While the far-reaching effects of COVID-19 have introduced the world to a “new normal,” the greatest impact has been in healthcare. In the long term, it has forever shaped the future of healthcare delivery, while its immediate effect has been on medical technology — with a focus on digital devices and a shift toward a more collaborative product development process.
“The health system of the future will be consumer-centric, wellness-oriented, care everywhere, and digitally connected,” says Reenita Das, senior vice president and partner at Frost & Sullivan. “Healthcare stakeholders will need to adopt more virtual, innovative health management tools and techniques to support patients at home. While we acknowledge the adversities that the pandemic has caused the world, we also recognize that it has raised growth opportunities to enhance companies’ performance in this new normal.
The Digital Revolution
COVID-19 ushered in a new era for telehealth and remote monitoring. The federal government made telehealth services easier to implement and access during the pandemic, spurring greater use of the technology. The growing trend toward digital technologies was already well on its way before COVID-19, but there have been dramatic changes over the past nine months in the areas of telehealth, teleradiology, telepathology, and other remote workflows, notes Ryan Warren, global lead for healthcare & life sciences, Lenovo Workstations. From a clinical perspective, he says Lenovo has seen customers embracing technology to deal with their changing environment while maintaining the high quality of standard of care expected of them.
“One example was when many in the industry were experiencing a shortage of PPE and other essential equipment,” says Warren. “Lenovo partnered with Microsoft to develop a virtual rounding solution, whereby care providers would call into each patient’s room via a smart display from their laptop and conference in their family as they performed their rounds.”
Lenovo has worked to develop solutions to address the pain points of its customers. For instance, it provides a teleradiology solution with a diagnostic display that shifts the traditional work environment from a desktop to a completely mobile workstation. This allows radiologists to move from multiple locations while still having the right devices for a complete diagnostic workspace. This type of solution was essential as its customers needed to address moving non-frontline workers out of the hospital at the start of COVID while maintaining an efficient work environment.
“The growth in digital medical devices will only grow over the next five to ten years as the world becomes more connected and the potential to analyze all that data collected will provide better patient outcomes and hopefully a healthier society,” says Warren.
Remote patient monitoring surged after FDA issued a new guidance to help expand the availability and capability of noninvasive remote monitoring devices in March 2020. An increased focus on digital devices for remote use remain part of the landscape in 2021.
“Home use devices and testing tools are being seen as critical to the provision of care, and as consumer confidence brings an appreciation for the convenience of these products, there will be a greater emphasis on their development,” says Danielle Bradnan, research associate at Lux Research.
“If there’s anything we’ve learned this year, it’s that the role of and demand for technologies enabling remote patient monitoring and remote patient care will only increase,” says Russ Johannesson, CEO of Glooko, which develops a platform for diabetes management. “For several years, there has been a push toward connected medical devices and data management solutions that enable providers to work with patients remotely. But often, the adoption of this technology has been led by defined segments of healthcare professionals — either inherent technophiles, visionaries driven by what the marriage of technology and medicine offers, or those who’ve simply had the opportunity to witness what new medtech can do. Accordingly, the adoption of digital health and remote solutions has been increasing over the past couple of decades at a rate that is steady, but not booming,” he says.
“With onset of the global pandemic, we’ve witnessed what happens when demands beyond our control move the reason for adopting technology from what we know it can do to the necessities of what we suddenly need it to do. The drive we’ve seen to adopt remote technologies is unprecedented, and it extends not only to patient care but also to clinical research,” says Johannesson.
Technologies enabling virtual care are expected to expand significantly. “Virtual care is enabled by interoperability, artificial intelligence, and advanced analytics all coming together,” says Sonya Denysenko, global digital health director at Frost & Sullivan. “It is exciting to see the growth opportunities and various ecosystems and platforms that will be created between vendors and in partnerships to provide these services going forward. We believe that home health monitoring will continue to expand across the healthcare continuum.”
Telehealth was deemed transformative during 2020 as it reduced disease exposure for healthcare workers and patients, preserved scarce supplies of personal protective equipment, and minimized a patient surge on facilities.
“In patient care, with the sudden need to limit medical visits to only the most essential due to safety, we saw primary care office visits in the U.S. drop more than 50 percent, from an average of 117.8 million visits per quarter in Q2 of 2018 and 2019 to just 58.7 million visits in Q2 of this year,” adds Johannesson. “By contrast, we witnessed telemedicine increase from just 1.1 percent of primary care visits in 2018–2019 to more than 35 percent of visits in Q2 of 2020.1 With reimbursement now available for telehealth, this shift is possible because, especially with chronic conditions like diabetes and cardiovascular disease, a large portion of medical visits are consultative and only need a telehealth session — the provider can review data from a patient’s connected devices and then confirm or adjust their therapeutic regime. In our own work at Glooko this year, we’ve seen a 50 percent increase in the use of our remote patient monitoring platform, which provides the diabetes data used in telehealth visits.”
Similarly, telehealth shifted many clinical trials to a virtual setting. “Many trials — as many as 80 percent — came to a sudden halt with the arrival of the virus. That’s because — out of the same safety concerns that curtailed medical office visits — clinical trial centers had to cease hosting participants on-site for data collection.2 In response, a vast number of trials were revived by the use of connected digital products for remote data collection, the use of real-world data and real-world evidence, and the capabilities of modern clinical research platforms, without which most of the impacted trials would still be at a standstill,” says Johannesson.
Diagnostics and Point-of-Care Platforms
“COVID has accelerated efforts to bring diagnostic testing closer to the in-home user. There will continue to be a focus on making devices that perform with simplicity and that are both highly accessible and available to the consumer,” says Claudio Hanna, business development director, medical, for Web Industries, a contract manufacturing organization (CMO) that provides medical device and PPE manufacturers with precision converting and outsource manufacturing services. “These factors already are playing a role in COVID testing, and they will be critical in fighting future pandemics.”
Digital point-of-care testing platforms will play a significant role in the future. These platforms will benefit from leveraging artificial intelligence (AI) and machine learning to drive the next phase of infectious disease point-of-care (POC) testing. “AI transforms the way that results are gathered and analyzed and ultimately delivered in terms of the speed and efficacy to the provider and the patient,” notes Denysenko. “It’s all about the ability to scale quickly, and platforms like this allow us to do that.”
Todd Martensen, vice president, medical technologies sector, at Benchmark, adds that POC testing is one of two major shifts he has already seen in the types of medical devices being developed over the past few years, and says that this trend will certainly continue through the next year.
“The demand for POC is driven by the desire to move more aspects of healthcare out of the clinical setting and closer to patients in their everyday lives. Innovative manufacturing techniques, including microelectronics and automation, are making these devices possible and competitive. The types of devices we’re seeing include in-vitro diagnostics, especially those involving microfluidics, as well as mobile imaging and therapeutic devices.”
Connected Devices and IoT
Smart, connected devices are on the rise, and the role of these connected devices in the healthcare industry has grown tremendously. “There is greater interest in collecting and providing realtime data from patients to care providers. Medical device manufacturers are including connectivity in all of their new devices, and we’ve also seen a great deal of OEMs ask for legacy devices to be modernized with connectivity capabilities,” says Martensen.
This connectivity will play a crucial role in the future of medical technology. “Connectivity allows for real-time processing of data sets and can immediately provide caregivers and patients answers to problems that need addressing. Connectivity allows for the collection of data sets that facilitate the development of digital biomarkers, which are a key technology for preventative care and early diagnostics,” says Bradnan.
Along with the move toward remote patient care and clinical research, experts believe he importance of the IoT and connected devices will only continue to grow. “In diabetes, we see the proliferation of connected devices in the form of glucose meters, continuous glucose monitoring systems, insulin pumps, and even smart insulin pens that are connected,” says Johannesson. “Even mainstream consumer fitness and biometrics devices are connected now, and most importantly, healthcare providers are increasingly growing to not just accept but to truly value patient-collected data as an important piece of what goes into shaping their clinical decisions.”
Johannesson adds that the proliferation of connected devices, however, is creating some interesting challenges for providers. “Medical technology has proven so effective at helping patients and their providers record and utilize their health data that it’s easy for clinical care teams to become overwhelmed with the massive amounts of health data contributed from stand-alone sources. Clinical teams often don’t have the time and — until recently — the tools hadn’t been developed to help them effectively analyze these data so they could regularly determine the most effective care for their patients,” he says.
“To help with this challenge, population health management tools that utilize data analytics have been developed to assist clinicians working in diabetes and other chronic disease states to effectively manage disease in patient populations through aggregating and analyzing patient data. These analytical tools can help clinical teams highlight risk, predict the course of a patient’s diabetes, and even intervene before predicted events turn into costly and negative patient health outcomes,” says Johannesson.
Martensen notes that in addition to device programming, there is now a desire for patients to be able to share clinical information through medical devices with hospitals, caregivers, and insurance providers. “IoMT has taken over the entire ecosystem of medical device development, and OEMs are developing new ways to monitor and collect data on patient health in realtime,” says Martensen.
Data management and access will be critical to decentralizing diagnostics, adds Hanna. “There already are niche applications for managing confidential financial and other health information, and we will see an IT segment develop around test results. IoT and connected devices will play critical roles in expanding diagnostics access to the consumer and making both tests and results easier to access globally.”
He adds that there will be a consolidation of features and functionality in solutions that deliver this greater diagnostics connectivity. “As with most technologies, we will start with many competing platforms and then see consolidation to a few. It will be similar to choosing whether to have Amazon’s Alexa, Google Home, or Apple’s Siri. Users will have one home health standard, and all their diagnostic devices and data will flow through that platform,” says Hanna.
Warren says he sees IoT’s role in medical technology being all about the generation of data, and ultimately harnessing and analyzing all that data to predict better patient outcomes and prevent down time of mission critical equipment within the healthcare environment. However, one area of concern with IoT devices in a healthcare setting is security. “As healthcare embraces IoT, that increases the chances of attack from an outside threat or a ransomware attack. Luckily, medical device manufacturers and software developers are continually developing new ways to prevent these types of situations from happening,” he says.
AR, VR, and Increased Collaboration
In medical device development, it’s critical to have constant communication between OEMs, partners, and suppliers. The COVID-19 pandemic led many companies to step up collaboration to drive innovation and get products to market more quickly. Tools such as augmented and virtual reality (AR/VR) emerged to help these efforts, and they will likely be part of the product development process in 2021 and beyond.
“A trend that will have a dramatic impact on the future development of medical technology is the cross collaboration of multiple companies to create new product offerings. The lines are blurring between hardware and software vendors as customers are looking for multiple vendors to come together to provide the best solution for their clinicians and patients,” says Warren.
He adds that Lenovo is starting to see customers embrace technologies like AR/VR to help facilitate a higher quality of collaboration and training versus a traditional video webinar. “With VR, healthcare workers are able to train and prepare for real-world events all while being in a remote location,” says Warren. “VR has been proven to increase trainee engagement and knowledge retention when compared to traditional training environments, while also reducing training time and cost in the process. VR hardware and software companies also have built-in tracking and analytics, which allows institutions to produce a more proficient workforce.”
Large medical device manufacturers are global companies and have employees based around the world. Augmented and virtual reality technology can help them collaborate in real time as they develop the next generation of medical technology, he says.
Some collaborations have benefitted everyone as device companies and healthcare developers have focused on core competencies, allowing new solutions to advance quickly. “These synergies will develop further as companies continue to explore new technologies in 2021. But after a period of high growth and close alliances, we will see consolidation in the industry as companies cement their collaborative partnerships,” predicts Hanna.
Biosensors and Wearables
Biosensors have emerged as a key technology because of their potential analytical tools used for the detection of an analytic with the assistance of a physiochemical detector, both in wearables and POC diagnostics. According to a report by Market Research Engines, although traditional laboratory techniques yield correct measurements, these area unit extraordinarily time-consuming, complex, expensive and need pre-treatment of the biological sample. By contrast, biosensor-based devices give speedy, on-site and time period watching while not the requirement for sample preparation.
In wearables, these biosensors will see increased use in continuous health monitoring, with the wireless sensors enclosed in bandages or patches or in a body-worn form factor. Biosensors predict the possibility of a patient’s worsening clinical condition and also monitor the impact of needed clinical interventions. Sweat, blood, and other biological agents are common analytes that are analyzed.
“I’d say that the largest role that the pandemic has had in this sector has been the acceleration of some technologies. There has never been a greater need for POC and connected devices than there is today as the world grapples with a predominantly digital environment. Overall, the digital transformation going on today will only enhance progress in the medical device industry in the future,” says Martensen.
There is no question that COVID-19 has propelled rapid technology advancement and rapid regulatory approval of technologies such as wearables, POC diagnostics, and digital health. “We need these factors to continue beyond COVID-19 and foster the emergence of more essential healthcare solutions, governed by a regulatory establishment that welcomes and supports continuous innovation,” says Hanna.
- “Use and Content of Primary Care Office-Based vs Telemedicine Care Visits During the COVID-19 Pandemic in the US,” JAMA Network Open, 2 Oct. 2020.
- IQVIA Q2 earnings call, 2020.