E-health, Telehealth, Telemedicine, Mobile health and on and on....whatever you call it, it is time to normalize this development as it is becoming 'a regular'.
As long as we'll keep naming it separately it never will become part of our daily routine. Not only the pandemic, but this was in the cooking for a long. Recently I said in an interview for a National newspaper :
We've been pregnant for digital health for years, now during this pandemic it came to life through an acute c-section.
As I clearly see this now being normalized and patients asking for it as they feel unsafe to come to the clinic and other healthcare places. It also shows how strange it still is digital health not has been used more over the past years.It has all kinds of implications like climate change. In my keynotes I often use the example of first outpatient visits to the hospital in the Netherlands, assuming these being 1/3 of the total and all patients for this would take their car. (not happening, but still, this is only one-third so seems credible) They would add up to 91 MILION Kilometers a year, just for these visits!
Another interesting development is people fleeing big cities as they are able to now work from almost everywhere. We're using impact on the real estate marker, but will this also affect healthcare? Is the Covid-induced urban flight out of the cities also invoke more use of Telemedicine and digital health? Do people want to keep their 'urban' doctor when they move to urban regions. If so what would the implication on the responsibility be, ethics, payment systems and the experience of the users. With the current pressure on the healthcare systems worldwide digital health is on an impressive growth. Whether or not this is here to stay is to be seen of course. I however expect this to plateau in the near future at 25-30% of the total of healthcare interventions. Or will this even mark a tipping point of the split for a physical healthcare blended with another remote digital healthcare provider. I'm very curious to your perspectives in the comments!
Daniel Croymans et al have written great perspective in NEJM on Telehealth during this pandemic :
At the start of the coronavirus pandemic, patients avoided doctors’ offices because of concerns about safety, and many skipped out on vital care. To combat this crisis, the U.S. Centers for Medicare & Medicaid Services (CMS) expanded coverage for telehealth, prompting many health systems to rapidly transition to virtual care (i.e., telehealth [specifically, video and phone visits]). At UCLA Health, telehealth visits in the Department of Medicine increased from <1% to 55% in fewer than 50 days (from March 9 to April 18, 2020) — a dramatic but necessary shift, given that almost 10,000 patients canceled or simply did not show up for their outpatient appointments during late March to early April 2020. Nine months into the pandemic, telehealth usage has leveled off at around 25% of all visits. Telehealth is likely here to stay.
ORCHA (the Organisation for the Review of Care and Health Applications) on digital health trends, that is founded by my friends Liz Ashall-Payne and Tim Andrews, has found that there has a been a significant rise in digital health, with health app downloads up from four to five million every day. The research provides 15 months of app search and downloadable data which began prior to lockdown measures.
WHY IT MATTERS The report found that the most downloaded apps were: Wysa for stress and anxiety, NHS Weight Loss Plan, Smoke Free, Low Carb Programme and Lincus Companion, a health and weight loss programme.
The report predicts that in 2021, with lockdown still a part of our daily lives, new sectors will discover the merits of digital healthcare within maternity and women’s health services, cancer, cardiovascular and stroke services.
The report authors call for improved procurement systems, allowing health and care professionals to prescribe digital health tools for patients, plus improved education, with more professionals being trained to use digital health as part of routine practice.
Key findings of the report stated that; downloads of apps supporting consumers with mental health needs increased by nearly 200% from summer 2019 to summer 2020; downloads of those supporting consumers with diets and weight loss rose by 1294% from mid-2019 to mid-2020; and downloads of apps helping consumers manage their diabetes rose by 482%.
It is at the intersection of technology and patient empowerment, which is where Lucien Engelen (1962), director of the Radboud University Nijmegen Medical Centre REshape Center and advisor to the Board of Directors (since 2007) feels most at home. The two worlds combined into the Radboud University Nijmegen Medical Centre and Singularity University in Silicon Valley & the Netherlands and in the Nordics, his modus operandi is always challenging, sometimes provocative but always techno-realistic. Writing on a new book that will be titled "Augmented Health(care)™ : The end of the beginning" (May 2018, Barcelone Spain) as he thinks we're at the end of an era of creating awareness, pilots, proof of concepts etc in the digital transformation of health(care). More on that on, his Linkedin Page has over 750.000 followers. He is Faculty Global Health(care) & Medecine since 2011 at Singularity University's Exponential Medicine in the US and in the Netherlands.