TABLE OF CONTENTS
COVID-19 brought a seismic change in the way healthcare systems operate. Care providers had to adapt quickly to the new normality, bringing to the surface new approach. There lies the potential of a new standard of care. The crisis undoubtedly became the catalyst for many changes that in other circumstances would have taken years. GemSeek follows closely the developments that COVID-19 has put forward in respiratory care, telehealth, remote patient monitoring (RPM), healthcare education and how they have affected MedTech suppliers, healthcare systems and patients.
Healthcare education in times of crisis
Recently we conducted a research, studying the impact of COVID-19 over the present and future of healthcare education.
The pandemic is undoubtedly serving as an activator for healthcare education providers to transform the delivery of education from traditional in-person to entirely digitised ways of learning.
One third of the 500 respondents argue that there will be an increase in remote and virtual education in the next two years because of the pandemic.[1] Not long after the study was conducted, we started seeing that the reality of healthcare education is indeed inclined towards digitization. Well-known events such as HIMSS, ECR, RSNA are preparing for yet another wave of virtual conferences and more healthcare professionals sharing expertise, best practices and new approaches with their fellow communities online. [1]
Telehealth is here to stay
The outbreak marked a turning point, when many healthcare providers turned to telehealth solutions for help. It still seems that they hold the promise to address some of the most pressing issues of the current healthcare systems: access to care, cost effective delivery and distribution of limited providers.
While implementing telehealth still poses serious challenges, COVID-19 triggered the speedy legislature and technology changes for a very short period of time to accommodate the needs of both patients and healthcare systems. Studies show patients are more prone to try virtual care now that the novel coronavirus is rapidly spreading – from 11% using telehealth in 2019, to 76% now interested to use the service going forward. [2]
GemSeek deep-dived into the topic of telehealth back in May 2020. What became obvious was that COVID-19 has indeed changed the way such services are perceived by patients and caregivers. Most of the service is now widely offered and effectively utilised. One thing became certain – the shift towards virtual connectivity and telehealth is here to stay.
Organisations’ COVID-19 tech strategies
The crisis forced many to adopt tech solutions, promising improved outcomes and more innovative care delivery. Remote patient monitoring solutions are such example. Valued for many reasons, RPM provides contactless continuous care during the pandemic, reduces readmissions and potential for transmission, collects more patient data, enabling early intervention and improves caregiver-patient ratios.
COVID-19 accelerated various healthcare technology trends. We see a rapid increase of AI usage in diagnostics, 3D printing in PPE and ventilators production, self-triage tools, exchange and utilisation of patient data and healthcare predictive analytics.
Forrester has partnered with HIMSS to survey frontline healthcare IT workers on what is working and what isn’t in terms of technology response to the pandemic. When asked “How important are the following technologies to your organisation’s COVID-19 strategy?” virtual care solutions ranked the highest (3.3/5), followed by acute virtual care/ICU, EHR, patient portals and remote patient monitoring (2.4/5). 27% of the respondents say that RPM technology needs more work from market suppliers to be useful during COVID-19. [3] This highlights two important factors: the lack of stable infrastructure amongst the providers of care and potential device vulnerabilities concerning data sharing, storage, authorisation, exposure of personal data, etc.
Remote patient monitoring and implementation of new digital tools – the new standard of care
Spotlight is now on telehealth and remote patient monitoring. Discussions about RPM began long before the virus. Healthcare systems desperately needed a reform in this domain, whilst struggling with disproportionate patient-caregiver ratios, outdated “spot checking” monitoring methods, inconstancy in patient data collection, storage and compliance and lack of continuous monitoring solutions. [4]
All these issues deepened when the pandemic hit, leaving the healthcare systems at a crossroad to either choose a quickly adoption of RPM or collapse from the influx of patients. The disproportionate ratio dilemma plus the surge of sick patients resulted in chaos in the healthcare ecosystem. The technological, legislative, and financial barriers to digital transformation were substantial but the extraordinary circumstances the COVID-19 crisis brought swept away many of them, thus enabling the healthcare organisations to get rapid traction on potential new solutions and pursue digital transformation without fear of failure.
A research conducted by Imperial College London’s Institute of Global Health Innovation observed a very similar trend to the one in telehealth: before the outbreak only 18% of health and human services organisations (HHS) had embedded digital tools in their workflow, where 62% increased the use of digital technologies right after the pandemic, globally. [5] The majority of the interviewees believe the pandemic was a catalyst for healthcare digital change with examples of increased telephone and video consultations, online platforms for health checks, self-assessment tools and mobile or wearable devices for continuous monitoring.
The same study dissected the reasons for the fast digital service adoption after years of slow progress and disputes. Some of the factors cited were:
16%
Increased demand from service users
14%
Rapid development of a strategic plan for digital and and realigning of priorities
14%
Improving digital literacy of staff
12%
Emergency funding to purchase tools, technologies and equipment
12%
Alleviation of practitioner concerns around loss of human interaction
12%
Rapid leadership buy-in (12%) [6]
Deep-dive in vital signs monitoring during COVID-19
We looked at studies focusing on the impact of the coronavirus pandemic, work patterns and vital signs recordings in hospitals. Both of them were conducted in the period of 45 days (March – April; March – May 2020) in big European hospitals. They draw a couple of important conclusions based on the data that was gathered and analysed [7] [8]:
- There was no evidence pointing towards COVID-19 affecting the pattern of vital signs collection across the 24-hour period or the week, when compared to pre-COVID period.
- The proportion of ‘missed’ and ‘late’ observations fell slightly, suggesting improved adherence to the vital signs monitoring protocol.
- The increased burdens of the COVID-19 pandemic, and the altered healthcare structures and processes developed in response, did not adversely affect the caregivers’ ability to monitor patients under their care and to comply with expected monitoring schedules.
- Although, the research observes higher admissions, worsened vital signs (lower SpO2, slightly higher HR and RR) and an increase in-hospital mortality, this could be explained by the different patient mix admitted in the hospitals – older patients with more serious health conditions and/or severe COVID-19 symptoms. There was a substantial drop of regular health checks, medical emergency visits and hospital admissions of people with mild symptoms and conditions that do not require immediate intervention.
- Both studies highlight the fact that the majority of the patients whose health is rapidly deteriorating face serious issues with their SpO2 but minor abnormalities in the other vital signs compared to the drops observed in the oxygen saturation.
At times of influx of COVID-19 patients, SpO2 becomes more and more important when it comes to vital signs monitoring. In the foreseeable future, its weight might become the trigger for changes in the way EWS is being calculated when monitoring COVID-19 patients.
Overall, it seems that reforms are coming in terms of vital signs monitoring, where SpO2 is the number one indicator that should be measured not only more frequently but with greater accuracy. Even though the studies suggest that hospitals are still not headed confidently towards this direction, we notice there is better adherence to the vital signs monitoring protocols.
Keeping the momentum
COVID-19 forced prompt, but vital changes within the healthcare systems. While there are still some barriers, the pandemic established new ways of care delivery. The adoption of new available technology allows for patients with serious health conditions to be monitored for changes in their vital signs away from the hospital setting. Virtual consultations, RPM and telehealth seem to be the long-lasting legacy of the pandemic. It’s vital to harness such transformative approaches to enforce faster and smoother shift towards value-based care.
GemSeek identified 3 key steps to keep the progress going, based on the above findings:
Do not create additional administrative burden
Adapting to new ways of working could be a huge burden for the already overwhelmed caregivers. The offered solutions should be user-friendly, intuitive and able to seamlessly integrate into the existing workflow. This would decrease the adjustment time and reduce the initial stress of introducing new system to the rapidly changing environment.
Vendors of such solutions should also take into consideration the training and continuous support, accounting for the different levels of tech literacy within the healthcare teams. This would require a quick, but comprehensive introduction to the new systems.
Focus on interoperability
Interoperability has never been more important than it is today. Health information is only useful if there is no unstructured patient data that has remained inaccessible to analysis. To understand better patients’ needs and ensure better healthcare outcomes, the data within an organisation should be structured and easy to share with the numerous stakeholders within the ecosystem. However, the reality for many healthcare systems now is that there is no seamless data sharing and silos of data stored in different places, making it impossible to use.
This raises an issue for value-based care, depriving healthcare providers from actionable insights taken from stored data. These ecosystems need a concentrated effort towards interoperability strategy to keep up with patients’ expectations and improve the quality of care.
Hear the voice of the customer
The pandemic encouraged patients into using digital technology as a main communication channel with their caregivers. Currently the new services are appealing, because they save time in commuting and reduce the risk of contracting the virus while visiting the doctor’s office. Focus on time and convenience would work the best for the short-term.
However, for a sustainable engagement that would last long after the pandemic, the drive could be different. In that case, we should focus on patients’ concerns using digital technology for health purposes: the accuracy of a telehealth diagnosis, the lack of personal contact and privacy issues regarding shared personal health information, such as appointment recordings. [9]
Organisations and governments should establish a stable legal environment, where such services are monitored, and personal data protection is a priority. Hence, requiring an infrastructure which will allow for easy access to such services, overcoming obstacles and factors such as living area, age group or income.
With this being said it seems that there might be no universal solution, but more of a healthcare system-specific approach.
