Foreseeing future trends
The current pandemic has changed some of the ways we manage our health, with these three changes likely to become permanent in the near future.
A TINY, spiky, “crown”-wearing virus is, almost with sentience, continuing to upend the most carefullymade calculations and predictions by healthcare experts, governments and societies.
Cities have been locked down, reopened, then locked down again; epidemiologists’ estimates of peaks and community transmission rates keep changing; the nature of immunity bestowed by antibodies against the SARS-CoV-2 virus is being debated; the global economy is in turmoil and wondering if the cure may be worse than the disease – the list of uncertainties is long.
Predicting the future in the context of Covid-19 is not straightforward – the virus doesn’t seem to be listening to the pundits.
However, while the future of the pandemic is cloudy, the fog appears to be lifting on the direction that healthcare itself is shifting towards.
Here are three healthcare trends that may shape our near future:
1. Technology that keeps hospitals at bay
From New York to New Delhi, we’re seeing an unprecedented rise in the level of health awareness and self-care.
This is particularly manifesting in the fields of preventive and chronic healthcare.
People want to know, more than ever, about what’s happening to their health.
What’s interesting is that they don’t want to solely depend on doctors to tell them their health status – they’re taking control into their hands, in big ways and small.
Beyond the pedometers and other similar wearables, health tech that keeps people away from the hospital or helps avoid a doctor visit is firmly taking root.
We’re witnessing a surge in people buying health tech devices that were previously rarely seen out of a hospital setting.
Sales of portable pulse oximeters – pint-sized devices that measure oxygen saturation when clipped on to the finger – have surged in the Indian tech-hub of Bengaluru and other cities.
This is the consequence of experts highlighting the vulnerability of people with respiratory issues to Covid19, especially as difficulty in breathing is one of the disease’s symptoms.
Down Under, more and more Australians living with diabetes are depending on cloud-based remote monitoring of their glucose levels from the safety of their home.
As an example, the adoption of remote digital health tools, which can be accessed with sensor-based glucose technology, more than doubled over the first three months of the lockdown.
Tech that’s predictive at some level and saves a trip to the hospital or doctor, especially for individuals managing serious health conditions, is now front and centre.
For example, a technology like CardioMEMS utilises a small, clipsized device to detect pressure changes in the pulmonary artery of heart failure patients and remotely alerts physicians of critical pressure changes in real time.
This has been proven to significantly reduce heart failure hospital admissions by 58% over an average of 12 months.
By helping to keep more heart failure patients out of the hospital, physicians also help patients avoid potential exposure to infection.
2. Hospitals may look a bit different
Apart from the rise of telehealth consultations across the board and deserted hospital outpatient departments in the initial months of the lockdown, the nature of medical conditions people usually come to the hospital with is also changing.
Emergency rooms are seeing less people with trauma from road traffic or construction accidents, and conditions such as chronic pain or the early stage symptoms of a heart attack or appendicitis.
While trauma cases may rise once the economy is more fully opened, the fear of contracting infection is likely to keep people, in general, away from a hospital.
Globally, the number of heart attack patients seeking urgent hospital care has dropped by more than half during the Covid-19 pandemic, according to a worldwide survey by the European Society of Cardiology.
This is leading to an increase in need for advanced and complex interventions, as the delay in seeking care is creating more complications and harmful consequences for patients.
Earlier this year, doctors from Hong Kong reported an increase in patients coming to the hospital late in the course of their heart attack when treatment is less likely to be lifesaving.
This is similar to the results of another poll by the European Association of Percutaneous Cardiovascular Interventions, which surveyed more than 600 interventional cardiologists from 84 countries during the first two weeks of April.
Nearly half the respondents said coronary intervention was delayed
due to Covid-19 fears – a situation likely to lead to premature death and disability.
What we’re experiencing is a departure from how hospital systems have evolved over many decades.
Health systems will now need to reorganise the established model of administering care and rethink the process flow, given the additional precautions needed to minimise Covid-19 infection risk.
3. The rise of predictive and AI-guided diagnostics
The paradox of the present time is that even as more and more people wish to know their Covid-19 status, diagnostics testing in general has seen a dip.
According to the Australian Continuity of Care Collaboration group, Australia has seen a 40% drop in the number of lab tests done this year.
These are regular screening and monitoring tests – for diabetes, cardiovascular conditions and cancer, to name a few – that people are avoiding, unless it’s an emergency.
Technology that harnesses data analytics is proving its value by bridging this vital information deficit, i.e. diagnostic tests that are predictive and minimise the possibility of a future hospital visit or the time spent in a hospital may gain traction.
For instance, highly sensitive blood tests can now more accurately predict the chances of a person developing heart disease, such as a heart attack, months to years before symptoms are experienced, when added to the current ways we determine risk.
Artificial intelligence (AI) is the newest tool lending itself to the cause of diagnostics.
A 2019 study in the journal Circulation showcases an algorithm created by AI technology and called the MI3 (Myocardial Infarction Ischaemic Index), that can help Emergency Department doctors better determine which patients are having a heart attack.
Trained and evaluated across 11,000 patients globally, statisticians have used AI technology to develop an algorithm that looks at the personal factors most predictive to someone having a heart attack, so patients can receive treatment faster or be safely discharged earlier, reducing the time spent in a hospital.
The fact is, no amount of scenarioplanning or “war-rooming” could have prepared us for what we are experiencing today.
There isn’t a template to refer to and we’ll likely keep acting with limited knowledge as we navigate this pandemic and the “new normal”.
And when we fly by the seat of our pants, even a small, but solid, glimpse of how things may look like in the immediate weeks and months ahead, can be reassuring and invaluable.
Ashish Oza is the senior director of Abbott Clinical Operations (APAC). For more information, email starhealth@ thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.