Global Health Impact Fund

Rachna Dayal

History

The concept of ‘Healthcare Mobility’ is an age-old one. In the early part of the last century, it was fairly common to have the doctor visit you at home to diagnose and treat ailments. However, as governments focused on healthcare as a basic right for their citizens, infrastructure was developed to provide healthcare to the masses through hospitals and clinics. This pushed the concept of care being taken to the patient into the background. This enabled the governments to eradicate common diseases and drive population health and longevity. And for one full century, the focus was to optimize the economics of care delivery.

After almost a century of this model in action, the pandemic hit in February/March 2020. People could not visit hospitals for regular healthcare or even critical issues besides COVID. Technologists jumped up at the opportunity and created platforms that could connect physicians and patients remotely. Prescriptions were written and delivered via online platforms and many elective surgeries were delayed due to hospitals being overwhelmed with managing COVID patients.

The changes triggered by COVID in Healthcare Mobility are not finished and nor should they be. This shift to new models of healthcare delivery presents an opportunity to radically improve the quality of healthcare as well as create better health equity.

360o Approach to Healthcare Mobility

When we think of Healthcare Mobility, to realize its true potential, it is critical to take a 360^o approach. It is not just about remote telehealth platforms but in this new post- COVID phase, we have an opportunity to take healthcare mobility to the next level. ‘Healthcare Mobility 3.0’ would focus on innovating devices and solutions that don’t just do what other systems did remotely but provide better clinical outcomes, resolve unmet areas of need and facilitate further movement of healthcare from big hospital buildings to ASCs, homes, and mobile health clinics to fit the lifestyle of patients.

For this to become a reality, let’s look at some aspects that need consideration. These mentioned below may not be the only ones but are some of the most relevant ones that will need attention for the next decade or so.

Remote Care

Remote care telehealth platforms that connect patients to doctors have become commonplace in the last two years. In future, the focus needs to shift to expanding access to populations that may have been missed from leveraging this service. Telehealth platform access is still limited by internet access, bandwidth and awareness. In addition to this, telehealth needs more access to data and vitals of patients to make remote diagnosis and treatment effective. We need to break a barrier here -there is a need for patient parameters beyond the vitals like EKG, Echo, basic blood/ urine markers etc. to shift from hospitals to homes. We also need different mechanisms to deal with data coming in from out-of-hospital settings.

Telehealth needs to expand beyond family medicine and become mainstream for specialities like oncology, cardiovascular, mental health etc. This is not to say that all will be done remotely but creativity and innovation are needed to move the needle for specialities beyond primary care.

Distributed Care Centers

As mentioned above, to make the leap from primary care to specialities, distributed care centres like Ambulatory Surgery Centers (ASCs), Pharmacy clinics and One Medical can play a critical role. This also takes away the burden from urban locations and helps in reducing medical travel costs for the average individual.

Devices for Continuous Measurements

For centuries, the diagnosis of diseases has been based on a single or a few data points of a patient’s vitals and other health data. Now, technology has enabled us to record and measure vitals continuously and on the go. This enables clinicians to diagnose based on a huge range of data. Not only that, but they also now have AI-powered solutions that can detect patterns and anomalies in long-range vitals data that would be hard to detect by the human eye/brain. This leads to more accurate diagnoses, quicker intervention, precise treatment plans and better outcomes. A couple of solutions that enable data capture on the go are shared below:

Imedrix is an innovative company revolutionizing mobile cardiology. Their new mobile ECG device is taking heart health management to community and home settings. iMedrix blends mobility with mobile design- used by semi-skilled workers, integration into other devices like ultrasound, and rapid cloud AI feedback to make cardiac care accessible, affordable and timely.

Plenty has created a holistic program for musculoskeletal care focused on individual recovery needs through easy-to-follow programs and behaviour-based patient engagement. The resulting bio-psycho-social data and analytics are insightful and actionable, leading to a healthier recovery.

Supply Chain

Medical Supply Chains have been optimized to deliver devices, drugs and services to institutions like hospitals, pharmacies and big care centres. Advancements in Healthcare Mobility require that devices be made available to new points of care like remote locations, homes of patients and patients on their vacation if they so desire. The extra ‘last mile' coverage can put strains on the existing business models if looked at myopically. However, if we are to calculate the advantage to a patient’s health and not just the extra last mile cost, we will most likely find that the overall burden on healthcare infrastructure is reduced.

All of the above changes driven for/by Healthcare Mobility are creating opportunities for new business models and new solutions in healthcare that deliver quality outcomes while sustainable managing costs. We are standing at the edge of possibilities of how healthcare will be delivered for generations to come. Some of the older systems may fail and some very new and radical systems will get established.

“The old order changeth, yielding place to new”