HCP to help manage your adherence.

According to David Rhew, CMO at Samsung Electronics, healthcare is simply too expensive and if we can virtualize that care through devices such as these it becomes more affordable and more effective. That will lead to improved access to care, reduced costs, and better outcomes.

Other devices included Neutrogena Skin360 from Johnson & Johnson, a device for your phone which mimics dermatologist detection without the patient needing to wait for an appointment or even leave their home. Of course we’re now living in the age of the smartwatch, and so there were products which made use of ECG-enabled wristbands, or watch applications which provided training guides for short cardiac rehabilitation exercises.

Why does all this matter? According to David Rhew, CMO at Samsung Electronics, healthcare is simply too expensive and if we can virtualize that care through devices such as these it becomes more affordable and more effective. That will lead to improved access to care, reduced costs, and better outcomes.

So how exactly do these devices lead us to these “better outcomes”? Well let’s take the example of Neofect’s RAPAEL product, a smart glove for hand rehabilitation. At the Digital Health Summit, we learned that being able to use a smart glove like this at home increases exercise repetition ten-fold. In a typical rehabilitation session at a clinic, the patient may make 30 repetitions of an exercise; at home, it can be more like 200 or 300 reps. More repetitions means a better, quicker recovery.


The Trust Barrier and the Role of the Caregiver

To wrap up, let’s step back and take a reality check for a moment. Healthcare is a risk-averse industry. It has to be; people’s lives and livelihoods are at stake. So convincing patients to trust new products and even entirely new systems of care might well be tough. While people are supportive of new health technologies, they generally support the use of these for ‘others’. “Try that one on the next person; I’ll have the proven, trusted approach from the very best doctor for myself, please.”

Helping patients to overcome that trust barrier and support these methods not just for others, but for themselves and their families, is key. A good example of this was given by Doctor on Demand, one of the telemedicine providers we mentioned earlier. Even when speaking with a doctor via a video call, the patient expects the person on the other end of the phone to be recognizably a doctor. By asking their HCPs to wear their white coats and to prominently display their medical diplomas in the background, Doctor on Demand found that their patients were immediately put at ease and more trusting of the new technology.

As an example, last year in the U.S. there were 365 million blood pressure tests carried out in-person that resulted in a normal reading and therefore no further treatment being required. If more consumers relied on at-home measurement of their blood pressure, we could easily reduce that number and give back many, many hours to our busy HCPs.

Naturally this isn’t just about convincing patients. Doctors have to want to adopt the changes too. Once these new methods of delivering care begin to show that they also deliver improvements in HCP efficiency (and for the most part, this is already happening), this should be enough to convince doctors who, after all, want to help as many people as possible. As an example, last year in the U.S. there were 365 million blood pressure tests carried out in-person that resulted in a normal reading and therefore no further treatment being required. If more consumers relied on at-home measurement of their blood pressure, we could easily reduce that number and give back many, many hours to our busy HCPs. 

For the last word on overcoming this trust barrier, I want to talk about the role of caregivers, those trusted others whom we choose to be involved in supporting our healthcare. After all, many of us rely on the help of family members or friends to maintain and monitor our health. And technology makes that easier for all. Those blood sugar sensors we discussed earlier have a function whereby the patient can share those minute-by-minute readings with their caregivers. That way, if the patient finds themselves so ill that they cannot act on a worrying reading, our trusted caregiver can be notified of the reading and step in.

It is likely to be caregivers who encourage adoption of these new devices, techniques and delivery models. After all, often you don’t want to make changes just for yourself, but when someone who loves you asks you to do so, you want to do it more—for them as well as for yourself. In addition to being patients and consumers, we are people. We are fathers, mothers, sons, and daughters. And while technology is important, personal relationships always win.

Chris Edwards 600

Author Bio

Chris Edwards is a Mavens Solution Architect with 8 years of technology experience. He has designed and built transformative healthcare and life science applications in areas such as patient support and engagement, field nursing, medical information, master data management, and commercial systems.