• Roopal Mundepi

Telehealth - Future of Healthcare

How often have you heard that the internet has revolutionized modern life? It has most likely impacted how you communicate with family and friends, shop for goods and services, and even look for health-related information. Technologies are shaping the future of the healthcare space. There are a number of technologies available to assist you in managing your health care and receiving the services you require. Technology has the potential to increase health-care quality while also making it more accessible to a wider range of individuals. Telehealth has the potential to improve the efficiency, coordination, and accessibility of health care.


What is Telehealth?

Telehealth uses digital information and communication technology, such as computers and mobile devices, to remotely access and manage healthcare services. Telehealth is generally performed online using a computer, tablet, or smartphone with internet access. In simple terms, telehealth allows your doctor to treat you without an in-person appointment.


Telehealth care can take several forms:

• Make a real-time phone call or video chat with your doctor.

• Use secure messaging, email, and secure file exchange to send and receive information from your doctor.

• Use remote monitoring so that your doctor can keep an eye on you while you're at home. You might, for example, utilize a device or mobile health apps to collect vital signs or other vitals to keep your doctor updated on your progress.

To summarize, telehealth technologies include live video conferencing, mobile health apps, and remote patient monitoring (RPM). Although the terms telehealth and telemedicine are sometimes interchanged, telehealth now covers a wider range of digital healthcare activities and services.


Telehealth and Telemedicine

Although the terms telehealth and telemedicine are sometimes interchanged, telehealth now covers a wider range of digital healthcare activities and services, while telemedicine is used in a more limited sense to refer to distant clinical services like diagnosis and monitoring. To comprehend the relationship between telehealth and telemedicine, it is necessary to first understand telemedicine.


"The remote diagnosis and treatment of patients using telecommunications technology," is the definition according to the Oxford definition of telemedicine. Telemedicine is the application of technology and telecommunication networks to provide healthcare to patients who are geographically distant from clinicians. A radiologist, for example, might examine and interpret imaging results for a patient in a distant county whose hospital does not have a radiologist on staff right now. For a non-life-threatening condition, a physician may provide an urgent-care consultation by video.

While telemedicine refers to the practice of medicine through the internet, telehealth is a broad word that encompasses all aspects and activities of healthcare and the healthcare system that use telecommunications technology.


Types of Telehealth

To overcome issues with video stability and bandwidth restrictions, telehealth requires participants to have good Internet access, usually in the form of a strong, reliable broadband connection, as well as broadband mobile communication technology of at least the fourth generation (4G) or long-term evolution (LTE) standard. Telehealth has grown more accessible as broadband infrastructure has improved.


Often, healthcare practitioners begin telemedicine with a needs assessment (a methodical approach of identifying and addressing needs, or "gaps," between current and desired situations, or "wants."), which evaluates challenges that telehealth can alleviate, such as travel time, fees, or time away from work.


There are four different categories of telehealth, and some platforms mix two or more to offer more complete services. Given that telehealth funding is increasing and is anticipated to continue, practitioners will benefit from understanding these four forms of telehealth.


1. Live Video Conferencing (synchronous telehealth)

Live video conferencing is the most well-known technology-based healthcare service everyone uses, from physicians at local hospitals to specialists who own their private clinics. Consultations are held via the internet utilizing two-way interactive software installed on desktop computers, laptops, tablets, and other mobile devices such as smartphones. Any video call or live chat software that allows a healthcare professional to engage with a customer or patient in real-time, or live, is included in synchronous telehealth.

Examples of software that may be used for real-time, live, interactive healthcare or telemedicine engagements include Zoom, VSEE, Vidyo, and Doxy.me. Live video-conferencing eliminates commute time and stress for both the patient and the practitioner and assists in the delivery of healthcare to rural areas that lack the same number of healthcare options as urban areas.


2. Store-and-Forward (asynchronous telehealth)

Store-and-forward telehealth, also known as asynchronous telehealth, uses specialized technology to capture a client's or patient's data, store it in a secure cloud-based platform, and then retrieve it by another medical professional or staff member, frequently in a separate location. This form of telehealth is commonly employed in rural settings where accessibility is scarce, particularly in terms of specialists. Patients' data is electronically sent to experts in different geographic locations for consultation by providers in these places.


3. Remote Patient Monitoring (RPM)

Medical service providers can use Remote Patient Monitoring (RPM) to capture and monitor a patient's health data from afar. It collects vital signs using technology gadgets (electronic transmission of patient’s data) in order to keep track of a patient's status. RPM is commonly used for seniors or in senior living facilities with chronic diseases like diabetes, asthma, and cardiovascular disorders. RPM has the benefit of providing regular monitoring at a lower cost.


4. Mobile Health

Mobile health, often known as mHealth, is the fourth form of telehealth. It entails the use of smart gadgets (smartphones, tablets, etc.) and health-based software programs developed for these devices to help with continuous healthcare. Several health-related apps are available that can track everything from a diabetic's blood sugar level to a person's average water consumption. These applications promote healthy habits and lifestyles. Telehealth providers recommend patients/clients such applications, who then incorporate the results into the patients'/clients' health records.

In the ever-expanding telehealth business, numerous types of telehealth can improve patients' lifestyle choices and overall health. Similarly, telehealth allows you to get a complete picture of your patient's daily vitals, allowing you to intervene and adjust treatment to improve their health.

Telehealth has shown to be a viable and long-term option for patient prevention, screening, primary care, and remote access to diagnostic imaging for both on-site and distant patients. It may be used to remotely screen, monitor, and treat patients and establish virtual OPDs, satellite centres, and distinct telemedicine rooms. Patients may get health assistance from qualified specialists using any computer, smartphone, or other devices that can access the internet from home comfort. The following diagram depicts the infrastructure of an on-demand, online platform for telehealth that protects medical data for hospitals, nursing homes, clinics, and individual doctors.



Patent Analysis – Telehealth

The timeline of telehealth patent filings appears to be gradually growing. The graph shows a constant increase till 2018, then an exponential increase from 2018 to 2020. Then, the numbers dropped. This might be because, following the pandemic, telehealth delivery fell due to changes in federal and state advice and funding, which happened amid structural and sociological constraints that hampered widespread telehealth adoption. While telehealth's popularity is still considerably above pre-pandemic levels — and many believe it will continue to grow — the recent drop in visits has caused an unmistakable whiplash effect. Hospitals that hurried to educate their personnel in March to give practically all sorts of treatment are now attempting to establish a new balance based on altering patient preferences and requirements.


Top 10 Players

The top 10 players own 54 per cent of the total patents. Qualcomm tops the list of assignees with 1179 patents, which is 664 patents more than the second-placed assignee, i.e., Panasonic Intellectual Property. This demonstrates how communications, particularly cellular communications, have become a critical component of telemedicine and telehealth. The advent of 5G wireless technology, in which Qualcomm has a significant IP position, will also be crucial to telehealth. 5G will offer significantly greater data speeds, allowing new telemedicine features, including high-quality mobile video communications and remote diagnostic imaging.


Top 10 Markets

Various successful and current telemedicine and telehealth models in the United States exhibit their potential. The top ten telehealth markets are depicted in the graph below. With 1339 patents, the US leads the graph. The United States is followed by Europe (933 patents) and World Intellectual Property Organisation (WIPO) (669 patents), while India stands fourth with 468 patents


Top Telehealth Software Companies by Market Share

Zoom is the industry leader in telehealth, accounting for over one-third of the market. It became a common mode of communication in people's personal and professional life during COVID-19. Despite the fact that it is a general telecommunications technology, Zoom is the leading telehealth vendor, with a 31.54 per cent market share.


Other than Zoom, no other telehealth provider has a monopoly on the market.

Cisco Systems is in the second position with a market share of 12.14 per cent. Healthcare-focused suppliers including American Well (Amwell), Doxy.me, and Teladoc make out the top five, each with a market share of 10-11 per cent.

Given that one-third of hospitals lack a telehealth solution, suppliers have a lot of potentials to grow their market share in the coming years.


Virtual Healthcare

The "virtual visits" (like videoconference) that take place between patients and physicians via communications technology — the visual and audio connectivity that allows "virtual" meetings to take place in real-time, from nearly any location — are referred to as Virtual Healthcare. Instead of in-depth diagnosis or treatments, virtual healthcare has mostly been utilized for meetings and consultations, check-ins, and status reporting. Even nevertheless, as technology advances, more severe disorders such as diabetes are becoming more accessible through virtual healthcare.


Virtual healthcare is sometimes confused with telehealth or telemedicine; however, the two terms are not interchangeable. Telehealth is a larger word that encompasses any remote and/or technology-driven healthcare. Virtual healthcare is a subset of telehealth. With 3X the amount of venture capitalist digital health investment in 2020 as it was in 2017, investment in virtual care and digital health, in general, has soared, fueling more innovation.


Virtual healthcare concepts and business models are growing and expanding, ranging from just "virtual urgent care" to a variety of services that provide longitudinal virtual treatment, telehealth integration with other virtual health technologies, as well as hybrid virtual/in-person care systems, which have the potential to improve user experience/convenience, accessibility, results, and affordability.


Teladoc Health is a telemedicine and virtual healthcare company with offices all over the world. Teladoc provides whole-person virtual care to patients from the convenience of their own homes. Teladoc Health's physician team is launching virtual primary care across the country in conjunction with Aetna and CVS Health Services. This virtual health company is now announcing a new partnership with Vivo to provide Brazilians with more virtual healthcare options.


Doctor on Demand (a leading virtual care provider) and Grand Rounds have merged to form a patient-centric virtual healthcare service. In 2021, at MedTech Breakthrough Awards Program, Doctor on Demand was recognized as "Best Overall Digital Health Company."

MDLive, IcliniQ, and Amwell are some of the most popular virtual care providers, allowing patients and healthcare professionals to communicate easily via video, audio, email, and mobile devices.


Future of Telehealth

The worldwide Telehealth and Telemedicine Market are expected to grow at a CAGR of 26.6 per cent throughout the forecast period, reaching US$ 285.7 billion by 2027, up from an anticipated US$ 87.8 billion in 2022.

The rising prevalence of chronic health conditions, the benefits of telehealth in light of the current scarcity of healthcare professionals and care staff, and advancements in telecommunications, as well as increased consumer acceptability, are all propelling the telehealth and telemedicine market share upward.

When compared to traditional techniques, telemedicine saves money for users. Telemedicine has a number of advantages, including lower healthcare costs and more efficiency due to improved chronic illness management, shorter travel times, pooled health professional staffing, and fewer and shorter hospital stays.

The market is expected to increase fast throughout the forecasted timeline as a consequence of all of the advantages.


References

https://catalyst.nejm.org/doi/full/10.1056/CAT.18.0268

https://en.wikipedia.org/wiki/Telehealth

https://medium.com/@jimmoeller149/connected-health-telemedicine-patent-landscape-2a1081d8f3a1

https://telehealth.hhs.gov/patients/understanding-telehealth/

https://www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine

https://isalushealthcare.com/blog/the-different-types-of-telehealth/

https://www.definitivehc.com/resources/healthcare-insights/top-telehealth-companies-market-share

https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality