Health care tech trends 2021

New technology and cultural change — accelerated by the 2020 pandemic — are changing health care faster than ever. We speak to Dr Sneh Khemka to ask: what’s happening in health care technology? What’s now and what’s next? And how will it help providers deliver better care and drive better health outcomes?

Dr Sneh Khemka is Aetna International’s Vice President of Population Health and our virtual health service, vHealth. He is a cancer surgeon by background and regularly appears on the UK’s LBC radio, answering people’s real-life medical issues.

Virtual health adoption will continue after COVID-19

Since the global pandemic helped to establish telemedicine as a practical and convenient health care solution, it’s had a huge impact on providers and patients alike. Rather than being a short-term solution, it is now largely seen as a natural path for primary health care that is here to stay.

“We can all see that COVID-19 has changed our lives for the long term,” says Dr Khemka. “How people look at health care and access treatment has changed. Those who once didn’t give much attention to their health, have now become very interested and this growing awareness has driven a new consumer mentality around health — aided by the fact that consumers have become digital very quickly.”

Dr Khemka believes that this transition to the digital world has changed the way people think. He suggests that the average consumer now expects health care to be digital, with the ability to get a consultation online without having to physically see a doctor. Plus, he points out that this makes perfect sense. “We don’t want people sitting in doctors’ offices spreading germs around when you don’t have to. People are now much more willing to use virtual health care for telemedical consultations than they were before.”

A second driver of adoption comes from doctors and clinicians who are now much more prepared to use virtual health care platforms. And it seems the system is willing to support it. As Dr Khemka explains, people and doctors are prepared to pay for and be reimbursed for virtual consultations respectively. He adds that the governments who once regulated against them, are now allowing virtual consultations.

As you might expect, there are varying rates of adoption in different parts of the world but, on average, the use of virtual health “has increased by 200-300% across the globe.” The big question is what happens next.

According to Dr Khemka, “use has increased, but will probably reduce when the pandemic is over”. There will be a sustained increase compared to pre-COVID19 levels, because people have become used to the technology. Roughly 40% of those who use it once, will use it again — although, there is geographical variation.

“Also, if there are second and third waves and further lockdowns, more and more people will be forced to move over to telemedicine. And again, those who use it will be more likely to use it in a post-COVID-19 world.”

Of course, it’s easy to talk about virtual health as though everyone has a smartphone with 4G and is merrily managing their health. Yet, in reality, virtual health is currently only available to more developed countries or wealthy segments of poorer countries. But as Dr Khemka points out, the long-term potential for mass adoption is huge — especially when supported by governments.

“Hundreds of millions of people in India don't have access to a doctor or health care professional,” he says. “If widely adopted, virtual health could deliver that access — either via a human or digital tools — and the impact on inequality would be profound.”

Virtual health capabilities will expand

With the right adoption, the expanding capabilities of virtual health are incredibly exciting.

Diagnostic algorithms are good and getting better

Answering questions to accurately diagnose a medical condition has traditionally been the realm of the doctor, but thanks to technological developments, this is rapidly becoming the realm of the robot. As Dr Khemka explains, “there are some very advanced systems — for example Ada Health — that use artificial intelligence to diagnose different medical conditions. After entering their symptoms online, the patient receives a diagnosis that’s as accurate as any doctor (sometimes more so).”

Virtual health will support general health and wellness

As well as diagnosis and triage, telehealth consultations can help to build and maintain ongoing health and well-being. Most people already visit ‘Dr Google’ before seeing a clinician. Virtual environments with proven outcomes will only help to support that with credible information and advice — for example fitness, diet and weight loss.

“People are already using devices to help to train and monitor them. It doesn’t mean they can’t get human help on top of that as and when required.”

Virtual health will streamline health care journeys

Digital primary care can help patients to navigate the health care system and connect them to the right specialists and treatments more directly. Sneh explains, “Health care journeys can sometimes feel disparate and disjointed. Virtual health is helping to make these journeys smoother for patients and medical professionals by bringing together the various aspects of treatment and accelerating labour-intensive stages.”

“The digital capabilities of tech such as Alexa and Google Assist are now being built into health models. This allows customers to book appointments at hospitals or with doctors, arrange investigative tests or get results more easily.”

Virtual health will revolutionise chronic disease management

Rather than regular visits to doctors, nurses and clinics, a growing number of people are managing their chronic conditions remotely. Increasingly, data is being captured digitally and fed back automatically often by diagnostic software.

Remote monitoring systems such as Glooko have changed the way diabetics manage their condition. Non-invasive products are the next step from companies such as Levels. “Rather than poking things into your skin, you just wear a patch to help continuously monitor your glucose levels.”

The ‘Internet of Bodies’ capabilities will continue to develop

It seems we’ve moved on from the Internet of THINGS to the Internet of BODIES, which involves medical devices being connected to our person. These devices can be external or internal (ingested or implanted). For example, blood-sugar monitoring for type-1 diabetes management – mentioned above.

Health care tech is a sweet spot for investors

“Those in private equity investment circles are excited by two sectors,” says Dr Khemka. “Tech and health care — especially in the post-COVID19 world. Investment has only just started and is already massive — growing at an annual rate of over 30% year on year. Realistically, the charge will be led by the tech giants: Apple, Google and Facebook, with all of them going into health and disrupting the existing players.”

National health systems need to address the role of tech in future developments

Access to cutting edge technology usually comes with a hefty price tag, which often makes it prohibitive to large portions of the global population. Ironically, many innovations improve cost efficiency once implemented.

When asked whether innovations such as virtual health remain the preserve of private organisations, Dr Khemka was quick to point out that these services are equally important for national health services. He believes that governments cannot afford to ignore technology and must play two important roles:

• “Providing services that reach those parts of the population — lower socio-economic bands — that don't have access to private health care”
• “Ensuring regulation is appropriate and not too heavy-handed — giving the right amount of control while not letting cowboys into the system.”

In the UK, the NHS is investing in NHS Digital and NHS X  — a joint unit bringing together teams from the Department of Health and Social Care and NHS England and NHS Improvement to drive the digital transformation of care.

The ‘human touch’ is here to stay

Inevitably, there may be concerns that these innovations are forcing human doctors and nurses into the background. But Dr Khemka believes that the technology is more about supporting doctors than replacing them:

“The problem with a lot of early digital health care, was that they thought they could replace the doctors. There was a mistrust of the technology — not the doctors — which resulted in a lack of adoption.

“The tech world has come to realise that rather than trying to entirely disintermediate, the health care system that exists, it’s aim should be to support it.

“An algorithm may be able to work out the right diagnosis, but it will never know how to read the non-visual cues of a patient sitting in front of you. For example the unspoken cues about life choices, whether an operation is going to be the right thing for them or how to deal with the emotional response to a health crisis.”

In many ways, it is reassuring that the tech world understands its revised role to support not replace. Ultimately, this approach will help to free up the time of expensively trained, highly qualified clinicians from non-efficient tasks, so that they can concentrate on the human side of care that needs a high acuity human touch.

As Dr Khemka puts it, “Humans are going to be indispensable for the soft skills for the rest of our lifetimes… and probably for eternity.”

Supporting mental health treatment through technology

Mental health is a current zeitgeist — both inside and outside the health care industry. It is also another area where virtual health is starting to add a great deal of value.

“The future isn’t laying on the Freudian couch,” says Dr Khemka. “It’s laying on your couch in your front room with your digital assistant by your side whenever you need to.”

Apps such as Wysa use artificial intelligence to fuel a chatbot that lets users discuss aspects of mental health confidentially and anonymously, while offering guidance.

One of the benefits of the digital environment is that it comes with a lack of judgement or the stigma that is often associated with mental health. Anonymity is also preferable with many mental health patients who feel shame, guilt or simply want things to be private — not to mention more convenient and cost-effective than a session on Freud’s couch.

“Many people find it liberating to talk to a machine that isn’t going to judge you,” says Dr Khemka, but adds, “Humans like connecting to humans. There's something about the time, the touch, the empathy, the compassion, the understanding and the forgiveness. And there’s no AI that can do that right now.”

Inevitably, digital tools to help mental health conditions will become increasingly sophisticated. An as long mental health remains in the public conversation, adoption is likely to grow apace.

Virtual reality will re-emerge to support mental health treatment

Virtual reality has been around since the 1960s, but bandwidth and processing power has limited its application until recently. It always seemed like computer games would be the natural home and champions of virtual reality, but, if Dr Khemka is correct, health care finally stands to benefit.

“Virtual reality will soon become another tool for tackling mental health. There are companies who are developing virtual therapeutic environments and journeys that make users feel much more connected to the therapy they’re getting. This can involve putting them into familiar surroundings and stimulating certain parts of the brain to increase your serotonin activities. It’s an exciting development.”

Psychedelic therapy may hit the mainstream

“There has been increased scientific research into the use of psychedelics. For example, cannabis (THC) has become a little bit more mainstream in dealing with physical issues such as epilepsy. There’s also a huge body of evidence about the use of psilocybin (the active compound in magic mushrooms) to deal with mental health conditions.”

“This is still very cutting edge,” he says, “but I think it will become part of the common narrative in mental health in the next five to 10 years.”

Genomic medicine will help deliver personalisation

One of the big plus points of technology is that it’s able to offer personalised journeys in every aspect of our digital lives. Dr Khemka suggests that we are already starting to see a similar revolution in health care.

“I fundamentally believe that human beings have the right to entirely personalised and precision medicine. And the revolution that’s going to drive this personalisation is genomic data.

“Now that we can sequence human genomes affordably, we can really understand the individual and give very specific advice. We will know exactly what gene combinations certain medicines work against. We’ll know exactly what medicine will work for your genes and not for the other 49,999 people. And that's going to happen within our lifetimes.”

The personal data ownership revolution is coming

Data is often in the news for the wrong reasons. Other people seem to want it, even if it’s sometimes hard to appreciate the value in a monetary sense. This is probably because we don’t always know what to do with it, where to keep it or who should see it. But Dr Khemka predicts big changes around patient data — in terms of who owns it, how it’s used and even how we can make money from it.

“At the moment, you accept cookies on various websites and give your data away to companies to use. But your health data isn’t currently owned by anyone. I think there will soon be a very specific, targeted and regulated drive to make sure that you are the owner of your data.

“In 20 years’ time people will not only be talking about how they’ve used their genetic data to inform the development of a drug, but how much money they’ve earned by doing it. The companies that are going to succeed in this space are those that know how to steward your data, how to secure your data and how to monetize your data on your behalf.”

Artificial intelligence will help diagnosis

Although humans are currently teaching machines, we’re moving into a phase of genuine machine learning, where machines are teaching machines. Eventually we will enter a stage where machines teach humans, which is true artificial intelligence.

As Dr Khemka explains, there are already some incredible uses of this kind of technology, with a sophistication and accuracy that will only improve with time.

“There is one service which can recognise patterns in your voice over the telephone to accurately diagnose whether you have a mild, moderate or severe mental health issue.”

“Artificial intelligence can use facial recognition including the recognition of facial expressions, how people’s eyes move, how they breathe, the flushing in their cheeks. These can all be measured and, when you’ve got artificial intelligence with the right algorithms behind it, their diagnostic value increases. We’re a few years away from perfecting the science, but once we have, we will move to clinical application.”

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