The dawn of digital medicine

La montée en flèche de la médecine digitale.

La Covid pourra-t-elle bientôt être diagnostiquée par Alexa ? La plateforme Doctolib deviendra-t-elle une référence pour les assistantes médicales ? Irons-nous bientôt consulter des spécialistes grâce à des applications sur notre téléphones ? Au fil de la pandémie, nous nous embarquons de plus en plus dans l’ère de la médecine digitale. Quelles évolutions et avenir possibles pour ce secteur ?

When it comes to digitisation, health care has lagged behind banking, travel, retail, carmaking and even packaged goods. Some 70% of American hospitals still fax and post patient records. The CEO of a big hospital in Madrid reports virtually no electronic record-sharing across Spain’s regions when the first wave of covid-19 washed over the country this spring.

2. By exposing such digital deficiencies, the pandemic is at last spurring change. Confronted with shutdowns and chaos, doctors have embraced digital communication and analytics that have been common in other industries for years. Patients are growing more comfortable with remote and computer-assisted diagnosis and treatment. And enterprising firms are scrambling to provide such services.

3. It is estimated that global digital-health revenues—from telemedicine, online pharmacies, wearable devices and so on—will rise from $350bn last year to $600bn in 2024. Swathes of America’s $3.6trn health-care market are in for a digital makeover. The same is happening in China, Europe and most other places where doctors ply their trade.

4. No wonder investors are giddy. Demand for digital medicine is surging. Doctolib, a French firm, says its video consultations in Europe have shot up this year from 1,000 to 100,000 a day. Ping An Good Doctor, a Chinese online health portal is expanding to South-East Asia in a joint venture with Grab, a Singaporean ride-hailing giant.

5. Technologies such as sensors, cloud-computing and data analytics are becoming medical-grade just as the risk of contracting covid-19 in hospitals and clinics makes their adoption look more enticing than ever. Specialist firms like Livongo and Onduo make devices to monitor diabetes and other ailments continuously. A study by Stanford University found that nearly half of American doctors surveyed used such devices. Of that group, 71% regarded the data as medically useful. 6. In June the Mayo Clinic, a prestigious non-profit hospital group, teamed up with a startup called Medically Home to provide “hospital-level care”, from infusions and imaging to rehabilitation, in patients’ bedrooms. Even the Apple Watch has been shown to predict a medical problem known as atrial fibrillation in a clinical trial.

AN APPLE A DAY

7. Patients are keen. A study of some 16m American ones just reported in JAMA Internal Medicine, a journal, found that their use of telemedicine surged 30-fold between January and June. American consumers surveyed in May by Gartner were increasingly using internet and mobile apps for a variety of medical needs.

8. Critically, regulators around the world are pressing health-care providers to open up their siloed systems—a precondition for digital health to flourish. The EU is promoting an electronic standard for medical records. In August the Indian government unveiled a plan for a digital health identity with interoperability at its core.

9. All this is helping medicine evolve from “a clinical science supported by data to a data science supported by clinicians”, argues Pamela Spence of EY, a consultancy. Does this make health care big tech’s for the taking? Amazon wants Alexa, its digital assistant, to be able (with your permission) to analyse your cough and tell you if it is croupy or covidy. In November the online giant, which already sells just about everything else, launched a digital pharmacy to take on America’s drug-distribution coterie of pharma firms, middlemen and retailers. 10. AliHealth, a division of Alibaba, China’s e-commerce champion, is disrupting its home pharmacy market. Its revenues leapt by 74% in the six months to September, year on year, to $1.1bn. Apple has its watch and nearly 50,000 iPhone health apps. Google’s parent company, Alphabet, has Verily, a lifesciences division.

A HYBRID FUTURE

11. Tech giants’ earlier forays into health care flopped, argues Shubham Singhal of McKinsey, because they had gone it alone. Medicine is a regulatory minefield with powerful incumbents where big tech’s business models, particularly the ad-supported sort, are not a natural fit. But the pandemic has also highlighted that existing providers’ snazzy hardware and pricey services too seldom genuinely improve health outcomes. If the new generation of digital technologies is to thrive it must “improve health, not increase costs”, thinks Vivian Lee of Verily.

12. That points to a hybrid future where Silicon Valley works more closely with traditional health-care firms. Epic is using voice-recognition software from Nuance, a startup, to enable doctors to send notes to outside specialists; it has also teamed up with Lyft, a ride-hailing firm, to ferry patients to hospitals. Siemens Healthineers, a big German health-tech firm, is working with Geisinger, an American hospital chain, to expand remote patient monitoring. Patients of India’s Apollo Hospitals can use an app to get drug refills, tele-consultations and remote diagnoses—and even secure a medical loan through Apollo’s partnership with hdfc Bank.

13. “Moving fast and breaking things does not work well in health care,” observes Hemant Taneja of General Catalyst. But nor does standing still.