Digital healthcare, which is the use of information and communications technologies and devices to provide medical services, can enable the local use of expert and international resources, as well as augment the capabilities of medical practitioners even in resource-constrained environments.

This can be achieved through the establishment of a digital medical services platform and an ecosystem to link healthcare consumers to their doctors and other healthcare professionals, enabling healthcare professionals to serve more patients more effectively, Discovery Health CEO Dr Ryan Noach tells Engineering News.

"Any healthcare consumer anywhere in the world with a broadband connection can consult directly with highly qualified practitioners. Similarly, a primary healthcare provider, even in an isolated or remote location, can get advice from a leading specialist, if necessary, to upgrade their care for a patient," he says.

"With the proven systems and devices currently available, medical practitioners can do almost a full clinical-grade examination remotely by monitoring vital signs and biometrics, even extending to managing infusion pumps remotely."

Noach adds that digital healthcare has relevance across the economic spectrum, including in developing countries.

Further, there are emerging opportunities to improve the capabilities and resources available to healthcare practitioners and professionals, such as a smartphone camera lens that functions as an otoscope to produce a high-resolution image of the tympanic membrane that can be sent to an ear, nose and throat specialist or a magnifying lens to image skin lesions that can be sent to a dermatologist, he points out.

"Even in developing countries and in remote places, healthcare professionals can use a simple smartphone devices' capabilities to improve diagnoses and patient outcomes and the data can be uploaded once connectivity is available or sent over available networks."

Simultaneously, patients with chronic diseases can be constantly monitored through the use of wearable devices or suitable remote monitoring systems, which will improve their ability to self-manage their conditions, as well as the ability of their physician to monitor their wellbeing and identify potential risks.

Many chronically ill patients typically only visit their specialist a few times a year for a check-up, while the use of digital, remote monitoring allows for real-time data that can improve their quality of life and prognoses.

Discovery Health sees the use of digital medical devices as horses for courses, meaning devices and solutions should be applied where most relevant and impactful, and not forced onto an unwilling practitioner or healthcare consumer.

“There are emerging therapeutic uses of devices, including for at-risk patients, that can enable healthcare practitioners to monitor patients' activity levels and vital signs, and enable healthcare insurers to offer incentives to patients to improve their wellness and potentially prevent the development of a metabolic disease, for example,” Noach comments.

Similarly, remote and robotic devices are being used to monitor the elderly, including monitoring their mobility, hydration and rest periods as examples, and provide frail care. Fall detectors are one of a range of systems that can be deployed to facilitate clinical-quality care in homes, and fall detection systems can also be used in hospital beds, he notes.

Further, analysis of data is providing insights and can allow for additional functions such as assessing compliance models or predicting the likelihood of patients developing a disease based on their lifestyle or familial susceptibility.

Data can even provide operational insights, such as what medical specialist a patient should be referred to, based on the nature and severity of the case.

“In many cases, we have access to data covering the entire lifespan of a person, from birth to death, and data models are becoming extremely useful and relevant in healthcare service provision.

“Establishing a digital healthcare platform requires bringing together complementary communities; and then facilitating meaningful interactions that provide greater value to all participants. The role of the platform provider – in this case Discovery Health – is not only to allow the seamless convergence of these communities, but also then to enrich these interactions with sophisticated analytics and plug-ins. The healthcare community has scarce skills in limited numbers, but must serve a broad base of consumers. A platform can enable this, as it aggregates professionals and consumers' needs at a point in time,” says Noach.

Trust in the system is, however, fundamental for its success. In order to participate, healthcare consumers need to consent to medical professionals viewing their data, and cybersecurity becomes extremely important.

However, a platform must also be open for participation, such as providing interfaces for third-party applications and plug-ins, to ensure the greatest accessibility and benefit to the healthcare sector and consumers and to allow devices, as they emerge, to enrich the platform.

“Healthcare insurers are a natural fit for serving as the nexus in the broader medical sector and as digital healthcare platform facilitators. We already aggregate claims and represent and articulate consumer needs and trends to our “creditors”, who are healthcare practitioners.

“This means we understand the broader system needs and our role is to function as the glue to bind together stakeholders and, crucially, ensure that the quality of systems and services is high.”

GLOBAL CHANGE

The global Covid-19 pandemic has contributed to a rapid realignment of regulations, as regulators quickly reviewed and removed regulatory barriers to adjust to the specific set of circumstances presented by the pandemic.

“Visiting healthcare facilities suddenly became more dangerous for patients, as they need to maintain physical distancing practices and could become infected, which meant there was an enhanced imperative to access healthcare remotely.

“Simultaneously, healthcare professionals were getting sick because they were repeatedly exposed to high viral loads from seeing sick patients, which led to severe illness among medical professionals.”

Telemedicine and virtual consultations protect the doctors and patients, and advice and consultations were, in many cases, adequate to serve the patient.

Doctors and practitioners would then make a decision on whether a patient exhibiting concerning or severe symptoms should visit a healthcare facility for further examination and tests, which is a decision doctors and healthcare professionals are well placed to make, Noach highlights.

“This led to regulators dropping hurdles, in South Africa as well as in many other parts of the world. What ensued was an explosion in the use of telemedicine, with healthcare providers in the US doing, on average, between 30 and 50 more virtual consultations a month compared to before the pandemic. Equally from the consumer perspective, management consulting firm McKinsey reported that the percentage of US consumers using digital health has grown exponentially from 11% in 2019 to 46% in 2020.”

“Discovery Health's digital platform for online doctor consultations has seen a 35-fold increase in virtual consultations, during the pandemic.”

Regulators aim to ensure that no harm is done, and the evidence provided during the use of virtual consultations during the pandemic showed that there were no safety concerns or undue risks for patients and the value of these types of consultations is high, he adds.

“Discovery Health is taking a progressive but cautious stance with regard to digital healthcare and devices, and focuses on supporting only established, proven and effective systems, but it is monitoring new developments in digital healthcare to identify suitable applications and uses,” concludes Noach.