Digital disruption in healthcare: how COVID-19 could change healthcare delivery forever
The ongoing coronavirus pandemic is placing unprecedented levels of strain on global healthcare systems, with a lack of equipment and resources to cope with the sudden influx of critically ill patients which is well documented in the global media.
During these testing times, there has seldom been such a heightened need for healthcare systems to be delivered in an efficient and effective manner, while the social distancing measures introduced in response to the pandemic are fundamentally changing how many critical services are being delivered.
The pandemic has led to a rapid increase in the adoption of digital technologies in both public and private healthcare with critical use cases being demonstrated and tangible benefits being realised. The pandemic is forcing both healthcare practitioners and patients to adopt digital solutions whilst breaking down numerous technology enablement and procurement challenges demonstrating benefits and (supporters hope) changing behaviours for the long-term.
This step change in the adoption of technology, which may have taken years to achieve organically, has the potential to improve the quality of healthcare whilst making significant economic savings to healthcare systems under cost pressures.
Virtual GP consultations
virtual daily GP consultations has increased from c.10% to >90%
Telehealth companies have raised significant rounds of funding in recent times such as Push Doctor, Bablyon Health and Your MD, despite having some critics. Yet anecdotal evidence from NHS GPs since the start of the outbreak indicates virtual daily GP consultations has increased from c.10% to >90% as a result of the social distancing measures enforced. GPs have been surprised by the breadth of conditions which can be effectively treated virtually. Key benefits of virtual consultations, in addition to keeping sick patients away from GP offices, include shorter consultation times, meaning GPs can see more patients per day.
Babylon Health has launched a digital care assistant to advise its UK patients on how to manage COVID-19, which has the additional benefit of providing a triage and information service to alleviate pressure on the NHS 111 services. US Medicare which provides care for older people and those with chronic conditions will temporarily be reimbursing virtual healthcare consultations at the same rate as those conducted in person by relaxing its strict rules. This could lead to a longer-term adoption trend after the epidemic dies down.
E-prescribing and dispensing of medications
Alongside virtual GP consultations, there has been a significant increase in the adoption of e-prescribing and dispensing tools, both in the community and hospital settings, which allow medications to be prescribed and dispensed virtually. In many communities, delivery of prescriptions to patients’ homes is also possible. In addition to the obvious benefit of minimising human contact, doctors are able to deliver essential medications to patients quickly and efficiently. This is supported by the anecdotal evidence from the NHS that pharmacy throughput has significantly increased during the COVID-19 pandemic
Real-time data reporting in hospitals
The rapid influx of COVID-19 patients has placed unprecedented pressures on hospital bed capacities globally, particularly in ICUs where critically ill patients require 24-hour care for c.2 weeks, typically assisted by respirators. While the NHS is scrambling to rapidly increase ICU beds in response, not in living memory has it been more critical for hospitals to effectively report data to ensure high quality care and hospital bed turnover is maximised. Within the NHS, there has been increased adoption of numerous real-time reporting tools, including those which monitor and report on patient illness, hospital bed capacity/turnover and stocks of medical supplies and equipment.
Workforce management and e-rostering tools
there has been a significant increase in the adoption of workforce management tools and e-rostering in the NHS
The dramatic increase in the number of hospitalised patients, alongside the intensive levels of care the critically ill require, is pushing global healthcare systems to their limits. Many healthcare practitioners are working overtime and several countries, including the UK, have introduced numerous measures, including fast-tracking medical students and recalling retired practitioners to increase the number of front-line staff. In response, there has been a significant increase in the adoption of workforce management tools and e-rostering in the NHS which are being used to effectively manage rotas and deploy practitioners within hospitals to ensure patient care is maintained while maximising workforce productivity during challenging circumstances. Workforce management within healthcare has attracted strong private equity funding such as US fund Vista’s investment in Allocate Software.
The ongoing social distancing measures, combined with the need to deliver current training and guidance to healthcare practitioners in relation to COVID-19, has resulted in a substantial increase in the delivery of e-learning courses to both medical students and NHS staff. This shift towards e-learning since the start of the outbreak has dramatically increased the total number of courses being delivered and has allowed for the rapid dissemination of NHS policies in relation to COVID-19. With significant private equity investment in training providers such as Agilitas Private Equity’s investment in Learning Curve which offers a range of courses for those in the NHS, investors also seem to be betting big on e-learning becoming the standard learning and development delivery model going forward.
Enforced behavioural shifts enabling tech adoption
A key barrier to the adoption of technology in a healthcare setting has been behavioural, with many patients and practitioners reluctant to adopt digital as an alternative to their legacy ‘tried and tested’ approaches. Long procurement cycles and complex buyer decision making processes have also been challenging. However, the pandemic is creating a new cohort of users who will become comfortable with digital enablement, which may help increase the adoption of technologies.
elderly patients are effectively adopting digital solutions such as virtual GP consultations
Another key learning from the pandemic is that elderly patients are effectively adopting digital solutions such as virtual GP consultations. Despite being considered a demographic who are the most resistant to adoption, many own smartphones and tablet devices and are willing to utilise the technologies available to them. Given this demographic places a disproportionate strain on healthcare systems, increased adoption has a significant potential to reduce pressures on healthcare systems globally in the long term.
Long term implications
Although COVID-19 has resulted in the increased adoption of existing digital technologies, the pandemic will also likely result in some long term changes in how care is delivered and has highlighted the need for new and improved technologies to better support healthcare systems.
The epidemiology of the pandemic combined with social distancing has increased society’s awareness of the duty of care they owe to the elderly and frail, with an increased need for tools that allow us to monitor and communicate with these groups in the community. Telehealthcare and connected care companies have witnessed significantly increased demand for their services since the start of the pandemic. We expect to see an increasing focus on a proactive healthcare system which utilises result tools that provide data and analytics to monitor at risk groups in the community and provide preventative solutions which reduce hospital admissions. Such solutions not only have clear patient welfare benefits but also reduce the burden on hospital bed capacities, which are particularly apparent today.
Reducing the burden on hospitals
While COVID-19 is placing an increased burden on hospitals, ageing populations, increased prevalence of chronic disease, and rising costs of care are all challenges they have been facing for some time. Although increasing hospital bed capacities is required in the near-term to fight COVID-19, it is a requirement that is essential in the long term if global healthcare systems are to cope. As such, there is a growing need for digital solutions which prevent hospitalisations, reduce patient bed days and allow for patients to be treated in the community. Such tools not only free up hospital beds but also improve the quality of care and reduce healthcare costs. For instance, software providers are focusing on streamlining and digitalising all stages of the patient journey in mental health which helps promote earlier intervention, which should prompt faster recovery rates.
Ensuring increased tech adoption is here to stay
increased adoption of digital technologies and long term digital transformation will require continued investment
The increased adoption of digital technologies as a result of the COVID-19 pandemic has created a unique opportunity for healthcare providers to ensure the behavioural shifts among patients and practitioners remain.
In the UK, the NHS has received a significant increase in funding to combat COVID-19 but increased adoption of digital technologies and long term digital transformation will require continued investment to support both existing and new solutions.
Historically, the lack of a central EHR database and previous well documented large scale ERP software failures due to integration issues have been significant barriers to entry for some digital solutions. Yet with new technologies being developed all the time, global healthcare systems need to ensure they capitalise on the uptake in usage post COVID-19.