February 20, 2021
Mobile healthcare: the roadmap for change
As medical mobile technology gets more sophisticated every year, mobile apps mature from a nice-to-have to an essential tool for practical care delivery support. Mobile devices become widely accessible to people, and healthcare mobile app development helps turn them into popular health assistants that can bring benefits to both patients and doctors.
Analysts from Grand View Research forecast the global mobile health industry to reach $236 billion by 2026, growing at a whopping CAGR of 44.7%. Among the foreseeable reasons for such a growth we can name the overall focus on personalized and preventive medicine, an increasing adoption of smartphones and smart wearables in low- and middle-income countries, as well as the availability of high-speed internet.
Telemedicine introduced a digital channel to healthcare, allowing providers and patients to keep in touch remotely. The global market share of telehealth is expected to dramatically increase from $38.3 billion in 2018 to over $130.5 billion by 2025.
Perfect for servicing remote and rural areas, telehealth solutions will inevitably spread in urbanized regions, especially with insurance companies and employers hopping on the bandwagon more eagerly than Medicare itself.
Insurers are interested in cutting the costs of hospitalizations, readmissions, and transfers. Telemedicine helps achieve just that by targeting high-risk patient groups with multiple chronic diseases and disabilities. Patients get the medical attention they need at the most convenient moment, which helps caregivers handle health status concerns before critical situations arise.
Providers get to enjoy their benefits in the form of non-penalized reimbursements for helping patients avoid post-discharge complications that lead to readmissions, as well as direct reimbursements for offering telemedicine services to the gradually increasing number of Medicare patients. Among them are individuals with at-home dialysis and stroke survivors in non-rural areas.
We don’t have any effective way of transferring money without physician activities going on. What we really want to do is change the mindset from paying for activity to some form of payment that allows us to reward non-consumption of resources.
MD, Senior Managing Director and Head of Global Health Practice, Accenture
The pandemic has changed the role of telehealth globally. Thanks to these technologies, providers have been able to reduce contact between patients, clinicians, and other personnel without any damage to the quality of care. Moreover, telehealth is believed to stay popular after the pandemic. McKinsey reports that over 70% of patients plan to continue with virtual visits. At this rate, the global telehealth market size may reach $559.52 billion by 2027, according to Fortune Business Insights’ 2020 estimates.
The pandemic-driven healthcare system crisis made regulatory bodies reconsider telehealth eligibility and reimbursement. In December 2020, CMS issued the final rule expanding telehealth coverage and reimbursement. Now beneficiaries may come from any area, not only rural ones. Telehealth coverage is expanded to over 100 extra services, which allows a wider range of providers to offer it (physical therapists, occupational therapists, speech-language pathologists, and more). However, some of the changes are temporary and will be revoked when the pandemic is over.
The healthcare system used to be supply-driven, rotating around the doctor. Whenever a patient required care, they had to locate a doctor, make an appointment within her office hours, wait in front of the practice room, finally be seen, and then go through the same process for a follow-up appointment.
Telehealth is turning the system on its head, making it demand- and patient-driven, when a patient can choose the form of care they want and access it anytime, anywhere.
Mobile payments have finally come to healthcare from retail and entertainment verticals, bringing in long-anticipated convenience. This step unwinds the consumerism era of healthcare, cutting on bureaucracy in the most stagnated part of the care cycle—patient billing.
Patients can now use healthcare mobile apps instead of cash, which is especially handy in emergency situations or during after-hours. In 2020, the pandemic accelerated the adoption and deployment of various contactless payment methods, including user-friendly payment portals fully adapted to smartphones.
We don’t expect that mobile payments will replace more traditional types of transactions just yet, but it is better to have a few options to pay for medical assistance, whether it’s planned or sudden.
The internet of things is gradually taking over the industry despite regulatory uncertainty. According to Grand View Research, the IoT in the global healthcare market was valued at $147.1 billion in 2018, with an expected annual growth rate of over 19.9% by 2025. Hopefully, five years from now IoT will prove the forecast right and get widespread adoption, fostered by both regulators and payers.
Within the context of healthcare, IoT goes by the more common name of the internet of medical things (IoMT). While connected to the internet, medical devices can provide more insights about symptoms and trends, as well as receive input from doctors. Some of those devices can make intelligent decisions, such as calling a doctor if an elderly patient falls down.
Examples of connected medical devices are insulin pumps, cardiac and asthma monitoring devices, fitness bands, eye lenses, and even ingestible sensors.
On the one hand, we have chronic patients who are in desperate need for continuous health monitoring as they have higher risks of hospitalization, complications, and readmissions. With IoT, such patients can constantly monitor their condition while in the comfort of their home, and connect with their healthcare providers whenever needed.
On the other hand, the insufficient number of qualified staff in healthcare organizations and ensuing overwork can result in delayed care and preventable medical errors. Connected medical devices allow receiving patient data without the need for doctors to tend to each patient individually. Additionally, this constant flow of real-time patient data allows making more informed clinical decisions.
AR in healthcare is a helpful assistant in medical education and guidance. According to the forecasts by Market Research Future, the global AR market in healthcare is expected to register a striking growth of 23% through 2017-2023.
AR can cover a range of medical training needs via mobile apps that can be installed on tablets, smartphones, or headwear, allowing all-level clinicians to:
The healthcare industry can consider AR as a cheaper alternative to AI in some cases. AR is cheaper to set up and integrate into a medical practice and it does not require such dramatic skill update compared to AI.
In other cases, AI and AR can work together for an optimal performance. One potential application of AI-enhanced AR is Google Glass. Healthcare facilities are looking to equip their doctors with Google Glass so that they can view patients’ notes and records without taking their attention off the patients.
In addition, there is an ongoing research about integrating natural language processing and facial recognition into Google Glass. This would enable features such as using a voice command to access patient records.
Healthcare blockchain stays on the mobile healthcare roadmap this year, too. The annual growth rate of blockchain in the healthcare global market from 2018 to 2025 is expected to reach 63.85%, according to data from BIS Research. Using blockchain for health data exchange is forecast to occupy the largest market share in 2025 among all healthcare blockchain applications, amounting to $1.89 billion.
Taipei Medical University Hospital cooperated with Digital Treasury Corporation to develop a solution that facilitates cooperation between healthcare organizations and allows secure sharing of patient data without violating privacy rules. This solution aggregates patient data and stores it on a blockchain. Patient data includes scans and written notes about a patient’s condition. All the data can be securely accessed by authorized doctors and patients via a mobile app.
A mobile device equipped with a camera, high-speed internet connection, and sufficient computing power can be a useful tool for diagnostics. Mobile devices make it easier to diagnose particular illnesses without the need to search for a physician and book an appointment. This is particularly helpful in rural areas and for people with limited mobility, which forces them to delay their visit to a diagnostician for a long time.
Smartphones offer convenient access to diagnostic tools, and allow discovering illnesses at earlier stages. Additionally, mobile apps can assist with routine checkups, for example of vision, from the comfort of a patient’s home, thus saving time and money on doctor visits.
Healthcare institutions have developed plethora of apps to diagnose different types of diseases. Some diagnostic apps work solely with the mobile phone, while others require extra clip-in tools.
Early diagnosis of HIV is vital as this can save lives. As soon as patients become aware of their positive status, they gain access to antiretroviral drugs that prolong life expectancy by at least ten years and prevent HIV transmission from mother to child.
Researchers at the University College London developed a disposable sensor that can be plugged into a smartphone and diagnose HIV in mere 10 seconds. The sensor contains micro-channels through which a patient’s blood flows. These channels end with particles that react to HIV (if present in the blood). The sensor detects particles reaction and sends signals to the connected app, which in turn notifies the doctor.
Practicing eye care using a mobile device is gaining popularity. One example is a smartphone-powered autorefractor device developed by NETRA. This device is used for eye diagnostics and is as accurate as an autorefractor sold at $45,000. It uses virtual reality to measure axis, cylinder and pupillary distance through interactions in a gaming style. This device screens patients for myopia, hyperopia, and other sight defects.
Patients need to install the NETRA app on their smartphones, watch a detailed tutorial on how to use the device, insert the phone into the autorefractor, and start using the tool.
The NETRA device was developed through 340 product iterations with 35,000 product tests to reach its current precision level.
Smartphones play an important role in enabling remote patient monitoring. It is convenient for patients, while also presenting an opportunity for a new revenue stream for healthcare providers.
Remote patient monitoring technology includes a dashboard with patient data at a physician’s fingertips, and a mobile app for patients to log their metrics. It does not feature interactive audio or video common for telehealth apps, but instead collects and interprets health data.
Remote patient monitoring offers several benefits:
The COVID-19 pandemic led to an influx of the adoption of patient-centered devices for remote patient monitoring. Coupled with telemedicine, this technology helps contain the virus spread, provide due care to vulnerable patient populations, and reduce the workload for clinicians. During an e-consultation, doctors can analyze the trends in data collected by the devices and synchronized with a telemedicine-ready EHR. This facilitates data-driven decisions regarding a patient’s condition and the need for hospitalization, and prevents exposure for both parties.
Until 2018, the Centers for Medicare and Medicaid Services (CMS)—the single largest healthcare payer in the US—only supported reimbursement of remote monitoring services for patients from rural areas. In 2018, the CMS designed new rules which made remote monitoring reimbursable for a wider range of patients, yet it still did not cover all the costs.
Finally, in 2019 the CMS came up with new reimbursement codes that embrace more costs. Under those codes, the CMS pays for both the initial setup and ongoing management of remote patient monitoring practice.
The 2020 pandemic crisis has influenced remote patient monitoring provision, too. The above mentioned CMS rule that came into force in December 2020 cleared out payment policies for some services, including pulse oximetry and respiratory flow rate monitoring that are critical during the current public health emergency.
With the richness of trends, technologies, tools, and approaches emerging, we are thrilled to watch the industry focus on the mobile side. From IoT to telehealth to mobile payments to population health management platforms, there are exciting changes underway.
Hopefully, they won’t be hindered by the technological and regulatory barriers that still remain, and regulators, payers, and providers will join forces to pave the way for these life-saving innovations.
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