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Big shocks change things dramatically overnight. Take 9/11. It transformed security, government surveillance and air travel in a heartbeat. The Covid-19 pandemic is doing the same in health. It has prompted the most rapid and radical innovation in long-distance, tech-based public healthcare the world has ever seen. What tech evangelists have spent years lobbying for has been approved almost overnight, creating unprecedented growth and investment opportunities. 

Following the outbreak in the UK, the notoriously slow National Health Service (NHS) chose 11 suppliers to provide video consultations in just 48 hours. Previously, online consultations were practically non-existent; now more than 7,000 doctors’ offices have been ordered to conduct as many video and phone consultations as possible. The proportion of NHS healthcare delivered through video calls or text messages increased from a meagre 1 per cent to 5 per cent in a matter of days, according to the Digital Health Council, a trade body. 

Over in the US, health-privacy legislation has been amended to allow companies such as Apple, Google, and Microsoft to facilitate virtual doctors’ visits through FaceTime and Skype. Microsoft also plans to launch a new booking tool for hospitals and doctors, who already use its Teams collaboration software to video-call patients.

 

The Covid-19 crisis is acting as a catalyst for the whole digital healthcare and telemedicine industry.

Luke Buhl-Nielsen

The telemedicine revolution has not come a moment too soon. For an industry of its size – global healthcare is worth an estimated USD 11.9 trillion – it has been remarkably slow to exploit new technology. Although some countries have well-established telemedicine services – notably Switzerland and China, where Ping An’s Good Doctor, the world’s largest online healthcare platform, offers more than 300 million users access to not just telemedicine, but also medical services including appointments, referrals, and prescription delivery – the majority still rely almost exclusively on the medical practice approach. That’s largely down to regulation and concerns for patient privacy (see panel). The Covid-19 pandemic has forced governments around the world to rethink radically their approach to telemedicine. It is no longer a ‘nice to have’, but a ‘need to have’.

Med-tech firms can scarcely believe their good fortune. “The Covid-19 crisis is acting as a catalyst for the whole digital healthcare and telemedicine industry,” says Luke Buhl-Nielsen, vice-president of business development and operations at Kry, a leading telemedicine operator based in Sweden. “Legislation is moving at breakneck speed,” adds Joost Bruggeman, co-founder and chief executive of Siilo, a Dutch communications tool for medical professionals. “It usually takes 12-18 months to convince middle management to approve innovations. Right now they’re saying, ‘Give it to us, we’ll figure out the contracts later.’”

Giant steps
Telemedicine isn’t simply about real-time interactions. It also includes mHealth, which covers the use of emerging technologies to create a new virtual health space for both patients and telemedicine providers. mHealth taps into the Internet of Things, such as environmental sensors, wearable devices, and mobile apps, for tracking and measuring patients’ health and wellbeing conditions.  

This is where the tech giants are trying to get in on the game. Apple has launched Health Kit, which integrates data from wearable devices, including the Apple Watch, to enable care teams to spot – or even predict – illness. The latest Apple watches have ECG sensors that can alert users if they have potentially dangerous irregular heart rhythms. The Cupertino giant is also rolling out its Health Records feature, which is designed to make it easier to store and use medical data on iPhones. “If you zoom out into the future, and look back and ask the question ‘What was Apple’s greatest contribution to mankind?’, It will be about health,” says the firm’s CEO, Tim Cook.

In Seattle, Amazon is working on something inevitably dubbed Amazon Prime health, which will have more of a supporting role for healthcare providers. It starts with Alexa, the firm’s voice-controlled virtual assistant. ‘She’ has begun using US government information to answer health queries. Ask her what your symptoms mean and she’ll tell you. She can even call 911 in an emergency. Facebook has done something similar by creating a tool called Preventive Health to encourage users to attend check-ups. Users can book appointments on the Facebook platform and opt to receive personalised preventive healthcare recommendations and check-up reminders, including routine health exams, mammograms, flu shots, and blood pressure screenings.

What other trends are emerging?
Remote health monitoring technology for hospitals looks set to boom. Many hospitals, notably in the US, are already using remote monitoring to treat Covid-19 patients with milder symptoms in their homes. Most are giving patients wearable devices that are worn 24/7 to track vital signs. Artificial intelligence establishes a baseline reading for each patient and data from the wearable is transmitted to the hospital, where doctors can quickly spot anomalies, such as a decrease in oxygen levels.

Clinical trials, a market that is worth USD 65 billion according to CB Insights, looks set to accelerate rapidly. The process can take an average of 7.5 years and cost up to USD 2 billion per drug, according to the research firm. “If you’re a physician working on a clinical trial, your experience is probably no different than 20 or 30 years ago,” says Gary Hughes, chief executive of Teckro, a software platform that tries to make the process of participating in trials easier for doctors and patients. “It’s still a people and paper process.” Irish-based Teckro has raised USD 25 million from investors, including Peter Thiel’s Founders Fund. US biotech firm Amgen is using artificial intelligence to improve trial planning so that it does not waste time and money setting them up in places where there will be few participants. 

One thing is certain. As telemedicine spreads, we will all spend less time in germ-filled waiting rooms. And even the most confirmed luddite would agree that is progress.