Pandemic and innovative solutions in the field of medicine

According to the American Medical Association, approximately 75% of primary care, urgent care and urgent care visits are “either unnecessary or can be completed safely and effectively over the phone or video.”

Investments in telemedicine technologies were significant even before the pandemic. However, patients for their part did not strive to increase their consumption of these services, and the demand was not significant. Everything changed in 2019-2021. Companies already active in the telemedicine field have experienced a surge in their business. Telehealth major Teladoc, a platform that connects patients and doctors, reported that its sales grew by 50% weekly after it rolled out the service across the US. The company continued to report significant growth in 2021. For example, Teladoc software (https://www.teladoc.com) enabled 4.5 million provider-patient sessions in Q2'21, up from 2.7 million in Q2'20.

The role of government regulation and legislation in the field of healthcare plays a large role in determining the dynamics of the development of telemedicine. For example, during the pandemic, the US government has taken steps to reduce legal barriers to businesses offering telehealth services. In March 2019, the Health Insurance Portability and Accountability Act was relaxed. This has enabled Apple, Google and Microsoft to implement virtual doctor visits through their chat and video applications, including FaceTime and Skype. The US Food and Drug Administration (FDA) also approved conducting clinical trials virtually to ensure continued drug development while physical sites were closed.

Telehealth providers such as Teladoc are optimistic that increased demand for their services during the pandemic will keep the industry moving forward. In accordance with the forecast, the growth rate of telemedicine services in the period from 2021 to 2028. will average 32.1% per year (CAGR) and the global telemedicine market will reach a size of USD 636.38 Billion. (https://www.fortunebusinessinsights.com/industry-reports/telehealth-market-101065)

Наиболее крупные игроки на этом рынке в основном американские компании —  American Well (Boston, U.S.), MDLIVE Inc. (Sunrise, U.S), Teladoc Health Inc. (Purchase, U.S.), Doctor on Demand Inc. (San Francisco, U.S.), Dictum Health Inc. (Oakland, U.S.), Grand Rounds Inc. (San Francisco, U.S.), OpenTeleHealth (Balticagade, Denmark). Следует отметить, что рынок телемедицины имеет выраженный локальный характер благодаря специфике местного законодательства в области здравоохранения. Преобладание американских компаний объясняется тем, что США оказались пионерами в этой области и тем, что правительство поддержало это направление развития. Однако и в других странах наблюдаются схожие тенденции.

The rise in demand for telemedicine has been fueled by a wave of technological innovations involving the use of artificial intelligence and chatbots in home healthcare. In this case, the goal of these technology providers is to help healthcare organizations reach more patients. For example, Orbita (https://orbita.ai), provides an omnichannel platform for interaction between doctors and medical institutions with patients using chatbots. The company recently launched an improved version of its virtual assistant. Orbita's Solution Center helps patients perform at-home tests, diagnose minor illnesses, file insurance claims, and more.

Wearable devices are innovative products that, when placed on the body, help measure temperature, blood pressure, blood oxygen, breathing rate, sound, GPS location, altitude, physical movement, directional changes and electrical activity of the heart, muscles, brain and skin . This wealth of information can help track calorie expenditure, exercise, stress, healthy posture, sleep quality, cognitive decline, and even early signs of infection and inflammation. We cannot manage what we cannot measure. Wearable devices can give us the ability to continuously measure our health and well-being without the need to visit a clinical center and take immediate action when needed.

The miniaturization of sensors and the development of artificial intelligence technologies are helping to reduce the price, availability and variety of wearable devices. Over the past five years, the number of their species has increased. With their help, it became possible to collect data in real time and identify the physical and chemical properties of the body to assess well-being. The companies are working on developments in photoplethysmography (PPG), Raman spectroscopy and infrared spectrophotometers to create wearable devices for monitoring blood pressure. Accurate, continuous and unobtrusive blood pressure measurement could expand the smartwatch market, with 1.3 billion adults worldwide suffering from hypertension.

Of course, there are limits to what current smartwatch touch technology can do without attaching to or penetrating human skin. To solve such problems, smart patches or smart patches are used.

Smart patches are typically produced by medical companies. They are small patches that are attached directly to a person's skin. Some “minimally invasive” smart patches use microscopic needles that painlessly penetrate the skin and act as biosensors. The same patches are used for injecting medications.

Unlike smartwatches, which provide a wide range of health data and information, smart patches are typically designed to perform a single function, such as measuring blood sugar levels or injecting medications. Smart patches also use a wider range of technologies. For example, there are smart patches that measure heart rate dynamics, often using electrocardiogram technology, which directly and more accurately tracks the electrical activity of the heart than smart watches.

In many cases, the data obtained through smart patches can be integrated with smartwatch or smartphone applications. The next step in the development of this area is the integration of indicators obtained by wearable devices into patient medical records so that doctors have access to more complete information for diagnosis and treatment.

With growing interest in monitoring one's health, the use of wearable technology has more than tripled over the past four years. According to Insider Intelligence research, more than 80% of consumers are willing to wear fitness devices. (https://www.insiderintelligence.com/insights/wearable-technology-healthcare-medical-devices/)

Deloitte Global projects that approximately 320 million wearable health and wellness monitoring devices will be sold worldwide in 2022. (https://www2.deloitte.com/xe/en/insights/industry/technology/technology-media-and-telecom-predictions/2022/wearable-technology-healthcare.html) By 2024, this figure is likely to reach nearly 440 million units as new offerings come to market and more healthcare providers begin to use them. These figures include both smartwatches, which are sold and purchased in the consumer market, as well as wearable medical devices and smart patches, which are typically installed by healthcare professionals but are increasingly becoming available in the consumer market as well.

The increase in wearable technology coupled with a shortage of trained caregivers is creating an opportunity for the development of real-time, point-of-care information systems that can integrate data from multiple devices. The creation of such systems requires the development of artificial intelligence based on knowledge and experience in the treatment of chronic diseases, surgery, post-operative care, neurology and emotional well-being. The goal of these systems is to enable more personalized care that empowers patients to engage in self-care, helps caregivers better support their loved ones, and enables providers to continue to provide high-quality care to patients at a lower cost.

Data from digital wearables combined with artificial intelligence systems can help guide patients to outpatient or inpatient settings for preventive treatment or early intervention before illness becomes intractable.

Wearable devices can be used for any medical specialty. But probably the most effective use will be for the treatment of chronic diseases such as diabetes, cancer, lung disease, heart failure, etc.

There are a number of factors that are slowing the adoption of wearable technology solutions. Solving such problems, on the one hand, represents an interesting business opportunity in itself, and on the other hand, contributes to the further development of this area.

These factors include the possibilities and areas of use of data obtained from wearable devices. If technology does not improve efficiency and is not used in the workflow, doctors are not interested in using it. As I mentioned above, this is slowly changing: Major EHR providers now allow consumers to share data from their health apps with doctors. However, today, most doctors either do not have access to data from patients' wearable devices or have to enter it manually.

The second factor is doubts about the accuracy of the data obtained. There is a belief that the accuracy of data from wearable devices and their interpretation depend on the medical knowledge of users, and that psychologically they can be detrimental in the event of serious illnesses. When such devices are worn incorrectly, their data may be inaccurate. Some who use wearable technology to monitor their health also fall victim to anxiety and compulsive behavior. For example, excessive attention to pulse rate and heart rhythm can cause physical reactions that mimic symptoms of serious diseases such as atrial fibrillation, resulting in unnecessary hospitalization and patient stress.

Another factor inhibiting the increased use of wearable devices is the ability to ensure data privacy. Since the COVID-19 pandemic began, consumers have become more willing to share their health data. However, data privacy remains an obstacle. According to the 2021 Deloitte Connectivity and Mobile Trends study, 40% of smartwatch or fitness tracker owners are concerned about the privacy of the data these devices collect. This figure rises to 60% among smartwatch owners who use it solely to track their health.

The next factor slowing down the spread of these innovations is cybersecurity threats. Like all devices that use a variety of communications, wearable devices are vulnerable to threats from hackers. The consequences for users can be serious. Fake smartwatch alerts may encourage patients to overdose on medications. There are also examples of medical devices such as drug infusion pumps and pacemakers being hacked. As smart patches that administer drugs become widespread, millions of people could become vulnerable to cyber threats. Thus, it is critical for companies producing wearable devices and related information systems to integrate cybersecurity measures into the development of their products, software, supply chains and cloud computing.

As in many other innovative technological areas, the factor influencing the dynamics of their development is government regulation. Since the flow of data from wearable devices into health records is tied to health insurance regulations in many countries, developments in legislation in these areas may either hinder or facilitate the development of systems using them.

These trends are not insurmountable obstacles and likely will not stop the growth of wearable device consumption. Devices will become more accurate and applications will become smarter. This will allow people to track a wider range of health indicators and conditions. It also seems likely that regulators will approve wearable devices for additional indications. For these reasons, large technology companies, healthcare providers and a huge number of startups believe that the wearables market is poised for rapid growth, and their investments and innovations will contribute to this.

The use of remote mental health services was not widely developed prior to the pandemic because practitioners were hesitant to take on treatment responsibilities outside of direct patient contact. However, forced social distancing and lockdowns have led to an increase in the number of people suffering from increased anxiety and depression. As a result, organizing remote mental health care has become a necessity.

Apps like Wysa (https://www.wysa.io), Talkspace (https://www.talkspace.com) and AbleTo (https://www.ableto.com/our-approach/) during the pandemic experienced a huge increase in demand. For example, Talkspace, which provides subscription-based matching of therapists to consumers' needs and goals, reports that its revenue grew by 49 % in 2021 to $114 million. (https://investors.talkspace.com/news-releases/news-release-details/talkspace-reports-2021-full-year-and-fourth-quarter-results).

Meanwhile, a number of healthcare startups were offering therapies for free or at reduced prices. For example, Hims & Hers (https://www.forhims.com; https://www.forhers.com) offers free specialized services and consultations for men and women. The company also offers the sale of medical and cosmetic products.

As noted above, the ability to use online medical services is limited by local healthcare laws and the use of personal data. However, as more people and governments recognize the importance of mental health, teletherapy services will likely continue to develop and be used more widely.

The use of remote mental health services was not widely developed prior to the pandemic because practitioners were hesitant to take on treatment responsibilities outside of direct patient contact. However, forced social distancing and lockdowns have led to an increase in the number of people suffering from increased anxiety and depression. As a result, organizing remote mental health care has become a necessity.

Apps like Wysa (https://www.wysa.io), Talkspace (https://www.talkspace.com) and AbleTo (https://www.ableto.com/our-approach/) during the pandemic experienced a huge increase in demand. For example, Talkspace, which provides subscription-based matching of therapists to consumers' needs and goals, reports that its revenue grew by 49 % in 2021 to $114 million. (https://investors.talkspace.com/news-releases/news-release-details/talkspace-reports-2021-full-year-and-fourth-quarter-results).

Meanwhile, a number of healthcare startups were offering therapies for free or at reduced prices. For example, Hims & Hers (https://www.forhims.com; https://www.forhers.com) offers free specialized services and consultations for men and women. The company also offers the sale of medical and cosmetic products.

As noted above, the ability to use online medical services is limited by local healthcare laws and the use of personal data. However, as more people and governments recognize the importance of mental health, teletherapy services will likely continue to develop and be used more widely.