It’s been over five years since my friend Jonathan Libov and I wrote a blog series on digital healthcare. I revisit these posts every so often – most recently, when I wrote the 2020 edition of our areas of interest in healthcare. Each time I go back, I’m reminded that despite so much development in digital healthcare technology and infrastructure, we have yet to see mainstream scale. 

Time and time again, I’ve pondered and written: what is the forcing function for healthcare to be delivered digitally? With so many stakeholders in the healthcare system, could it be patients? Caregivers?  Medical care professionals? Clinics and hospital systems? Pharma? Pharmacies? Payers? Government?

Turns out, it’s all of the above working together to fight a global pandemic. 

Over the past month, we have seen an acceleration in the adoption of digital healthcare in response to the novel coronavirus. From telemedicine apps to IoT sensors, many digital healthcare products have been built and ready-to-go, but they never quite hit escape velocity. Until now. Virtually overnight, these have become critical tools while we’re sheltering in place. To be specific: 

Telemedicine 

Not too long ago, telemedicine was considered a convenient alternative to seeing a doctor in-person, although many physicians preferred in-person visits because of reimbursement incentives. But today, telemedicine is used as the primary entry point into the healthcare system, and is extensively used for triage, as well as for non-Covid-19 and non-urgent clinical visits. 

Sensors / connected devices

Traditionally embraced by “quantified self” enthusiasts, sensors are now appealing to all consumers as a way to continuously and actively monitor one’s health, i.e. measuring temperature, SpO2 (oxygen saturation), blood pressure, pulse and respiration rates. With fear and uncertainty of a global pandemic, there is a greater urgency for self-care. And the ability to take your own health into your own hands is easy with the purchase of smart watches, thermometers, pulse oximeters, blood pressure cuffs, etc. 

The above examples are just the start towards more consumerization of healthcare. As you can imagine, we should also expect at-home test development and usage to rise. While sensors and connected devices give us a view of and monitoring capacity for our health, they are not diagnostics. In fact, there is a big opportunity for Scanwell Health (a V1 portfolio company) to lead the charge in being the next generation LabCorp/Quest Diagnostics in the home. Scanwell’s first product is a self-administered UTI test kit, and while they have been working on other chronic disease detection tests, it’s now all-hands-on-deck to bring the first and only at-home Covid-19 antibody test to the US market.

Finally, given all that is unfolding today, it will be interesting to see the lasting impact and behavioural changes that this pandemic has with respect to how we engage with the healthcare system. What will be the new normal post Covid-19? Some questions that are top-of-mind: 

• How does healthcare scale with more patient-collected data / fragmented endpoints as well as increased accessibility to medical professionals via telehealth? How do we refrain from bombarding the system?
• What will require in-person consults in the future? What role will the physician play going forward?
• What are the long-term effects of isolation on our mental health? How do we address this today and in the future? Can virtual support help? And if so, who is best to deliver this (i.e. loved ones, therapists, communities, etc.)?
• What is the role of big tech companies in this transformation of healthcare? Apple and Google just announced their partnership in contact tracing to help public health authorities track the spread of disease and inform the potentially exposed so that they can be tested. It’s interesting to think about their contribution to population health studies (like Kinsa does with its thermometer), but it comes with concerns around data privacy in a world where every interaction is recorded (not a new story!)
• What are the second-order effects of more care being delivered in the home? There is a great NY Times article on how hospitals are eerily quiet. The unanticipated consequence of this is early reports of EMTs and paramedics in certain regions of the country being laid off due to a reduced volume in 911 calls (partly from fear of going to a hospital where there is almost guaranteed coronavirus exposure and partly from fewer people being outside). We’re also hearing that non-Covid-facing doctors are receiving cuts in pay because they cannot practice during these times. 

Throughout the course of history, crises have sparked new waves of innovation, and Covid-19 will undoubtedly accelerate the adoption of digital healthcare. Increased digitization will likely change how diagnostics are given, how therapies are provided, how clinicians practice, how we pay for healthcare, and more. When it comes to the healthcare system, “back to normal” will mean a new normal.