Friday, Jun 19, 2020 | 4:00 PM ET
COVID-19 Updates with Pravene Nath
In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates.
Healthcare Must Adapt and Embrace Digital Health to Survive
The COVID-19 pandemic has had a tremendous impact in the United States and around the globe. It has taken too many lives and disrupted too many more, including by postponing or preventing medical treatment. The fragility it has exposed in our healthcare system must be addressed in order to restore public confidence. In some ways we have started already. In a matter of weeks, we’ve seen a decade’s worth of growth in the adoption of telehealth and other digital health tools, as hospitals and clinics scramble to keep serving patients. Blue Cross Blue Shield of Massachusetts reported recently that the number of telehealth claims it received per day went from about 200 in February to more than 38,000 in May. In some cases the rapid adoption of virtual care was made possible by leveraging previous investments in then underutilized telehealth platforms. However, much of the recent mobilization occurred through general consumer/business video platforms such as FaceTime and Zoom, the use of which was liberated by the temporary relaxation of outdated regulations.
For this recent shift to make a permanent impact, however, and truly improve the lives of patients, we need to think and communicate clearly about how these technologies can be used effectively in a post-COVID world. I see three essential ways that digital health technologies will have to adapt in order to continue providing real benefits to providers and patients.
Serve the Neediest
Telehealth has been widely adopted during the pandemic for the simple reason that it allows doctors and patients to consult without the risk of infection. It has also allowed physicians to reach underserved communities, many of whom are at greater risk for COVID-19 complications, and manage milder cases of the virus remotely, freeing up hospital beds for the sickest patients.
But when the pandemic has ended, those applications will abate as well. When they do, digital health technology risks becoming little more than a convenience for those who could visit a provider’s office but prefer not to. Telehealth offers much more value to people who have great difficulty reaching a doctor’s office because of disability, advanced age, remoteness or some other significant obstacle. At the same time, it is these very populations that are often limited in their ability to access and navigate modern smartphones, computers, and connected devices. Extending these technologies to the populations that need them most should become our paramount goal, achieved not just through the design of appropriate software and hardware, but through empathetic support services which can bridge this divide and address health disparities.
Emphasize the Benefits to Quality of Care
Similarly, we need to more fully communicate the vast functional value of telehealth. During the pandemic, its simplest expression – enabling people in remote locations to see each other and converse in real time – has been tremendously valuable. But if we are to make continued progress, we need to convince providers and patients that telehealth is much more than conducting medical appointments by videoconference.
Technologies like remote patient monitoring, tracking apps and algorithms that make sense of longitudinal patient data can do much to increase the quality and effectiveness of healthcare. Many of these applications have been employed ingeniously during recent weeks out of necessity. For example, during Italy’s initial COVID outbreak, Roche created an app in collaboration with a startup, clinicians and patient advocacy groups to monitor patients remotely and set up virtual doctor’s visits at a time when hospitals and clinics were overwhelmed. Others have developed chat bot assessments, self-monitoring tools and analytics tools to support COVID patients and manage demand for services. A paper published online May 5 in Diabetes Technology & Therapeutics described how two patients with type 1 diabetes, one newly diagnosed, were successfully treated at home for diabetic ketoacidosis during the pandemic thanks to the availability of continuous glucose monitoring systems. These tools have value far beyond COVID, but for it to be widely realized the healthcare system will have to recognize the full potential of digital health.
Protect Patients and Their Data
We must also remember that the digital health experiments of recent weeks required loosening regulations and reimbursement policies. Medicare coverage has been expanded for telehealth services, HIPAA rules have been suspended for communication by phone and videoconference and restrictions on practicing medicine across state lines have been loosened to make remote care more feasible.
Some of these regulations may have been unnecessary in the first place, but not all of these rollbacks should remain in place after the crisis has passed. We need good regulations for digital health that make sense during normal times as well as crisis, allow the introduction of new digital biomarkers and therapeutics into a trusted system for validation, and enable the transmission and use of patient data while maintaining privacy and security. Data is the lifeblood of modern medicine, and managing it responsibly is of utmost importance.
The overnight explosion in the adoption of digital health tools due to COVID is a welcome silver lining to what has been a difficult and tragic few months for healthcare. The pandemic has exposed many weaknesses, among them our inability to collect, analyze, and act on data as quickly and effectively as we should. We can and must do better, and one way to make progress is to move digital healthcare forward with the needs of patients in mind.
It seems likely that the vast majority of people who have ever visited a doctor remotely did so for the first time in the last few weeks. This is a rare chance to transform that brief introduction into a long-term relationship. If we do not think carefully today about how to use digital tools effectively and communicate their value in a post-COVID world, we risk losing the momentum this unique historical moment has provided us.
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Pravene Nath - Global Head of Digital Health Strategy, Personalized Healthcare
Pravene is responsible to launch digital health products and ensure strong acceptance and adoption by healthcare systems (including physicians, hospitals, payers, and patients) - and ultimately deliver the full potential of these digital tools to patients.
Prior to Roche, Pravene worked at Mindstrong Health, where as the Chief Product Officer and SVP of solutions and healthcare operations, he was in charge of building teams to launch Mindstrong's digital biomarker, patient engagement, telehealth, and care management products. He also oversaw the build-up of Mindstrong's inside sales team, customer support operations, and payor/provider implementation teams. Before that, Pravene was the CIO and CDO for Stanford Health Care and Stanford University School of Medicine, where he oversaw 600 employees and a $200 million operating budget deployed across digital health strategy, healthcare analytics, enterprise information technology, product development, and physician and nursing informatics. While there, he led the efforts to develop and launch the Stanford MyHealth mobile apps that reached 320,000 subscribers within 3 years. He received Becker's Healthcare's CIO Leadership Award and Stanford was designated by US News as the Most Connected Hospital. Prior to his time at Stanford, Pravene was the Chief Medical Information Officer for NYU Medical Center in New York, where he oversaw all enterprise EHR and physician/nurse informatics programs.