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Digital Health Companies Adapted With Agility to Meet Outstanding Demands During the Pandemic

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Screenshot of Kinsa CEO Inder Singh

January 19, 2021—The COVID-19 pandemic continues to pressure digital health companies to adapt and scale with remarkable agility to meet unprecedented demands for their services.

At the Consumer Technology Association’s annual Consumer Electronics Show on January 12, David Kirkpatrick, editor-in-chief of Techonomy Media, facilitated a robust discussion with a panel of experts on the telehealth lessons learned from 2020 and the future of digital health.

“As a country, we were unprepared,” said Lee Schwamm, vice president of Digital Health Virtual Care at Mass General Brigham. “Internet service providers were not prepared for the increased internet load, and video teleconferencing providers were not prepared for the spike in demand.”

The panelists agreed that while many things were learned from the pandemic throughout 2020, the main thing that was brought to light is that people need quality health care at affordable prices.

According to panelists, the costs associated with health care are a major roadblock to digitizing the health system, as payers may wonder what the true value of the health services they are paying for is.

These payers include employers who may seek to save money on health expenses when trying to find the best providers for their employees. If employers can hold digital health companies to a high standard, their employees can enjoy lower health care costs, thus saving money for the employer’s bottom line.

Deneen Vojta, executive vice president at United Health Group, further critiqued COVID-19 responses in 2020, saying America’s health care system focuses too heavily on the end stage of diseases and health ailments. Vojta said directing resources towards early health care treatment in the form of signal detection and prevention is severely under cared for.

The future of digital health care

Looking forward, “there is a great challenge to find the best and safest ways to bring employees back to school and students back to work,” said Vivian Lee, president of platforms at Verily.

Lee discussed ways to leverage technology to bring employees and students back to traditional, in-person settings, such as building digitalized back-to-work and school programs, getting COVID-19 testing to all, and developing health apps, which can aid research in numerous ways, as many have access to smartphones and computer devices.

Inder Singh, CEO of Kinsa, further voiced optimism in telemedicine applications and tools. When the next pandemic hits, people must be prepared to combat it not just physically, but digitally, he said.

Kinsa makes a connected thermometer on smart devices via an app that communicates with others if the user has early signs of sickness. Kinsa was able to predict flu incidents months out on a city-to-city basis thanks to the nearly 2 million user downloads it had on smart devices.

Singh reminded that many underserved communities still lack access to broadband, noting that smartphones are more commonly accessible to low-income Americans.

In addition to getting the current COVID-19 pandemic under control, Lee believes mental well-being should be a priority of digital health initiatives going forward. By having access to mental telehealth services, patients can see health providers much faster and easier than the traditional means of physically traveling to a practice or clinic.

Lee warned that not all telehealth care is the same, as intense discussions over fee-per-service or value-based health care continue to rage on. Lee said she believes that health providers should be paid only when “delivering better health outcomes resulting in the patient’s improvement, rather than utilizing a fee-per-service” based system.

Expert Opinion

Craig Settles: Communities to Roll Out Telehealth Integration

‘We figured out how to train people to be digital navigators [and] get customers comfortable with telehealth.’

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The author of this Expert Opinion is Craig Settles, who unites community broadband teams and healthcare stakeholders through telehealth-broadband integration initiatives.

A pacesetter among municipal broadband owners, the City of Chattanooga is giving away 1,000 free telehealth appointments that also brings broadband into low-income homes. Vistabeam, a Nebraska Wireless ISP, is bringing telehealth to rural towns through Community Empowerment Centers that increase broadband as well as improve residents’ health. 

“The Enterprise Center works hard at the intersection of technology and inequality, whether it’s using technology to work efficiency, for learning, or improving personal health,” states CEO Deb Socia. The center is partnering with residents, community organizations and the Parkridge Medical System to identify needs and bring in resources to combat high levels of diabetes, stroke, heart disease, and asthma. 

Vistabeam owner Matt Larsen says, “You can’t just lay down some fiber and routers, then call this a broadband success. Rural areas often lack the human and tech resources necessary for broadband to thrive.” So Vistabeam is designing Community Empowerment Centers to offer communities private telehealth consultation rooms, digital skills and telehealth training, full-time digital navigators and inventory rooms with shared computing devices and equipment.

These and other communities are finding that telehealth increases broadband adoption as well as improves the physical and economic health of residents. Telehealth is the “killer app” that can harness and focus broadband investments into digital inclusions advancements for urban and rural communities.  

A perfect storm for telehealth

Chattanooga’s public broadband network, through a city electric power board that offers both electricity and broadband, is an advantage to telehealth. Socia says, “EPB has a deep connection to the community, and they invest money, technology in public spaces, and energy upgrades in the homes. EPB cares about the health of our community.” (EPB, formerly known as the Electric Power Board of Chattanooga, provides broadband in the city.) Communities without public broadband may have to work harder to find large ISPs with similar levels of commitment.

Communities wanting to leverage telehealth likely will need new strategies for winning and managing grants. You can’t have telehealth without broadband, but the integration of broadband to facilitate telehealth delivery may involve a myriad of people, organizations, and resources besides the network builder. 

For years Chattanooga has had a culture of cooperation among its many civic groups. The nonprofit Orchard Knob had a preexisting collaborative, so when the telehealth opportunity came up as part of a larger “healthy community” initiative, it was it much easier to create a grant of the size that the group currently has.

The community created the Orchard Knob Collaborative, which includes Parkridge Medical Center with their 1000 telehealth appointments, the Orchard Knob Neighborhood Association, Habitat for Humanity of Greater Chattanooga Area and United Way of Greater Chattanooga. EPB contributed money, energy upgrades, and public WiFi. Green Spaces is another nonprofit and the Center provides project management plus various Tech Goes Home digital inclusion programs.

Telehealth opens the door for larger grants. “I think the anticipated grant-raising outcomes are quite specific when you’re producing social determinants of health,” Socia says. “Projects that involve telehealth are a much tougher ‘ask’ for funders and everyone else involved. But at the same time, you can leverage other additional dollars and other partners for a much better healthcare outcome.” 

Telehealth and the ‘human element’

Every state is developing a digital equity plan. How important is telehealth to the success of a digital equity plan? Quite important! But remember that telehealth deployment strategy in rural communities likely could take shape differently than urban deployment. Vistabeam’s Centers represent one approach.

Digital equity in telehealth is just one component of a giant ecosystem of social services that good societies use to help take care of people. The challenge is the need to successfully coordinate scarce resources to get maximum impact from the resources. However, in rural communities there can be a real lack of coordination between a lot of these resources.

“It makes sense to start out by focusing on getting telehealth into some smaller communities at locations where people can come in and access telehealth in an environment that develops trust and familiarity with the technology,” says Larsen. “To do that, we’re going to need a ‘human element’, facilitators such as digital navigators to plug community telehealth into the ecosystem. A lot of rural communities have trust issues with government programs.”

Using surplus office space to create customer service centers

There are plenty of large incumbents’ mobile device showrooms in communities. But these employees tend to be sales-oriented with scripted content. Vistabeam happens to have surplus office space they are using to create true customer service centers.

“We figured out how to train people to be digital navigators, we get customers comfortable with telehealth and our staff connects people with complementary social services and other resources,” says Larsen. For the last few months, Vistabeam has been promoting exclusively the FCC’s Affordable Connectivity Program of free Internet access and subsidized computing devices. There’s a complex enrollment process residents have to complete that’s confusing for many, so Vistabeam trained staff to walk people through the process, get them qualified, and connected.  

As for the potential of telehealth deployment to the home, Larsen believes the technology represents a tremendous amount of potential utility and value for both rural and urban broadband deployments. Though broadband is currently underutilized for telehealth, in large part because communities are just beginning to plan for it, the pandemic revealed a burning need for strong video streaming capacities to bridge doctors and patients.

“What’s missing is a telehealth killer app or device,” says Larsen. “I believe preventive healthcare will be the answer – technology that detects or prevents things from happening before they become big problems. This app could be a way to check vital statistics and watch for health or illness markers. Maybe we’ll see a device connected to the Internet that accesses research data to help you and your health professional with health planning.”  

Just about everybody gets sick or hurt, or they are responsible for others when those loved ones aren’t doing well. Telehealth and its many iterations are designed for people to use when they’re sick or hurt or for preventative healthcare. The universality of telehealth and its symbiotic relationship with broadband technologies give communities great potential for expanding digital inclusion. Together with the bezillion grant dollars coming out the ying yang, what we’re seeing is the perfect digital storm. 

Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to commentary@breakfast.media. The views reflected in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

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Health

Providers Call for More FCC Telehealth Funding as Demand Grows

‘I think obtaining funding from the Universal Service Fund would go a long way.’

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Photo of FCC Chairwoman Jessica Rosenworcel

WASHINGTON, July 26, 2022 – Health care providers in parts of America say they are struggling to deliver telehealth due to a lack of broadband connectivity in underserved communities, and recommended there be more funding from the Federal Communications Commission.

While the FCC has a $200-million COVID-19 Telehealth program, which emerged from the Coronavirus Aid, Relief and Economic Security (CARES) Act, some providers say more money is needed as demand for telehealth services increases.

“The need for broadband connectivity in underserved communities exceeds current availability,” said Jennifer Stoll from the Oregon Community Health Information Network.

The OCHIN was one of the largest recipients of the FCC’s Rural Health Care Pilot program in 2009. Stoll advocated for the need for more funding with the non-profit SHLB Coalition during the event last week. Panelists didn’t specify how much more funding is needed.

Stoll noted that moving forward, states need sustainable funding in this sector. “I am hoping Congress will be mindful of telehealth,” said Stoll.

“The need for telehealth and other virtual modalities will continue to grow in rural and underserved communities,” she added.

Brian Scarpelli, senior global policy counsel at ACT, the App Association, echoed the call for FCC funding from the Universal Service Fund, which subsidizes basic telecommunications services to rural areas and low-income Americans. “I think obtaining funding from the Universal Service Fund would go a long way.”

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Artificial Intelligence in Healthcare Has Benefits, But Also Challenges That Must Be Rectified: Experts

The technology needs to be examined to ensure it doesn’t create inequities in healthcare, panel hears.

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Screenshot of the Atlantic event in late June

WASHINGTON, July 11, 2022 – While the use of artificial intelligence in healthcare has been lauded by some, experts said at an Atlantic event late last month they are concerned that inaccurate data can also hamper progress in the field.

Artificial intelligence has been used widely across the medical field to analyze relationships between medical providers and patients to improve equality of care, including providing patient risk identification, diagnostics, drug discovery and development, transcribing medical documents, and remotely treating patients.

Carol Horowitz, founder of the Mt. Sinai Institute of Health and Equity Research, argued that while AI plays a substantial role in diagnosing health problems at earlier stages, diagnosing patients more quickly, providing second opinions in diagnoses, enhancing scheduling abilities, stimulating hospital workflow, and finding drug availability for a patient as in dermatology, therapeutics, or population health, it’s not a golden ticket.

She reasoned that it “can reflect and really exaggerate inequities in our system,” negatively affecting healthcare equity among patients.

She stated that AI tools have led to inaccurate measurements in data that have proved harmful to individuals’ health. Horowitz shared the example of faulty AI technology during March 2020 meant to allow individuals to self-monitor their own oxygen levels as a precautionary method to the COVID-19 pandemic but led to inaccurate pulse readings for those with darker skin, and inaccurate data gathering, resulting in delayed treatment for many in need.

Michael Crawford, associate dean for strategy of outreach and innovation at Howard University, added that if these certain mismeasurements and flaws in the technology are not addressed, “AI could increase disparities in health care.”

Alondra Nelson, head of the White House Office of Science and Technology Policy, said when it comes to assessing AI technology innovation for the future, there are both cost and benefits, but we must find “where can we move forward in ways that don’t harm human society but that maximize human benefits.”

As we grapple with how to implement this technology, “we must do science and technology policy that always has equity at the center” for future innovation, said Nelson.

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