Predictions, predictions for telehealth, digital health, and all those cybersecurity risks

crystal-ballJanuary is the month for predicting what’s ahead, and while this Editor has no pretensions to be Sibyl the Soothsayer despite the picture, let’s look at what others see in their cloudy crystal balls.

Frank McGillin, CEO of The Clinic by Cleveland Clinic, works intensively with telehealth in this joint venture between Cleveland Clinic and Amwell. His prediction: telehealth will evolve towards concierge care, as providers reduce “platform sprawl”, coordinate the virtual care experience, and provide multidisciplinary virtual care.

  • Telehealth is now “a permanent mode of access”, though the pandemic created “platform sprawl” as providers reached for any and all modes and providers which could be implemented quickly
  • Healthcare providers and plans now have to scale back and reconcile all this to “design a digital trajectory with intention”
  • This means developing a personalized approach to telehealth delivery and to provide a seamless, highly coordinated care experience
  • Their approach is to focus on multidisciplinary virtual visits and case analysis for patients with complex conditions, such as their Virtual Second Opinions program for conditions such as brain tumors and prostate cancer.
  • Virtual multidisciplinary support reduces the risk of suboptimal treatment plans and can eliminate long travel times and exposure to COVID-19 for vulnerable patients. For payers and employers, this can add up to better outcomes and reduced cost of care.
  • “Intelligent” remote monitoring also removes another layer of risk in providing the right care at the right time
  • Continuation of relaxed interstate licensure requirements are needed to provide fast access to medical experts, particularly for primary care providers.

Interview with Healthcare IT News 

Healthcare Dive has been running a series on industry trends, and this installment focuses on digital health.

  • Healthcare will become more predictive and proactive, with insights fed by connected devices and analytics (commonly lumped under AI) that enable organizations to collect, analyze, and act on massive amounts of data.
  • But algorithms don’t have judgment and data can have bias, leading to poor decisions, such as the distribution of vaccines. Expect more oversight from the Federal level down on AI research and policymaking, 
  • Virtual care will continue to grow in virtual diagnostics, patient-reported outcomes applications, and digital homecare platforms
  • Telehealth and digital health is integrating into the traditional delivery and payment model–partnerships with health systems, payers, and employers.
  • Virtual care access is booming in niche areas such as women’s health, hospital at home, and mental health, with investment dollars flowing in. Telemental health is moving into consolidation.
  • Cybersecurity will become more of a focal point for healthcare companies in 2021, with hackers finding their way into all these contact tracing apps designed in a hurry, plus digital health systems, many of which are poorly protected. Targeted attacks have skyrocketed.

And speaking of cybersecurity, over at HealthITSecurity, they rounded up the experts to opine on All Those Security Risks that fast implementation of telehealth and moving devices out of the hospital walled garden have created. Remote patient management is now an asset, no longer a ‘nice to have’, for providers, setting up a situation where patients are increasingly both the beneficiaries of more convenient health delivery and victims of security breaches and ransomware.

  • ‘Out of hospital’ care means that data is being transmitted between multiple points. Network security isn’t guaranteed. So attacks can originate at the weak points–either the home or hospital environment.
  • The fast implementation of telehealth during the pandemic meant not only did systems not work together well, it also meant multiple points of vulnerability
  • Over 80% of surveyed healthcare providers globally harbor concerns about data security and privacy (Kaspersky/Arlington Research). And a shocking 70% admitted that their practice used outdated legacy operating systems, exposing them to security vulnerabilities.
  • “A culture of security” means maintaining endpoint security and BYOD policies across the organization’s network, identity management and zero trust tactics, and yes, security consciousness on patients’ parts.
  • Patients should not be responsible for security, providers partly, which leaves the responsibility with the vendor. But healthcare organizations are responsible for evaluating their vendors, and how they are interacting with and storing their data.  

A tipping point in consumer acceptance of health apps, AI, and virtual care? Accenture thinks so.

Accenture’s 2018 Consumer Survey on Digital Health indicates that the tipping point may be here, sort of. Some key findings:

  • Consumers had high rates of favorable acceptance and likeliness to use AI-enabled clinical services: home-based diagnostics (66 percent of respondents), virtual health assistants (61 percent), and virtual nurses to monitor health conditions, medications and vital signs at home (55 percent), which may be good news for the future of telehealth services.
  • The 2,301 respondents already are using mobile and tablet health apps (48 percent). 44 percent are using patient portals for to fetch their health records, primarily to get information on lab and blood-test results (67 percent), to view physician notes regarding medical visits (55 percent), and their prescription history (41 percent).
  • Wearables are being used by 33 percent and favorably viewed by over 70 percent as beneficial in understanding their health condition (75 percent), engaging with their health (73 percent), and monitoring the health of a loved one (73 percent). 

Virtual care seems to be leading the way over wearables and remote patient monitoring–and after-hours care, patient follow-up, and patient education are leading virtual care.

  • 25 percent had received virtual care services in the previous year, up from 21 percent in last year’s survey. 16 percent are taking part in remote health consultations, compared with 12 percent in 2016. 14 percent are participating in remote monitoring, up from 9 percent in 2016.
  • 47 percent state that given a choice, they would prefer a more immediate virtual medical appointment over a delayed in-person appointment.
  • For after-hours care, 73 percent said they would use virtual care for after-hours (nights and weekend) appointments.
  • 71 percent said they would use virtual care for taking a class on a specific medical condition. 65 percent would use virtual care for a follow-up appointment after an in-person visit.
  • Most respondents said they would also use virtual care for a range of additional services, including discussing specific health concerns with medical professionals (73 percent), in-home follow-up after a hospital stay (62 percent), participating in a family member’s medical appointment (59 percent), and being examined for a non-emergency condition (57 percent).

Accenture release and report.

Primary care ‘virtual health’ could save $10 billion annually: Accenture study

A newly-released Accenture study on US primary care estimates that savings of about $10 billion per year in US primary care could be achieved through use of ‘virtual health’, defined as “digital tools such as biometric devices, analytic diagnostic engine and a virtual medical assistant” that would allow much of the work of a typical office visit to be done prior to or separately from the visit, and follow up/check in tools such as video visits/telemedicine which would further offset costs. The cost savings were calculated by Accenture Insight Driven Health as a total of time-per-visit savings of five minutes–when aggregated, $7 billion, $300 million in telemedicine visits, telehealth self-management in diabetes alone $2 billion, health system savings $63 million. This could potentially solve the shortage of US PCPs now projected at 31,000 in the next ten years. Nary a mention of patient care savings, chronic care management or telecare for proactive behavioral home monitoring, however. Accenture release (BusinessWire), Accenture page and paper.