"Our Need Will Be The Real Creator"
By JB Stockslager ‘21
“ποιήσει δὲ αὐτήν, ὡς ἔοικεν, ἡ ἡμετέρα χρεία” - Plato
The Greek from Plato’s famous work the Republic is translated to say, “our need will be the real creator.” This phrase is taken from a conversation where the main characters Socrates and Adeimantus are trying to properly define justice by first attempting to define the ideal state. Similarly, during Kellogg Business of Healthcare Conference 2020, we were focused on attempting to define the future of healthcare, talking about what our needs may be and trying to back into what the future may look like, as my blog for last year’s conference shows.
However, only weeks after last year’s conference we entered into a world-wide pandemic and quickly experienced its significant impact on healthcare delivery. This highly contagious disease put individuals with comorbidities (estimated to be around 45.4% of the U.S. population) at risk of severe complications and has now had over 27.7M cases and 486K deaths in the U.S. alone at the time of writing. [1] [2] So, it comes as no surprise that people are doing all that they can to receive care from a distance.
Remote care is not a new concept. For proof, look no further than the Mercy Virtual Care Center, opened in 2015. Coined the “hospital without beds,” Mercy has 700 doctors and nurses but 0 beds or patients providing ICU monitoring, neurologist assistance, doctor supervision, and continuous monitoring for health systems on demand. However, while remote care and telehealth have been buzzwords for a long time, society has never quite bought into the need for such care options, until now.
Before the pandemic, large segments of the population appeared to have a high level of discomfort with telehealth. Even more pervasively, U.S. doctors and hospitals were not eager to provide telehealth as reimbursements were lower and doctors struggled to trust the quality of the solutions. Then, within the first few months of 2020 alone, telehealth went from rarely used to readily accepted with 60% of patients saying COVID-19 increased their willingness to use telehealth and both the federal government and health systems responded in-kind to meet the demand. [3]
The Mayo Clinic hospital system reported a 78% drop in in-person visits from mid-March to mid-April, while remote patient video appointments increased by 10,880% before increasing an extra 2,000% by July. [4] The growth rate for telehealth use at Cleveland Clinic from February to March 2020 was upwards of 1,700% while in the span of 6 weeks (from March 7 to April 11) total Cleveland Clinic outpatient visits went from 2% remote (virtual or phone) to 75% remote. [5] Even telehealth visits for the more local Advocate Aurora health system increased to $100K in the first 4 months of 2020 compared to less than 10K in 2019. [6] These care organizations and many others have scrambled to quickly scale their telehealth solutions to keep up with demand and will continue to innovate and tailor their offerings accordingly.
Non-traditional companies have also responded to this new demand with innovative solutions as I have seen first-hand working with the online eye exam start-up easee, recently named the one of the top 3 most innovative start-ups in the Netherlands. [7] Ophthalmology was one of the medical specialties with the least virtual engagement in the U.S. during the pandemic, with only 9% of visits happening virtually. Additionally, optometry visits were even more meagre with only 3% of visits happening virtually as these specialists struggled to figure out how to meet patient needs virtually. One ophthalmologist explained his telemedicine appointment to me saying he would “email Snellen tests to patients and walk them through it over phone or virtually to satisfy remote needs for elderly patients.”
This is a gap that easee has set out to fix with just a webcam, a smartphone and 10 feet of space in the comfort of one’s own home. easee can test visual acuity and refractive error, and has been shown to be non-inferior to an in-person eye exam within an initial test group with other studies now being conducted to expand the population range. easee has the potential to provide the perfect solution for ophthalmologists, optometrists and retailers alike to safely and easily test eye health and are already hard at work doing so, as can be seen through their relationship with UMC Utrecht.
easee is empowering the UMC Utrecht TeleTriageTeam to meet ophthalmology patient needs through its online exam. Using easee has helped UMC Utrecht to reduce the amount of in-person visits needed with only 38.5% of the 1.1K patients treated thus far requiring an physical ophthalmology department visit. Solutions like easee are critical in making data collection easier, in helping heighten the focus on patient care and in making proper eye health more accessible during the pandemic and beyond.
There are many innovative solutions like easee’s on the verge of becoming mainstream as a result of COVID-19 that can meet patient needs in transformative ways. These, along with more traditional telemedicine offerings, are potential game changers, as Judd Hollander, associate dean for strategic health initiatives at Sidney Kimmel Medical College points out. “In the era of COVID-19, telemedicine improves the safety of patients and providers alike…but independent of the pandemic, it simply offers better, more convenient care that costs less.” [4]
That’s not to say our future needs are fully determined and realized, far from it, but the pandemic has accelerated remote care, and spawned much innovation over the past year at a speed not often seen within healthcare. As Bart Demaerschalk, medical director for synchronous services at Mayo’s Center for Connected Care says, “The COVID-19 pandemic has essentially accelerated U.S. digital health by about 10 years.” [4] While we have a long way to go before a future of healthcare is fully realized, hopefully we can use the experiences brought about by concerns over limiting the spread of a world-wide virus to help us continue to accelerate progress and continue to push towards a healthy future for all.
[1] https://www.medrxiv.org/content/10.1101/2020.03.30.20043919v1
[2] https://coronavirus.jhu.edu/data/cumulative-cases
[3] https://www.sykes.com/resources/reports/2020-telehealth-survey/
[4] https://www.sciencemag.org/features/2020/11/telemedicine-takes-center-stage-era-covid-19
[5] https://www.kentucky.com/opinion/op-ed/article242408096.html
[7] https://www.kvkinnovatietop100.nl/site/Easee-Meet-je-ogen-voortaan-thuis
ABOUT THE AUTHOR
JB Stockslager is a 2nd year MBA student at Kellogg. He spent this past summer at online eye exam startup easee helping to strategize how to usher in a new era in eye care. JB has also spent time consulting for Northwestern Medicine and many other companies as an employee of Kearney Consulting. JB is passionate about innovative solutions that can help all people gain access to better care.