26th June 2020

Medtech after COVID-19: The digital and AI space

There is much talk of the new normal, about how the world will adapt with regards to controlling the spread of COVID-19 until a vaccine or adequate therapies are found before we return to something like the pre-lockdown life. But in some cases, these changes could be long lasting.

With so much technological innovation in the world, medtech is bound to be one of the most affected sectors. As a result of the pandemic technologies such as telemedicine, tracking apps and those with a more digital and AI focus may have had their lasting breakthrough.

Here we got the view of a few companies operating in the sector.

For several years Nuance Communications has been championing the use of ambient clinical intelligence (ACI) to help clinicians better engage with patients and write up notes in a more efficient manner with their voice recognition technology – allowing them to alleviate pressure on physicians and lessen the rate of fatigue among doctors.

Explaining its approach to the pandemic, and the potential aftermath, Dr Simon Wallace chief clinical information officer at Nuance Communications, said: “In order to help clinicians to tackle the growing demand for their services and the associated growth of clinical administration, we launched a free COVID-19 content pack for all Nuance Dragon Medical One users in the UK. This pack has been designed to provide structured templates to support healthcare professionals with their documentation processes during this difficult period.

“During – and after – COVID-19, we need to take care of healthcare professionals so that they can take care of us. Advances in technology which correct the imbalance and enable clinicians to spend face time with patients, rather than on administration, are a vital ingredient to achieving this and will likely see increased investment moving forward.

“This technology – which automatically extracts coded information into a structured note – can distinguish between human speakers to capture a patient’s response as well as the clinician’s, leading to a faster, more accurate documentation process than ever before.”

A survey in the first week in April from NHS Digital found a 38% increase in use of its services, which included use of its website, the app, the 111 service, electronic prescribing service and its pathways service.

A contact tracing app has been trialled on the Isle of Wight but roll out across the UK has been blighted by delays, with disputes between the government and Apple has to how much dialogue there has been between the two over its development.

There is the potential it opens up an avenue to it becoming the norm as medical devices increasingly become smarter and interoperable with consumer technology.

Similar technological experiments were taking place with Evergreen Life mapping the spread of COVID-19 and identifying hotspots in the process – with the support of academics and co-operation with the NHS.

The main feature of change seems to have been in telehealth, with more remote consultations taking place as people have stayed at home during the pandemic – avoiding the potential petri-dish of a surgery.

Cloud communications provider X-on developed the GP@Home service – one example of the digitisation of the health service being necessarily sped up in the UK – allowing video and phone consultations between the doctors and patients with ‘Video Connect’.

During its launch in late April, Dr Barry Sullman, Newham GP and Clinical Commissioning Group clinical lead, said: “This is a game changing piece of software that has allowed my practice to perform normally through the COVID-19 crisis.

“By being able to diagnose a diverse range of conditions such as skin rashes reliably, and by being able to assess the clinical condition of a patient confidently through high quality video, face to face appointments at the surgery are saved, which in turn increases the access capacity of the surgery. The technology also records the phone or video call, and links it to the clinical record, so that doctors can refer back to the information if required.”

Florence Jean head of global health at Europ Assistance says the company has seen the use of telehealth consultations grow five times its normal rate during lockdown across Europe, and relaxation of certain regulations in European states to allow them to provide teleconsultations and medical assistance services.

She believes that only time will tell as to whether teleconsultations are going to be more widespread.

“I’m curious to see what will change in the habits after the end of the lockdown. Medicine is human interactions and the use case of telemedicine has been enlarged. People still need to, and want to, physically meet their doctors and have this close relationship with their doctors. How far and to which extent will they continue to use teleconsultation? I’m curious about it, I’m really curious.”

Olive CEO, Sean Lane, doesn’t think there will be a return to the ‘old normal’ – believing the pandemic will have a lasting effect on healthtech and medtech, and provides the opportunity for cost savings and growth.

“The health systems and healthtech companies that embrace change and challenge will drive healthcare transformation – new initiatives will be spearheaded, and new efforts will be made to create positive change in the way health systems operate.

“The tasks that keep the lights on from an administrative perspective currently rely on the work of humans, sitting at desks in offices. But these processes should and can have a lighter human touch, and software, systems, and technologies need to be resilient to current global circumstances. That’s where an AI workforce comes in: automating and optimising key processes.

“We’ve observed the pandemic being a catalyst to highlight broken processes and weak points, and health systems are being more aggressive in seeking out sustainable solutions that offer long term reliability, and the adoption of an AI workforce is one of them.”

But if use is going to become more widespread, there could be need for more infrastructure in place. In an online event, the team behind the HETT event shared their early experiences of adapting to life with COVID-19. In a blog post, Corby Ganesh, HETT’s portfolio director, picked up on a comment made by Dr Sandeep Bansal, CEO of Medic Creations, describing some of the key challenges around communication within the NHS.

He said that for a wider roll-out: “You need a lot of infrastructure in place – the right Wi-Fi, 3G and 4G capabilities, plus devices – and I know there’s a lot of work taking place with telecoms providers to make that happen across the NHS rapidly.”

While there was the focus on the internal infrastructure for NHS systems, that also brings into the focus for a point for wider infrastructure across the country to encourage sections of the population to take up use of telemedicine.

The consensus from that particular event suggested that the crisis had proven to be a catalyst for modernisation projects that could have taken years otherwise.

Away from the event, Justin Hall VP and GM EMEA at iRhythm Technologies, summarised the overall picture, saying: “The need to stay at home has driven a surge in telemedicine, with many GPs turning to online consultations in order to continue effectively diagnosing and treating patients, without having to physically see them. The benefits of this are already becoming clear, with some physicians saying this model won’t diminish once the COVID-19 outbreak has passed.

“Our priority during this time has been to ensure that both healthcare professionals and patients still have access to the tools they need to give and receive the highest quality of care remotely.

“The UK health service has shown immense resilience in the face of COVID-19, adapting practices and going above and beyond in order to save lives and restore a sense of normality. Once the crisis is over, however, it is critical that we do not take five steps back. Instead, we must continue to drive much-needed innovation across the sector, modernising our digital infrastructure to further develop a future-proof NHS.”

This isn’t just an issue for the NHS – as resources for social care has been brought into sharp focus with a large proportion of Coronavirus cases taking place in the care home setting.

Research from academics in York and Barcelona, supported by Tunstall Healthcare showed that:

• In the UK, with the Lancashire Telecare Service, £4,500 per person was saved per year in care costs when reactive telecare was included as part of the care services.
• In Spain older people offered proactive and personalised technology (preventative) were able to stay independent at home for on average 262 days longer, before having to move to a care home facility, equating to a potential cost avoidance of £5,900 per person.
• Proactive and personalised telecare reduced pressure on emergency services. Emergency calls for help were reduced by 54% and ambulance mobilisations by 36%.
• Proactive telecare service users reported feeling significantly safer (96%) and more self-sufficient (78%) – with 98% feeling it gave peace of mind to their family.

Zillah Moore, marketing director UK & Ireland of Tunstall said: “Until now there has been lack of independent analysis on the impact telecare is having on health and social care systems – and this is the first time the socio-economic value has been studied in this way. It proves the benefits that can be realised, and that when technology is deployed in a person-centred way, it can create a more sustainable and resilient health and care system.”