Perspectives

The future of healthcare enabled by technology

5 May 2021

Technology is changing the way we live, with smart consumer services reaching further into our lives and connecting with the interface of our physical world. The digitisation of our daily experiences is a trend that had commenced prior to the COVID-19 pandemic. However, the environment of the past 18 months has further accelerated the adoption of these technologies, as global populations have been required to work, study, and conduct many daily activities from home.

The accelerated shift to a digital society has altered essential relationships in our communities, including the way we seek medical advice and assistance. Historically, some medical professionals have expressed concerns that technology may impede their ability to make independent diagnoses and change their relationships with patients. However, changes brought about by the pandemic have provided an opportunity for the sector to close the digital gap, become truly mobile and optimise big data. For an industry built on the desire for good patient outcomes, the COVID-19 pandemic has required practitioners to embrace technologies that ensure their services can still be delivered successfully, without the need to see their patient in person.

Australia’s healthcare landscape

Australia has a world-class healthcare system that delivers high quality health outcomes. However, it is also complex, jointly run by all levels of government, with a complicated network of health professionals, healthcare providers, funding regimes and regulatory frameworks. This level of complexity in any industry can make innovation a challenging prospect.

Like many OECD countries, telemedicine represents a very small proportion of the overall volume of services provided by Australia’s healthcare system, even if it is one of the countries where telemedicine is most used (see chart below). Studies have shown that prior to the pandemic, depending on the year, there were between seven and 25 teleconsultations per 1,000 people in Australia, compared to between four and eight traditional face-to-face doctor consultations for every person (teleconsultations representing between 0.1 per cent and 0.2 per cent of face-to-face consultations).1

Source: OECD

The reasons for slow digital adoption in Australia’s healthcare system are complex and varied, from a lack of patient trust and regulation in place, to uncertainty around reimbursement and funding. The introduction of My Health Record in 2012 highlighted concerns raised by Australians around the collection and use of their medical information (data breaches present the risk of compromising personal information). According to figures released in February 2019, more than 2.5 million people opted out of My Health Record and the numbers cancelling their records were continuing to grow.2

Responding to a pandemic

The impact of the COVID-19 pandemic drove increased adoption of digital health services in many countries globally, including Australia, says David Bailey, Senior Research Analyst at Macquarie Capital.

“The need for virtual access to essential care, combined with the burden of the pandemic on Australia’s healthcare system has pulled forward the adoption of new technology in the sector. To continue providing essential healthcare to those who were confined to their homes due to lockdowns or self-isolation, regulation has shifted to allow a number of services that were usually delivered face-to-face to be provided virtually, and also bulk-billed.”

In March 2020, the Australian Government introduced new Medicare Benefits Schedule (MBS) codes for telehealth items available to GPs, medical practitioners, specialists and other providers, enabling them to offer a range of services virtually, thereby reducing the risk of community transmission, providing protection for both patients and health care providers.3

In line with these changes, the use of telehealth services, especially over the telephone, grew throughout 2020 (see chart below). In Greater Melbourne, Australia’s capital city most impacted by COVID-19, the lockdown in early July saw medical practitioners shift from face-to-face to telephone and video-conference consultations.4

Source: MBS, Macquarie Research

Monitoring, wherever you are

The pandemic has also seen a response from Australia’s largest healthcare companies, which increased the number of remote monitoring solutions brought to market. These solutions aim to improve patient care through digitally transmitting health data, enabling healthcare practitioners to ensure their patient’s condition is being well-managed and that they are following treatment plans provided while at home.

Remote Check from implantable hearing device provider Cochlear enables patients to complete a series of hearing tests using their smartphone, while AirView, from sleep technology company ResMed, allows a healthcare provider to monitor and change their patients' device settings remotely using a cloud-based system.

This idea of a hospital-at-home is not new, but this rapid adoption is, and it is proving effective in managing chronic diseases, keeping people well and out of hospital for longer. A recent review in the US found that remote monitoring led to positive outcomes in 77 per cent of studies conducted.5

There has also been a steady emergence of consumer-focused technology that encourages a healthier lifestyle and helps users understand health outcomes. This includes a wide range of wearable devices that count steps, monitor the quality of sleep, track fitness, monitor glucose levels, check hydration and much more. Australia was an early adopter of this wearable technology, with its popularity set to continue.

“Patients no longer have to be tethered to hospital beds for a week of monitoring. Clinical wearables enable them to enjoy freedom of movement and undertake their monitoring at home. Beyond the patient experience, the business model is also compelling, with this at-home model of care using technology costing 20 per cent of the legacy option. At Seer, we have assisted 6,000 Australians with an epilepsy diagnosis that would have cost $A40m more to the health system if performed in a hospital, taking up more than 85 bed years. The outcome for society through using technology in healthcare is compelling: radically better quality of health outcomes at a fraction of the cost.”

Dr Dean Freestone,
Seer Medical CEO

Transforming diagnostic medical imaging

Artificial intelligence (or AI), through machine learning or deep learning, is proving a game-changer for diagnostic imaging, not only through standard applications of scheduling patients and managing staffing, but also to interpret images and speed up scan time.

Algorithms are able to learn features of an image and manage classification, without the need for human intervention, creating data that can improve clinical decision‐making. Collecting and disseminating medical imaging data has played an important role in responding to COVID-19, assisting to diagnose patients and manage the outbreak around the world. Chest X-rays and chest CT scans have been the two most common images used to diagnose and treat COVID-19 patients, with studies showing that deep learning can effectively segment COVID-19 lung lesions and quantify and monitor the extent of lung parenchymal disease.6

There are still some hurdles to overcome, including scepticism among radiologists about the effectiveness of this data-driven approach, and regulatory approvals. However, it is largely accepted that AI is set to transform diagnostic medical imaging into the future, with the data sharing we have seen during this pandemic finding many more applications.

The pandemic has also seen increased adoption of remote teleradiology reporting, through providers such as Australian company Everlight Radiology, which can receive medical images as they are taken in hospitals and have them assessed by its team of radiologists. Providers like this use technology to help clinicians manage increasing patient volumes and case complexity, as well as providing 'follow the sun' services by having locations in Australia and elsewhere. While teleradiology has been used around the world for many years, COVID-19 increased the need to provide remote solutions as healthcare systems became generally overloaded.

Healthtech into the future

The onset of the COVID-19 pandemic over 2020 resulted in the adoption of a range of technology initiatives across the Australian healthcare industry in a matter of months. Looking to the future, telehealth services provided over the phone or video conference have potential to bring medical treatment to a larger proportion of the population, including those in remote and rural communities. Greater patient engagement through a range of technologies may also mean greater adherence to therapy and better outcomes for the patient, while remote monitoring can drive further efficiency within clinics, prioritising cases and reducing delays. And, with the industry only touching the surface of what AI and machine learning can deliver in diagnostic services, its application in the future presents further opportunities for the industry. The opportunity now is for the pockets of innovation we are seeing in the sector to shift to more widespread application.
 

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1. Tiago Cravo Oliveira Hashiguchi, Bringing health care to the patient: an overview of the use of Telemedicine in OECD countries, Organisation for Economic Co-operation and Development (OECD) Health Working Paper No. 116, 17 January 2020, https://www.oecd.org/.
2. Christopher Knaus, More than 2.5 million people have opted out of My Health Record, The Guardian (Australia), 20 February 2019, https://www.theguardian.com/.
3. Department of Health, COVID-19 Temporary MBS Telehealth Services, Australian Government, http://www.mbsonline.gov.au/.
4. The Australian Institute of Health and Welfare (AIHW), Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use, Australian Government, 17 December 2020, https://www.aihw.gov.au/.
5. Frederico Arriaga Criscuoli de Farias et al., Remote Patient Monitoring: A Systematic Review, Telemedicine and e-Health Vol. 26, No. 5, 6 May 2020, https://www.liebertpub.com/.
6. Sudhen B.Desaia, Deep learning and its role in COVID-19 medical imaging, Intelligence-Based Medicine Vol. 3–4, December 2020, https://www.sciencedirect.com/.