Can Healthcare Seriously Go From Fax Machines to Digital Therapeutics?

Updated: Jun 23




Mass General Brigham (MGB), recently hosted the World Innovation Forum 2020 as a virtual, daylong conference in May. While I missed catching up with people personally, the information spread was exponentially larger than a live conference could provide, with 10,000 registrants from 80 countries, 45 states, and 3,000 organizations. The speakers and panelists delivered a blitz of information that almost persuaded me that we might see the end of fax machines in every practice.



Telehealth

For all of the hype about telehealth, the Covid-19 virus exposed the three elephants in the room in what we like to think is a coherent and cohesive public and private health care system.

  • Health disparities on a massive scale

  • Skimpy facilities and staffing standards in nursing homes

  • Digital inequities; not everyone can simply get online

A few days later, I listened to a podcast where Joe Kvedar MD (MGB), a leader in Telehealth, sorted out what worked and why, and what’s important. In three months in the MGB system, the volume growth of telehealth virtual visits increased 15,000%, from 1,600 in visits in February to 242,000 in April. Dr. Kvedar reminded us that the humble telephone still worked well, especially for the one-third of people who don’t have a smartphone.


Virtual visit aspects that work:

  • 100% show-up rate for telehealth visits, unlike no-show rates in clinics

  • Patients overwhelmingly enjoyed the interactions dispelling the myth that it is too complicated for elders

  • Successful asynchronous patient management and follow-up for both patients and clinicians

  • Accurate, in-home, retail or other locations testing with results and interpretation support (versus you had to 'come in' for your test)

Dr. Kvedar also said that many of his in-person visits are highly social – asking about the patient’s family, what are the kids doing is very important to building a trusting relationship. I think this is an area that needs more research on how the on-screen relationship compares.

Digital Therapeutics (DTx)

What are digital therapeutics (DTx)? The term describes digital interventions that are clinically validated with evidence-based measured outcomes. The first use of the term I found was through a company, Omada Health, that works with employers, health plans, and individuals to manage chronic conditions. So yes, they fall under the umbrella of telehealth, providing care to people – directly to the consumer, via employers or health plans.


To be successful, DTx should be:

  • Accessible, affordable and reliable

  • Scalable from the few to the many, anywhere in the world

  • A clinician extender --- “therapist in your pocket”

  • Care optimizing

  • Synchronous and asynchronous

  • Astute about cognitive-behavioral strategies

  • Triggering, identifying, and offering drug refusal skills

  • Tailored to patient needs


Here are some interesting top ten companies for you to explore and some of the latest in virtual diagnostics, both in the field today and developing technologies that support DTx and staff support:


Conference Attendee Impressions of DTx:

  • “All innovation needs to address disparities.”

  • “Single biggest revelation is the impact of SDOH (Social Determinants Of Health) and how it really opened our eyes – the bigger question is how are we going to respond”

  • “Virtual visits are a game-changer.”

  • “Virtual care; it is important to build, not supplant, the patient-physician relationship.”

  • “Chatbots are here to stay, to create new highways to reduce congestion.”

  • “Virtual care changes the whole workflow.”

  • “The patient experience has to include access and equity of care.”

  • “Our goal is to decrease the digital divide.”

  • “People get personalized care at home, 24x7 - it works around their schedule – can be midnight – notably 46% of our patients' text between 9pm-9am.”

  • “DTx – it feels like we’ve come from cautious optimism to a burning need.”

Concluding Thoughts By Influential Figures

  • The internet is not a luxury, it is a necessity.” – Barak Obama, President USA

  • “Telehealth is going to be health. We do not talk about telebanking anymore. We talk about banking.” John Sculley, Chairman RxAdvance former Apple CEO

  • “It isn’t innovation if you leave any patients behind.” Jim Weinstein, MD, SVP, Microsoft

3 out of 8 patients do not belong in your waiting room - Arista MD

#telehealth #faxmachine #DTx #worldinnovationforum2020 #MGB

First Image Credit: Tech Spirited

Second Image Credit: Arista MD

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