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Telehealth: Now And Its Future Evolution

Roopesh Mathur

IIT AGNE has been conducting events on various topics of interest to the Indian tech community, including healthcare. The virtual panel discussion held on August 13th, 2020, was on the timely topic of "Telehealth : Now and its future Evolution" and featured a distinguished cast of speakers who work in healthcare and technology. 

The speakers included Mr. Girish Navani, CEO and cofounder, eClinicalWorks; Dr. Dhrumil Shah, CIO, Compass Medical and Dr. Dave Prakash, a thought leader on Digital care delivery and AI and Air Force test pilot. The panel was moderated by Ms.Reena Shah, who leads product management for healthcare technology. 

The panel discussion started by marveling at the speed at which telehealth has been adopted during the Covid crisis, and how the healthcare insurance companies and governments have rapidly pivoted to paying for telehealth. Mr. Navani said that the number of telehealth visits zoomed from a scant 50,000 minutes per month to 2 million minutes per day, with almost 85% of all doctors visits moving to telehealth. 

The conservative healthcare field has moved rapidly to adopt the technologies needed for telehealth, though there has been a pullback as hospitals and doctors have learnt to have safe physical visits. But it is a sign of the future that we will be moving to a healthcare model that involves telehealth visits, as an integral part of healthcare. 

Dr. Dhrumil Shah has found that he is able to work with patients who cannot afford the time or money to make physical visits, and involve family members in the process. Additionally, he gets a sense of the home environment which has a significant effect on patient health through telehealth visits. In his view, we are not going to be back to only personal visits, in the same way as we are not going to go back to paper charts. In a recent poll, 85% of the responders said that they had not used Telehealth prior to Covid-19 while 64% had in the last 6 months and 48% had a positive experience.

Additionally, with the advent of trackers and monitoring devices, as well as remote diagnostics, personal visits for routine healthcare may not be needed at all, and can be reserved for more urgent care. However, the data gathered from these devices has the potential to overwhelm physicians, without additional technology to process and make sense to get actionable information. 

Dr. Prakash, a thought leader in this area, talked about the role of AI and other algorithms to process the data, and determine critical information that can be presented to the physicians. Here, we have to deal with the questions of fairness and inequity, because the real world data used to train the algorithms is contaminated with biases. For example, poorer people have worse outcomes from cancer than more wealthier people; and people of color are vulnerable to serious hospitalizations and death due to Covid. 

Bringing it back full circle, when telehealth, trackers and monitoring devices and AI become integral to healthcare, the role of physicians is going to change. They will play the role of a coach rather than a quarterback, directing RNs and administrators who will themselves be empowered; and perhaps newer entities that do not exist yet. 

Newer technologies will become easier and faster to adopt given the pace at which telehealth has become commonplace within a few months. This will impact the business of healthcare and technology, where mergers and acquisitions are increasing recently, practices and hospitals deal with change and some cannot cope. The pace at which healthcare technologies are created, funded and adopted will increase significantly. 

The Covid-19 crisis has jump-started the transition to telehealth by disrupting healthcare systems and technology, causing a revolutionary and irreversible change. 

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