After the COVID Deluge: a Topol-esque view of what (tele)medicine will look like

A typically cheery view by Eric Topol, MD of what medical practice will look like after COVID is over. With the full court press to go remote in hospitals and practices worldwide, telehealth and telemedicine has gone fast forward in a matter of under two months. But what will it look like after it’s over? Most of what the good doctor is prognosticating will be familiar to our Readers who’ve followed him for years–certainly he was right on mobile health overall and especially AliveCor/Kardia Mobile— but not so on point with mobile body scanners (anyone remember VScan?)

When the high tide recedes, what will the beach look like?

  • “Telemedicine will play the role of the first consultation, akin to the house-call of yore.” (Terminology note–interesting that Dr. T still uses ‘telemedicine’ versus ‘telehealth’–Ed.)
  • Chatbots will serve as screeners–once they are proven to be effective (a ways to go here, as the Babylon debate rages on)
  • Smartphones will be the hub, connecting with all sorts of monitoring devices (the ‘connected health’ Tyto Care and Vivify Health model–which makes the Editor’s former company, the late Viterion Digital Health, even more of a pioneer that died crossing the Donner Pass of 2016)
  • Smartwatches are also part of this hub (this Editor remains a skeptic) 
  • Now is the time to harness technology by both health systems and individual practices, but multiple barriers remain. (This Editor can speak to the difficulties for both primary care and specialty practices in not only practice but also reimbursement–and acceptance by patients.) Device expense is also a problem for the non-affluent.

As to the rest, it is pretty much what we’ve heard from Dr. T before.  The Economist

Your Editor will add:

  • Easy to use, secure platforms that don’t put users through multiple security steps remain a concern for users. This Editor’s concern is that easy to use = insecure. Skype and Zoom are inherently insecure–Skype’s user unfriendliness and insecurity outside enterprise platforms and Zoom’s major security problems on its platform and user flaws are well-known (ZDNet).
  • Reimbursement, again! CMS has done a creditable job in broadening reimbursement for telehealth a/v and telephonic services, but coding remains a nightmare for practices struggling to remain open and with some lights on. After COVID, will CMS and HHS get religion, or put it right back in its rural bottle? Covered in the CARES Act passed at the close of March, $200 million sounds like a lot from the FCC to bankroll telecom equipment for providers, but these funds will go quickly. At least they are not delayed in endless rule making, as the Connected Care Pilot Program has been for two years. Mobihealthnews 

Comings and goings, short takes, and in other news…: Vivify’s new SVP Sales, Parks’ Connected Health Summit, $35M for 3D portable ultrasound, Oxford Medical Sim new pilot

In comings and goings….remote patient monitoring company Vivify Health announced that Chris Fickle has joined them as Senior Vice President, Sales. Mr. Fickle was previously with Qualcomm as senior director, business development including international and in the home health market as general manager of Healthfield and American HomePatient. Vivify currently has customers such as UPMC, Trinity Health, and the Ontario (Canada) Telemedicine Network and provides remote care management through personalized care plans, biometric data monitoring, and multi-channel patient education. Certainly in the umpteenth iteration of their website and June’s MedTech Breakthrough Award, they have apparently bounced back from their bounce-out from their VA award in early 2018 [TTA 14 June 18 and 16 Jan 18].

A reminder that Parks Associates’ Connected Health Summit in San Diego is now open for registration. TTA has been in the past a formal media supporter of the CHS and while not this year, it’s a great way to spend a few days in late August. The location, content around the demand for both clinical and consumer health and wellness solutions aimed at improving the quality of life for people living and seeking support at home, and the speaker list has always been outstanding. Follow their Twitter feed at @CONN_Health_Smt | Hashtag: #CONNHealth19. And register here.

This Editor has been following handheld ultrasound since GE Healthcare debuted the VScan in what seems an eternity ago (only 2010!) –and yes, it’s still around–Mobisante demonstrated at TED by no less than Eric Dishman in 2013–and last year the locally-based Butterfly IQ hit the market at about half the price and raised $250 million. Now Redwood City, California startup Exo Imaging has gained a $35 million Series B round to develop its portable ultrasound that through AI assistance generates a 3D image. Release. Mobihealthnews

The UK’s Oxford Medical Simulation has picked up another pilot of their Oculus Rift VR headsets to simulate in-practice interactive patient treatment at the OxSTaR (Oxford Simulation, Teaching and Research) center, part of  John Radcliffe Hospital, Oxfordshire. We covered OMS in April with their pilot with Health Education England Wessex at the Portsmouth and Southampton Hospitals. Mobihealthnews

 

Butterfly IQ handheld ultrasound offers clinical-quality body imaging for under $2,000

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/03/butterfly-iq.jpg” thumb_width=”200″ /]Butterfly IQ is a NYC and Connecticut-based company which has developed a handheld ultrasound that transmits images to a smartphone. Where it differs from current handhelds like GE’s VScan is that it uses a single transducer for all images both near-field and deeper in body, and connects to a iPhone loaded with their software.

Larger machines, even on portable carts like the Philips Lumify [TTA 27 Mar] operate on an older vibrating crystals-based technology. The IQ uses capacitive micro-machined ultrasound transducers or CMUTs. 

It claims to be FDA-cleared for 13 applications. All this is delivered for under $2,000, far under other handhelds or carts (VScan is above $12,000, Lumify about $6,000), with delivery this year (pre-order notification at present) in the US only. Butterfly is also working on problems such as the volume of blood a heart is pumping or detecting problems like aortic aneurysms.

The IQ has a brace of impressive testimonials from doctors at Yale, UC Irvine, Denver Health, Rocky Vista University, Mass General, St. Elizabeth’s (Boston), and Metrowest Medical Center. According to vascular surgeon and company chief medical officer Dr. John Martin, he used it on himself to diagnose a mass in his neck last year that turned out to be Stage 4 cancer, for which he is under treatment. Daily Mail, 9to5 Mac, MIT Technology Review  Hat tip to Editor Emeritus Steve Hards