Improving Diagnostics and Adherence Using Digital Technology

Improving Diagnostics and Adherence Using Digital Technology

Technology is dramatically changing the way in which healthcare providers (HCPs) deliver patient care and increase employee productivity. As a result, the healthcare industry is fast becoming more open to implementing digital technology to drive efficiency, reduce costs and better serve patients.

While the healthcare industry still lags behind some other industry sectors in terms of digital transformation, the costs of advancing digital technology are slowly beginning to fall as patient demand increases. It’s the perfect opportunity for HCP’s to incorporate developments in connected health or technology-enabled care (TEC) to provide better patient solutions.

Wearables are widely adopted, mobile devices have the processing power of a desktop computer and we’re already seeing cloud-based data solutions such as IBM’s Watson Health Cloud, analyse vast amounts of data from these devices to support clinical decisions.

As digital technology becomes more pervasive in the pharma and healthcare industry, how are HCPs using these transformative solutions to improve efficiencies in the areas of diagnosis and adherence?

Rapid growth in mHealth

In a bid to maximise patient outreach and minimise cost, many HCPs are turning to mobile healthcare (mHealth) to improve efficiencies in the healthcare system.

With a myriad of uses ranging from biometric monitoring and chronic care management, to complex predictive analysis, the global mHealth market is predicted to grow at a CAGR of around 33.8% over the next decade to reach over $181 billion by 2025.

Previous concerns over patient access have recently eased over the years as older generations – who are the largest users of health and social care services – are fast becoming adopters of mobile technology. In fact, 2021 data from Pew Research Centre suggests that 83% of US adults aged between 50-64 own a smartphone device.

Leveraging the smartphone is considered one of the cost-effective and easily accessible ways in which patients can monitor their health and aid medication adherence.

There is a plethora of healthcare apps on the market that incorporate features such as pill reminders alarms, refill reminders and patient diaries. Some apps even have the capacity to integrate with a patient’s local pharmacy or primary care provider’s (PCP) database.

Patients are also opting for smart pill bottles such as Vitality Glow Cap due to their familiarity. The bottle itself works by detecting when medication is removed – usually by a weight sensor – and sends a notification to an app via a Bluetooth-connected device indicating that the medication has been used. This data can also be used by the patient’s PCP to evaluate adherence.

But as a user-dependant, indirect measure for medication adherence, mobile apps and smart pill bottles alone aren’t considered the most reliable for doctors who monitor their patient’s health. For example, the elderly or patients diagnosed with a mental illness.

Ingestible pill sensors could be a viable answer to solve this issue. In fact, the FDA recently approved the first medical ingestible pill sensor in the US, Abilify MyCite, which digitally tracks if patients have ingested their medication.

The IEM sensor – which was approved for the treatment of schizophrenia and bipolar disorder – breaks down in the gastrointestinal tract and communicates to an external wearable sensor attached to the abdomen. The sensor then relays the data – including the date and time the tablet was ingested – to an app on a compatible mobile device.

But it’s the blend of traditional multi-dose delivery, indigestible sensors and a compatible app platform that collects this data that will truly benefit HCPs in the future in order to effectively monitor patient medication intake and identify any issues.

Diagnoses through smartphones

Point-of-care (POC) testing – such as glucometers to test blood sugar levels – is nothing new to the healthcare industry. Physicians, nurses and patients alike have a wide range of devices that provides added convenience and increased efficiency when making clinical decisions. But the focus of smartphone-based POC testing is to hasten diagnosis where the patient is seen – even in the patient’s home.

In 2016, healthcare providers spent $18.4 billion on point-of-care diagnostic testing services, ranging from pregnancy tests to blood and endocrinology tests, according to Kalorama Information.

ResApp provides patients with the ability to analyse their breathing, or even coughing, to instantly diagnoses and manage respiratory disease using a smartphone. The mobile app is also a cost-effective solution to POC diagnosis compared to mass production of a bespoke diagnostic device.

Based on the premise that a cough and breathing sounds carry vital information about the respiratory tract – much like how stethoscopes are used to listen to breathing in the chest – the app records a patient’s cough and breathing pattern and identifies the signatures that characterise the respiratory tract. The app then uses machine learning to match multiple signatures from a database of recordings in order to generate an accurate diagnosis.

Other customer-friendly concepts which are currently being tested in the UK by the NHS include CliniCloud, a microphone that connects to a smartphone and acts as a stethoscope to diagnose chest infections. Similarly, the Cardio app is also being tested to analyse the change in a patient’s tone of voice to predict if their congestive heart failure is likely to get worse.

But it’s the ubiquitous presence of smartphone devices that will enable healthcare providers to truly extend their global reach in order to diagnose individuals who have limited access to immediate health care – especially for communities in remote or rural areas. In fact, we’ve already seen reports of smartphone-compatible devices that are able to diagnose diseases including HIV and malaria as well as symptoms of exercise-induced asthma.

Empowering Patients

It’s safe to say that patients and caregivers are increasingly turning to the internet to research and share their medical experiences online. It’s estimated that 80% of internet users in the US have searched for a health-related issue online now that there’s an abundance of platforms and forums where individuals can identify symptoms to self-diagnose or stay abreast of the latest medical treatments.

But digital technology has the capacity to be used more efficiently to connect patients and their POCs to ensure better healthcare outcomes and provided a more personalised service in which patients and caregivers can feel more empowered about their treatment – while also encouraging better adherence.

Advances in wearable technology and the popularity of mobile apps have propelled services such as remote monitoring (or telehealth) beyond mere tracking activity and HCPs are able to monitor a range of physiological activity including heart rate, posture, adherence and brain activity.

These biosensing devices have seen some noteworthy results from some HCP’s in the UK who tested these devices with patients in order to support the management of chronic diseases such as COPD (Chronic Obstructive Pulmonary Disease) by automatically monitoring and detecting real-time changes in patient’s health status.

In 2015, Harrow CCG trialled a patient monitoring service with Closercare, which provided patients with remote monitoring devices which were wirelessly linked to a team of nurses. When any abnormal results were identified, nurses would call the patient and either monitor them more closely or contact the patient’s PCP. By using the service for three months, patients experienced a 63% drop in hospital bed days, 12% drop in A&E attendance and a 16-20% cost-saving as a result of fewer admissions to hospital.

Its reported that there’s a growing appetite for this kind of virtual health not only from patients with chronic diseases but from individuals who prefer the convenience of virtual services over traditional in-person health care.

According to a survey by Accenture, 76% of US respondents said they’d like to use virtual services to be examined for non-urgent health issues and 77% said they’d use digital services to track health indicators such as blood pressure, pulse, glucose levels and managing medication adherence. This presents an opportunity for PCPs to make some considerable cost-savings in the future.

It’s estimated that with diabetes management alone, primary care physicians in the US could save $2 billion annually where diabetes sufferers received one in-person annual physical exam coupled with technology-enabled self-management for the rest of the year.

Digital Therapy

Confidence in mobile technology and the rise in the gig economy has opened up opportunities in the mental health arena. A growing number of people are flocking to text-based therapy platforms where patients pay a premium to receive therapy by licensed professionals online without the need to travel to an office.

According to the National Institute of Mental Health, roughly one in five people – nearly 43 million people – suffer from mental illness in the US.

With the current stigma placed on mental health and the fact that treatment is more than often too expensive, it’s no surprise online platforms such as Talkspace have become so popular with younger generations seeking to take back control of their lives using the devices they are more familiar with.

Talkspace, which launched in 2012, is spearheading this shift in digital therapy and recently received an additional $31 million in new financing this year. Driven mainly by millennial users – with an average age between 33 and 34 – the US-based startup has treated over half a million people since its inception, with many users checking-in with their therapist at least once or twice a day.

It’s unclear how this trend in digital therapy will develop and many professionals believe that there are some limitations to this type of treatment – some even calling it a gateway to face-to-face therapy rather than an endpoint. But we could see these types of therapies incorporated into patient monitoring strategies and multi-dose delivery systems in order to achieve a holistic view of patient health.

Deloitte suggests that the UK is quick on the uptake of technology-enabled care, however still lags behind many other European countries in the context of adoption. Signalling a wide variability in the maturity of the digital health market in Europe alone.

There’s also concerns over privacy, patient safety, liability and universally agreed standards as the healthcare sector continues to develop with the help of third-party technology companies. But a forward-thinking patient-focused healthcare vision that encompasses digital technology to deliver cost-effective patient care is crucial for healthcare providers to thrive in the future.

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