Sick Care or Health Care: 10 Post-Covid Expectations for American Healthcare

Sep 16, 2020 | Techonomy, Media & News

The Apple Watch Series 6 helps illustrate how continuous health monitoring is going mainstream.

I’m thrilled Techonomy is starting its Health+Wealth of America initiative and urge you all to take part. I’ve been thinking a lot about digital health in a post COVID world and the role that technology will play.

Despite all our advances in science and technology, I’m still befuddled that our response to the COVID pandemic was not that much different than our response to the one we had in 1918. That doesn’t mean we won’t come away from this pandemic with aspirations for a new, high-ech health ecosystem. A major tech-infused health care movement has been in the works for more than a decade. COVID just kicked it into high gear. Most of us see this shift in the amazing pace of development for COVID testing, vaccine development, and genomics analysis.

But there’s so much more. The new health paradigm will be focused on the decentralization of monolithic institutions, continuous instead of intermittent monitoring of health, next-gen tech applied in many places, and rethinking the business incentives of the healthcare system. 

Ten things you need to think about:

1. FOGO is Real

In her new book, Health Citizenship: How a virus opened up hearts and minds, Populi’s Jane Sarasohn-Kahn says because of the pandemic we’ve moved from FOMO (fear of missing out) to FOGO (fear of going out). FOGO is propelling the idea of the home as the hub of healthcare. Hospital revenues plummeted during the pandemic, doctors visits were down, and telehealth became the lifeline.  According to McKinsey, consumer adoption has skyrocketed from 11 percent of US consumers using telehealth pre-COVID to 46 percent of them using it now, during COVID. And 76% of consumers are now interested in telehealth. As I’ve talked and written about before, 2021 needs to focus on new diagnostic tools consumers can use in their homes to make telehealth visits more than a simple phone call.

2. Telehealth Offers Hidden Treasures

It’s like a seeing an animal in its natural habitat. While the purpose of a telehealth visit is often symptom related, when using it healthcare providers will learn a lot of useful information about a patient’s natural habitat.  What’s their home environment like?  How are cleanliness, possible pollutants and environmental contaminants?  Nutrition OK?  Who does this person live with?  Get ready to see a new kind of medical exam. It may yield valuable new environmental insights that help keep us healthier.

3. Continuous Instead of Intermittent Monitoring

The traditional paradigm was simple. You went to the doctor when you were sick, maybe once a year for a checkup. These episodic moments in time will shift to health care on a time continuum. Wearables that measure vital signs, apps that track and modify unhealthy behaviors, and a variety of in-home monitoring systems are going to allow consumers to check in with their doctors who will be able to detect abnormal patterns in daily rhythms. Just this week Apple added continuous blood-oxygen-level monitoring to its Series 6 smart watches, on top of their existing feature enabling constant heartrate monitoring.

4. Value-Based Instead of Fee-Based Services

Imagine a doctor that gets paid for keeping you well instead of treating you when you’re sick!  Better thinkers than I, including Daniel Kraft from Singularity University and Neil Batra,  principal in Deloitte’s Life Sciences and Health Care practice, talk about migrating from today’s reactive model that revolves around specific fees for specific services, often called “sick care,” to a value-based incentive system for physicians and hospitals. “Sick care is episodic,” says Batra. He means there’s no systemic incentive to keep you well. “The shift occurs when you go from a monolithic system like a hospital to the health ecosystem that might rotate around your life.”

5. Health As Retail Bright Spot

Pandemics make new heroes. CVS, Walgreens  and Walmart have created some of the most inventive recent retail programs. They’ve done COVID-testing drive-throughs, movie parking lot drive-ins for testing, curbside pickup, created new Amazon Prime competitors, and launched predictive prescription refills–each of these companies stepped up their services quickly.  Best Buy is investing heavily in digital healthcare initiatives, including a program to sell Tytocare home diagnostic tools for remote medicine.

6. Enter Quantum and Nanotech

Digital Health’s future is going to take involve a lot of data and a lot of processing power. Deloitte’s Batra believes that “personalized precision medicine and drug development are two areas that are going to demand mass computational power.” He says that while the pharmaceutical industry, for instance, pours billions of dollars into R&D, each company is also thinking about how to capture exclusive market share. That, he argues, is inefficient. Large and costly quantum-computing projects may provide an incentive for them to undertake more collaborative efforts.

On the nano side, new materials with embedded sensors will give us more granular data.  Ingestibles,  digital health tattoos, and flexible bandages are some of the formats we’ll see.  Projects like an injectable biochip to detect infection will become more commonplace, making earlier discovery of disease possible.

7. The Product You Buy Today Will Be Smarter Tomorrow

You probably bought an Alexa to get weather forecasts and a little background music. Now it’s controlling your smart home. A Tesla gets smarter week by week, gaining new features. Privacy issues notwithstanding, health products, will similarly get smarter about things like generating behavioral nudges, learning your personal patterns, and sharing them with healthcare providers.

8. APPS, AR, VR, and Games as Digital Therapeutics

Akili Interactive recently became the first video game to get FDA certification for treating ADHD. Companies like Neuro Rehab are using VR in rehab. Popular apps during COVID have included meditation and sleep apps. The old digital health joke about “taking two apps and call me in the morning” is becoming more real.

9. 5G is More Than Just Faster

5G lets more processing occur at the end points and then quickly be transmitted to some sort of central hub. In healthcare, this might enable remote kiosks to offer quick checkup walk-ins, or having your condition quickly analyzed from a remote location against a database of eye information to pinpoint problems.

10. Tech and the Doctor Shortage

If the pandemic didn’t make evident enough the urgency for creating a digital health ecosystem, then take this stat and chew on it. The Association of American Medical Colleges predicted that by 2030, the demand for doctors will outstrip the supply and that the United States of America will then experience a shortage of up to 121,300 physicians. Offloading some of their work to pharmacies, home hubs, kiosks, robots, and digital monitoring technologies may then start to become a matter of survival for all of us.


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