Kairous Capital

Dr. Michael Gan

The digitization of healthcare is wrought with challenges, mainly due to the following factors: healthcare is highly regulated, patient data is highly sensitive, and the industry is highly litigious. There are also various payors and payment systems, and multiple players in its complex supply chain. Healthcare is also getting increasingly costly due to an array of factors; and being fragmented with multiple silos, there is no one size fits all system. Healthcare is typically a decade or more slower than other sectors to embrace technology, this is probably attributed to the various challenges as mentioned.

BIG DATA Since the turn of the century, Hospital Information Systems (HIS), Electronic Medical Records (EMR) and other systems became available and currently most healthcare facilities have adopted digitization, albeit at differing magnitude and sophistication. Medical records in various forms and formats, including a multitude of text and ‘lossless’ images have been digitized, and even moved to the cloud. Equipment that directly captures and stores electronic records are also readily available. As all these become mainstream… what’s next?

The application of data science and predictive analytics will be able to make sense of the data and churn out meaningful insights, for individual patient and population health. Artificial Intelligence will then assist and support medical decision making. Even with an increasing amount of data being collected, faster decisions and interventions can be carried out, improving disease prevention and better outcome from early treatment. Another emerging technology that might be able to improve portability, accessibility and security of healthcare data is by putting it on a blockchain network.

The practice of medicine is not an exact science but rely on published, peer reviewed, unbiased evidence. As the body of knowledge gets wider, it is evolving into becoming more complex with plenty more permutations. The role of technology will become essential for effective and efficient healthcare delivery. Above and beyond the usual patient data; genealogical, genotypical, phenotypical data on a particular patient will be available and this can lead to individualized and personalized medicine, within both the preventative and therapeutic areas.

EMPOWERING THE HEALTHCARE CONSUMER As healthcare information become increasingly accessible online, patients (also the healthcare consumer) are becoming much better informed. Laboratory and imaging investigations are also more readily available to the public. There are of course, pros and cons of this. But there is no denying the fact that in this new era, patients will be taking more control of their own health. Digital Therapeutics is the utilization of various evidence-based online tools, sensors and wearables at the consumer end for prevention of disease and healthcare intervention. Many common diseases especially the non-communicable types can be prevented or even reversed largely by just reducing risk factors which can be done via education and lifestyle changes. Typically, the patient has to be motivated and empowered by an app in a smartphone, coupled with interactivity (both automated and human), and input from multiple sensors. Data collected from various sources can then be analysed and appropriate intervention carried out. Digital Therapeutics can also be effective to assist in managing and alleviating chronic diseases as well as acute exacerbations. Moving more towards the wellness paradigm coupled with early detection will certainly improve outcomes, which can eventually lead to a reduction in healthcare costs by reducing and redistributing the healthcare burden from tertiary hospitals. With sufficient data, insurance premiums can fluctuate in correlation to the insured’s health, lifestyle and well-being.

Automated medical triaging platforms have a built in AI to provide differential diagnoses based on symptoms and can assist the patient to navigate the healthcare ‘maze’, or as a supplementary tool to the practitioner. They can even provide medical concierge services with chatbots or digital assistants at the frontline. This can be further supplemented by ‘kiosks’ with remote diagnostic equipment and telemedicine services. All in all, leading to decentralization and automation of the primary healthcare system.

IMPROVING HEALTHCARE DELIVERY Mobile broadband and smartphone penetration have fuelled the delivery of healthcare by enabling huge amounts of data to be shared almost instantaneously, with further improvement by 5G. Telehealth has evolved from just a phone call to harnessing the power of audio-visual communication channels. All these would greatly assist the connected doctor to deliver healthcare consultations virtually. With telehealth platforms, patients are able to seek consultation from a healthcare professional, proceed with ancillary services (lab investigations and diagnostic imaging), access their medical information, and get medications delivered, all within their smartphones.

Other forms of telehealth can include telepharmacy, virtual physiotherapy, mental health counselling etc. Augmented Reality (AR) / Virtual Reality (VR) are also currently being used for treating certain conditions, particularly mental disorders and pain, and is very valuable for surgical training.

The digitization of healthcare will continue to progress, with the emergence and advancements of various technologies such as 5G, IoT and IoMT (Internet of Medical Things), smaller chipsets and better sensors and batteries, better algorithms and processors to analyse big data, etc. Growth in supplemental areas such as insure-tech and fintech will also help improve the healthcare ecosystem.

THE DIGITAL HEALTH STARTUP Technology is advancing at such a rapid pace that anything that is considered too far-fetched now will become possible sometime in the future, which is why startup founders have to keep close tabs on emerging technological trends. Successful founders can achieve breakthroughs by harnessing new emerging tech but founders who overlook or slow to adopt might get disrupted.

Any startup in the healthcare space would need to “know thy payor”. There are many payment models with few payors in this industry. Startups should be able to map themselves in the ecosystem and identify their stronghold in the value chain. Platform players with strong technology and value-add will have an advantage.

No man is an island. It’s best to ensure interoperability with all the various systems (both software and hardware) out there, in order to gain traction by reducing user friction. Compliance to standards and regulations are also of utmost importance.

Evidence based. The buy in and acceptance from healthcare practitioners will have to come from proven research. This has been the tradition and practice for generations and the adoption of new technologies is no different. The product or service has to fit into the healthcare workflow, with sufficient evidence to support its value.

This article just scratches the surface of healthcare digitization and startups. Exciting times lie ahead with many opportunities as most players start to embrace technology, which is further accelerated by the global pandemic.

“Don’t worry about failure, you only need to be right once” – Drew Houston, founder of Dropbox