2020 was a challenging year for so many of us. Yet in searching for the silver linings, we’ve noticed a couple of things that stand out. Firstly, the pandemic has brought science and healthcare to the forefront of nearly every conversation. Secondly, it has demonstrated that many of the longstanding gaps in our current healthcare system can be addressed through digital health.
Healthcare has historically lagged behind many other industries in the adoption of digital solutions. Many such solutions have existed for the last decade and yet it had been a struggle to integrate them into mainstream health systems. The onset of the COVID-19 pandemic, with many people unwilling or unable to leave their homes for critical healthcare services, has resulted in rapid adoption of many of these digital health technologies.
Here are five key digital health trends that we see continuing in 2021 and beyond—plus a snapshot of ten companies to keep an eye on.
When the COVID-19 pandemic hit in late 2019, it quickly became apparent how unprepared we were to handle it. Many digital health companies with technology solutions for similar applications in adjacent industries rapidly pivoted to COVID-19 testing, monitoring, and surveillance solutions. To date, the FDA has authorized 309 tests and sample collection devices.
We see this trend continuing as digital companies try to make testing faster, cheaper, and more accessible so we can bring our lives back to normal and re-open our schools and workplaces. In a post-COVID-19 world, many of these companies are likely to expand their applications to address other infectious diseases.
Some notable companies in this area are:
Telemedicine solutions have existed for many years prior to the pandemic, but widespread adoption was relatively limited due to patient and physician resistance, privacy issues, and a reluctance by payors to reimburse, other than in a few exceptional circumstances for reaching rural and underserved areas.
However, COVID-19 created an urgent need for telemedicine services as elective visits were cancelled and clinicians were no longer able to see patients in person. According to the Centers for Medicare and Medicaid Services (CMS), in late March 2020 telehealth visits jumped from 10,000 per week to 300,000 per week. While those numbers are expected to come down after the pandemic, it is clear that for many clinical areas, the convenience and simplicity of accessing a healthcare provider from the comfort of your couch is something that both physicians and patients are now seeing the benefits of.
As a response to the pandemic, the CMS in March issued a waiver to extend coverage to telemedicine services. On Dec. 2, 2020, CMS Released its Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021, showing roughly 60 new telehealth services expected to be reimbursed by Medicaid. And Teladoc’s $18.5B acquisition of Livongo provided further validation that telemedicine is here to stay.
One note of caution: While telehealth has many advantages for clinicians, patients, and potentially payors, more widespread adoption will also require a massive overhaul of our health system. Furthermore, we must be able to deliver care to patients through the channels that are most appropriate for them. For example, for seniors who may not be technologically savvy or for those without access to good internet or streaming devices—how do we ensure they don’t get left behind and we don’t widen gaps in access to care? This was one of the fascinating topics discussed at the Social Determinants of Health in the Virtual Care Setting webinar that we hosted last year at MDisrupt.
Some notable telehealth companies we would like to highlight:
Consumer genetics giant 23andMe first brought lab testing into the home. The company demonstrated not only that consumers had an appetite to access health information about themselves, but that they were willing to pay for it directly and could effectively collect a sample at home and ship it to a lab.
Throughout the pandemic, we have seen states struggle to deliver COVID-19 testing efficiently. They have faced challenges with test availability and distribution as well as long turnaround times. And as we see new surges in infection rates, these problems have worsened. Furthermore, as many people have been reluctant to leave their homes and wait in long lines for testing, we’ve seen a new demand for at-home tests.
Here we highlight:
And if we can do at-home testing for COVID-19—why not all other types of lab tests? Of course, these tests may take longer to develop. But we believe that digital health companies who take the right steps in consumerizing and democratizing access to healthcare services responsibly are here to stay.
What are the right steps? Digital health companies need to be willing to:
In 2020, both COVID-19 and the death of George Floyd turned the spotlight onto racial injustices and health disparities. Many articles and studies have shown that digital health products are being built with inherent biases and are not serving important segments of the population. The problems range from wearables not being built to accurately detect the heart rates of people with darker skins to genetic databases being developed primarily based on the genomes of Caucasian populations to algorithms being built with inherent racial biases that impact how health services are delivered and who gets them.
Furthermore, at the 2020 Rock Health Summit, a large part of the discussion was about how digital health investors tend to only invest in founders they relate to and problems they’re familiar with. Yet by widening the lens to consider a broader range of people and their needs, these investors could make bigger returns by solving health problems that impact larger segments of the population.
Fortunately, there is a new breed of investor emerging who wants to invest in minority founders. With that, we will see more companies working to close gaps in health disparities. This extends beyond racial disparities and into areas such as femtech, elder care, and solutions to ensure that LGBTQ communities have more health solutions available to meet their needs.
Interesting companies to watch in this category are:
The COVID-19 pandemic has highlighted divides not only in how people access healthcare but also in how those who have caught the virus have experienced it. Some have had only mild symptoms, while others became severely ill and many hundreds of thousands have died. Furthermore, some survivors, known as COVID long haulers, have suffered long term symptoms.
What is clear that for health systems, governments, and payers it is critically important to be able to identify the highest risk patients much more swiftly and, where possible, to proactively deliver preventive interventions earlier. And while COVID-19 has highlighted this need, this principle applies to all aspects of chronic disease management.
In order to do this we need a more holistic approach toward patients within a health system. This will require a variety of datasets beyond just medical records, particularly those that can be predictive or preventive of chronic disease.
There are new opportunities for digital health companies to innovate in this area including adding datasets such as: genomics, lifestyle and behavioral health and social determinants of health.
Some examples of companies and health systems taking a novel approach to population health management are below.
These solutions are complex to build. In the US, as we shift to value-based care models of payment, the pressure on digital health companies to demonstrate their ability to deliver improved outcomes will also increase. Another fascinating discussion about Reimagining Population Health Management can be heard at our recent webinar featuring health system executives, payors, and digital health entrepreneurs.
Back to silver linings. We are at an inflection point. We believe 2021 will be another year when science, healthcare, and digital health will be thrown into the spotlight and have the opportunity to make a significant impact on the health of humanity. The pandemic has shone a light on the gaps in our healthcare system. That, together with changes in regulations, reimbursement, access to funding, and physician and patient willingness to adopt novel health solutions have created an unparalleled opportunity for digital health companies.
