Big Tech is Stepping Up its Efforts in the Healthcare Industry

Introduction

The presence of technology in healthcare has transformed the industry forever in the last decade. With the advent of Electronic Health Records and e-billing, there is less room for error and greater transparency for the patients. This also gives better quality of healthcare due to a clearer past medical history present before the doctor, as paper records were often misplaced by hospital and patient both. According to a study from the University of Michigan, the shift made from paper to EHR can significantly reduce costs of patient care, up to 3%. In a larger network with innumerable consumers, these savings will add up to a big amount. Alert systems can serve as life-saving reminders for patients to comply with medications and doctors’ visits.

3 D printing is a fairly nascent technology but it has already transformed the prosthetics industry by allowing to create tailor-made limbs, joints, implants, and even organs for surgeries. Robotic surgery can assist in greater precision and less invasive procedures. Perhaps the greatest presence of technology has been felt in telehealth where one can now talk to a healthcare provider remotely. With the rise of awareness about keeping healthy and the use of technology to aid that, it is no wonder that big tech giants are choosing to move into this sector to create a more streamlined experience for both the patient and their healthcare provider. An aging population, a trend of eating wholesome foods, and an increase in lifestyle-related disease, provide ample opportunity and guarantee that investing in technology for healthcare is the future.

The healthcare industry is undergoing significant change, with big tech companies entering the field and developing new solutions, which has been expedited by the pandemic. We’ve compiled a list of some major tech companies that are making ripples in the industry.

Apple

Apple is one such company that is moving into healthcare swiftly and making its presence felt. It has partnered with the Geisinger Health System to create Electronic Health Record Systems (EHR) for its patients, eliminated the need for paperwork and bulky files, intelligently applied the use of iPads for patients to access to their lab results in a way that is understandable for them. The Apple Health app comes preinstalled in every iPhone, which tracks patients’ activity, sleep, and offers mindfulness support. Combine this with their ECG feature on their smartwatch, it becomes a powerful tool that can detect atrial fibrillation, and perform Fall Detection. These features have saved numerous lives of ordinary people who would otherwise not have gone to a hospital in time. The company has encouraged developers to create more health oriented applications for their platform by providing a Health Kit, Research Kit and Care Kit which allow for building of apps that can offer patient care even beyond a doctor’s office or a laboratory.

Google

They are using AI to assist in the diagnosis of cancer and the prognosis of patients. They have also developed a research tool to interpret skin images of patients and their medical history, then provide a list of possible skin conditions, which has helped primary care physicians make decisions of ordering biopsies or dermatology referrals. With their platform being the most used for information access, it has played an important role during the COVID pandemic to create a comprehensive database with information gathered from epidemiologists, research labs, and hospitals from around the globe. They have also begun a COVID-19 Community Mobility Report which tracks movement trends of people to grocery stores, workplaces, pharmacies, etc. to keep a check on how the population is contributing to flatten the curve. The company also provides clinically verified self-health assessments when people search for things like anxiety or postpartum depression.

Amazon

With the introduction of Amazon Pharmacy, Amazon has further strengthened its position in the healthcare sector, two years after purchasing PillPack. The tech giant has in place a significant supply chain so it could easily fill prescriptions and also negotiate lower drug prices for its large consumer base, just as they disrupted the book market. Their Alexa service became HIPAA compliant in 2019, thus allowing consumers to order medications and connect to telemedicine with an assurance of privacy. It has put in place Amazon Transcribe Medical, which allows for voice commands to be transcribed automatically into medical records by physicians. Amazon has also acquired Health Navigator, a startup that assists digital health companies with tech and services.

Conclusion

Healthcare is rapidly changing and the coronavirus pandemic has hastened the process of online consultations even further. With more people taking charge of their health thanks to blogs and information on the internet, the demand for better and easier medical services is on the rise. The involvement of these tech companies will only grow in this sector, as we rely ever more on our devices for everything.

Battling COVID-19 Through Digital Innovation and Transformation

Introduction

With a global pandemic gripping the world and many healthcare systems collapsing under inefficient models of work, there is a market for new innovations that can provide easier and faster solutions for the diagnosis and treatment of the novel coronavirus disease. Technologists have repurposed several existing technologies to create quick solutions to the coronavirus pandemic. In any crisis, such creativity and invention are vital, but they are especially encouraging during a critical period like COVID. As companies seek new tech solutions to fight the COVID crisis, some interesting themes have emerged.

According to a Boston Consulting Group analysis, 25% of new digital solutions deal with detection and containment, 20% with healthcare provider enablement, and another 21% with economic resilience. Furthermore, roughly a third of these use cases were global, demonstrating the pandemic response’s collaborative and interconnected nature. Highlighting these innovative use cases can serve as a reminder of the world’s resiliency and ingenuity in the face of the global crisis.

  1. SaNOtize

It is a nitric oxide nasal spray whose core function is to eradicate the virus from your nasal passages if someone sneezes on you – one can pull out the spray and use it in the nose to kill any virion particles deposited there. It is developed on the therapeutic properties of nitric oxide, first discovered by Professor Ferid Murad of the University of Stanford, which got him the Nobel Prize in Medicine in 1998. Professor Murad has been a key part of developing SaNOtize. The product has concluded a double-blind, randomized placebo-controlled trial which was effective in reducing the viral load by 95% in 24 hours and up to 99% in 72 hours. It has received permission to go ahead with a clinical trial in the USA currently. The company describes it as an ‘upper airway disinfectant’.

  1. Halodine

It is essentially considered a nasal antiseptic, and can rapidly inactivate the SARS-CoV-2. It comes in single-use ampules of liquid povidone-iodine and can easily be stored at room temperature. Since it inactivates the virus in as little as 15 seconds of contact, at concentrations of just 0.5%, it will be vital for use by frontline workers along with personal protective equipment. Intranasal use of this solution at different concentration strengths of 0.5% and 1.25% have been very effective in reducing viral load in nasal passageways.

  1. CRISPR-based Covid-19 Test

While conventional rt-PCR tests take days and sometimes even weeks to return results, the new CRISPR-based test can provide outcomes in a matter of 20 minutes. The PCR employs the conversion of viral RNA to DNA before it can be amplified and detected as a positive result. With this new application of CRISPR, there is room for direct detection of viral RNA through the protein Cas13, which cleaves RNA. The test can be hooked up to a smartphone and report the swab test as positive if it picks up signals from the Cas13 protein. It can be cost-effective as it doesn’t need complex lab equipment and only a CRISPR kit plus a smartphone.

  1. HITES

The Handheld Infrared Thermometer with Enhanced Safety was developed at IIT Kanpur to enable monitoring of body temperature at a physical distance of 6 feet. The generally used traditional infrared thermometers violate the basic tenet of social distancing necessary during COVID-19. HITES ensures the safety of healthcare and essential workers by giving interpersonal space of 6 ft and doesn’t require a battery to run as it is powered by mobiles, and allows seamless cloud storage of body temperature data which can help keep track of infection patterns.

  1. GigaGen Surge

It is a gene sequencing platform developed by the Jeffrey Modell Foundation in New York, which aims to provide a ‘blueprint’ of a patient’s immune system, by creating a library of all the antibodies present in a person’s blood. This is done by running donor blood samples through the Surge System, and subsequent isolation of antibody-producing B cells. These antibodies can be integrated into mammalian cells and result in a recombinant antibody treatment, allowing the development of immune-mediated treatments for COVID-19. The clinical trials have begun in early 2021 and offer hope that traditional convalescent plasma or immunoglobulin therapies cannot.

  1. DocDot

It is a mobile app that utilizes artificial intelligence to keep a track of patient’s vitals remotely. It allows for teleconsultation, telemonitoring, and tele prescription during any covid related emergencies. The mechanism by which it works is called remote photoplethysmography (rPPPG), which allows a smartphone to interpret light signals reflected off blood vessels beneath the skin surface. It surveys blood volume, changes in respiratory rate, blood pressure, variability in heart rate, and oxygen saturation. So it works by a simple means of transferring signals from the body into measurements on an app.

This allows for earlier diagnosis of any infections, and also serves as a triaging tool. It was developed by an Italian company called SDG Group, and is currently in the process of clinical trials in the US, having already completed such trials in Japan, Canada, and India. It is potent in the detection of Covid-19 hotspots and does real-time data collection that helps in resource allocation planning.

Conclusion

If necessity is the mother of invention then COVID-19 has certainly been that maternal catalyst that has pushed the boundaries of traditional medicine and combined technology with medical research. One of numerous characteristics of countries that have flattened their COVID-19 incidence curves and maintained low fatality rates could be the incorporation of digital technology into pandemic policy and response.

Countries that have quickly deployed digital tools to facilitate planning, surveillance, testing, contact tracing, quarantine, and clinical management have remained front-runners in managing disease burden in the fight to contain the spread of a highly transmissible virus. As the disease progresses and we learn more about it, we can only hope to find more compelling and new ways to look at our diagnostic and treatment modalities.

References

Role of Digital Technology In Combating Covid-19 Pandemic

The COVID-19 crisis has highlighted the value that digital health solutions can bring to patients since the start of the pandemic – whether it’s managing patients in their home environments, reducing the burdens and risks associated with traveling to clinics, or streamlining hospital care pathways. As healthcare providers around the world seek to leverage technology to help combat the crisis, the pandemic has propelled digital health onto the global stage. In combination with global trends towards the digitization of medicine, this has resulted in rapid technological adoption and accelerated transformations in digital health.

Digital technology initiatives used in pandemic preparedness and response

Digital health technology can facilitate pandemic strategy and response in ways that are difficult to achieve manually.The control of the COVID-19 pandemic rests, as with the control of outbreaks and pandemics before it, on the detection and containment of infection clusters and the interruption of community transmission to mitigate the impact on human health. Some of these applications for digital technologies in pandemic management and response are discussed below, highlighting ways in which successful countries have adopted and integrated digital technologies for virtual care, pandemic planning, surveillance, testing, contact tracing, quarantine, and quarantine.

  1. Telemedicine: embracing virtual care

Over the past few months, during the coronavirus pandemic, telemedicine has experienced a huge rise in adoption. It has become the ‘new normal’ way of accessing healthcare, with people locked down at home. Patients can consult doctors regarding their symptoms from the comfort of their homes or be monitored for other ailments. This decreases unnecessary visits to hospitals, allowing doctors to concentrate on urgent cases that require prompt medical attention.

As a matter of fact, since January, Amwell’s use of telemedicine apps in the US has increased by 158%, and appointments through PlushCare have increased by 70%. In comparison, before the pandemic, only 1 in 10 US patients used telemedicine services.

  1. Planning and tracking

In several countries, Big Data and Artificial Intelligence (AI) have helped facilitate COVID-19 preparedness and human tracking, and thus the spread of infection. To collect real-time data on the location of people, tools such as migration maps using mobile phones, mobile payment applications, and social media-enabled Chinese authorities to track the movement of people who had visited the Wuhan market, the epicenter of the pandemic.

Machine learning models were developed with these data to forecast the regional transmission dynamics of SARS-CoV-2 and to guide border controls and surveillance. Taiwan initiated health checks for airline travellers from Wuhan as soon as China reported the outbreak, integrating data from immigration records with its centralized, real-time national health insurance database.

The need to track COVID-19 has fuelled data dashboard innovation that visually displays the burden of disease. The coronavirus dashboard at Johns Hopkins University (MD, USA) and the HealthMap web-based platform provides up-to-date visuals of COVID-19 cases and deaths around the globe.

  1. Screening for infection

To screen and guide people to appropriate services, China uses open, web-based, and cloud-based instruments. High-performance infrared thermal cameras set up at Taiwanese airports are used to capture real-time thermal images of people, identifying people with fever easily.

In Singapore, at the entrances of offices, schools, and public transport, individuals have their temperature measured. Thermometer data is tracked and used to classify emerging hot spots and infection clusters where research may be initiated. Iceland has launched systematic monitoring of asymptomatic citizens, unlike most other nations.

Iceland gathers patient-reported symptom data using mobile technology and integrates this data with other databases, such as clinical and genomic sequencing data, to reveal knowledge on the pathology and spread of the virus.This approach has contributed to the knowledge base of asymptomatic COVID-19 prevalence and transmission. To date, Iceland has had the highest testing rate per capita and one of the lowest mortality rates per capita for COVID-19. Germany and South Korea are other countries offering widespread research.

  1. Smartphone tracking: high tech contact tracing

Digital contact tracing automates tracking on a scale and speed that is not easily replicable without digital resources. It reduces reliance on human recall, particularly in areas with mobile populations that are densely populated. Digital contact tracing apps were developed for use in many countries during the COVID-19 pandemic; these apps rely on techniques and technology not previously tested on this scale and are contentious in terms of privacy. It is important to determine their accuracy and efficacy.

At least 10 countries are using such methods of surveillance. The opt-in app in Singapore uses Bluetooth and wireless signals to trace nearby users. In addition to bank transfers and CCTV video, South Korea’s successful management of the outbreak was in part due to monitoring phone use. A QR-based system was launched by Moscow to monitor the disease. Both Apple and Google, the tech giants, have formed an unlikely alliance to provide contact tracing in their operating systems.

The boundaries between civic responsibility and one’s privacy are blurred by these invasive methods. Fortunately, there are ways to retain privacy while facilitating contact tracing that is in the works.

  1. Quarantine and Self-isolation

In some nations, the indiscriminate lockdowns for infection prevention have had significant socio-economic repercussions. Quarantine may be enforced with digital technologies for people who have been exposed to or infected with the virus, with less rigorous restrictions placed on other residents.

China’s Quick Response (QR) code system, in which people are supposed to undertake a symptom survey and record their temperature, enables health monitoring and motion control by the authorities. The QR code serves as a certificate of health status and travel pass for COVID-19, with color codes representing low, medium, and high risk; individuals with green codes can travel unrestricted, whereas individuals with red codes are required for 14 days to self-isolate. In Taiwan, via government-issued cell phones monitored by GPS, electronic monitoring of home-quarantined individuals is facilitated.

In Hong Kong, individuals in self-isolation are required to wear a wristband connected to a database through cloud technology that warns authorities if quarantine is violated. Iceland has introduced a mobile phone solution to track people with COVID-19 and ensure that they stay in self-isolation.

  1. Clinical Management

Rapid diagnosis and risk prediction of COVID-19 can be facilitated by AI. For the identification of COVID-19 pneumonia cases in China, a cloud-based AI-assisted CT service is used. CT images are processed in seconds by this technology, differentiating COVID-19 from other lung diseases and greatly speeding up the diagnostic process. On chest x-rays, COVID-Net, an open-source deep convolutional neural network architecture available to clinicians worldwide, will easily classify COVID-19 cases of other lung diseases.

The probability of developing acute respiratory distress syndrome and critical illness among infected patients can be predicted by machine learning algorithms developed in China. Medical decision-making and resource distribution can be driven by these prediction models, recognizing areas and hospitals in need of critical care services and medical supplies.

  1. Public communication: informing populations

The successful implementation of pandemic strategies is focused on public education and collaboration, assisted by an adequate communications plan, which requires active involvement by the community to ensure public confidence. With 4.1 billion people accessing the internet and 5.2 billion unique smartphone subscribers, targeted engagement across digital channels can quickly reach billions and promote community mobilization.

A United Nations study found that by early April 2020, 86% of Member States had put COVID-19 data on national websites, and many use text messaging to reach populations who do not have internet access. Chat-bots also provide data to minimize the burden on non-emergency health advisory call centers, and the rapid adoption of remote health service delivery, including telemedicine, especially in primary care, is transforming clinical practice.

Conclusion

One of the characteristic features of countries that have flattened their COVID-19 incidence curves and retained low mortality rates may be the incorporation of digital technology into pandemic policy and response. As a significant tool for sustaining wellbeing and health care delivery around the world, digital health is very likely to be accelerated by Covid-19. With the digital health armamentarium, it is the right time to motivate ourselves better to fight diseases and improve health.

References:-

National Digital Health Blueprint: A Blueprint To Transform Healthcare

Universal Healthcare (UHC) is a key commitment for India by 2030, as it affects the achievement of all other goals for sustainable development (SDGs). Even though India’s business growth has been slowed down by the pandemic, India is perceived as one of the fastest-growing economies. India needs to introduce and implement initiatives that ensure a healthy workforce, improve the public healthcare framework, and, most importantly, integrate public and private healthcare resources to stimulate growth and development.

The National Digital Health Blueprint (NDHB) was published in the public domain by the Ministry of Health and Family Welfare in July 2019, inviting comments from various stakeholders, including the general public. The purpose of this blueprint is to establish and manage core digital health data and to provide the adequate infrastructure necessary for its continuous exchange.

Understanding the need to introduce the National Digital Health Blueprint

This National Digital Health Blueprint is an extension of the 2017 National Health Policy (NHP 2017), which was formulated to provide all Indian citizens with universal healthcare based on digital technologies to achieve greater efficiency and efficiency.

The National Health Stack (NHS), which is a digital arrangement aimed at developing a clearer and stronger health insurance system, was introduced in 2018 by the NITI Aayog.

In essence, multiple mechanisms are covered by the NHS, including an electronic national health registry that would function as a single health database for the nation. Another mechanism involves a platform for coverage and claims to function as the building blocks for robust health protection schemes, allowing the states to horizontally and vertically expand schemes such as Ayushman Bharat, and further enabling a robust fraud detection system.

Also, the NHS aims to provide a Federated Personal Health Records (PHR) system to provide the citizens with access to their health data, and further facilitating the accessibility of the health data for medical research, which is crucial for evolving the understanding of human health. The NHS also aims to provide citizens with access to their health data through the Federated Personal Health Records (PHR) system and to further facilitate the accessibility of health data for medical research, which is crucial for improving the understanding of human health.

The NHS also requires the implementation of additional horizontal structures with a specific digital health ID, health data language, and supply chain management through health programs, to ensure that different facets of the NHS are completely linked and avoid the accumulation of disconnected silos.

The NDHB is a constructive document that has been introduced for the application of the NHS, keeping in mind the above initiatives. The underlying concept is to make a national digital health ecosystem capable of supporting universal health coverage in a professional, open, comprehensive, fair, timely, and secure manner by offering comprehensive data, information, and infrastructure collection services.

Features of the National Digital Health Blueprint 

The NDHB recognizes the need to set up a new agency called the National Digital Health Mission (NDHM) to help and simplify the creation of a national digital health ecosystem that can promote the implementation of the blueprint.

A coherent architecture, a collection of architectural components, a five-layer system of institutional architectural blocks, a Specific Health ID (UHID), control of privacy and consent, national portability, electronic health records, suitable principles and guidelines, and health analytics are the main features of this blueprint.

For its execution, the Blueprint sets out five horizontal and two vertical blocks of construction. Although the document lists National Health Standards as Vertical Layer-1, the implementation of STGs, which will be the basis for incorporating providers’ patient data, is not comprehensive.

Personal Health Records are included in the Horizontal Layer-2, suggesting a federated structure of multiple players operating on an interoperable standard for health data sharing. The Blueprint also recognizes the significance of protection and seamless interoperability requirements for all building blocks and prescribes the use of EHR standards.

The objectives of NDHB include:-

  • Establishing and maintaining the core digital health data and the infrastructure needed to share it seamlessly
  • Promoting the adoption of open standards by all stakeholders in the National Digital Health Ecosystem to build multiple digital health systems from wellness to disease control across the sector
  • Creation of an international standards-based EHR framework that is easily accessible to people and service providers based on citizen consent
  • Establishing pathways of data ownership such that the patient is the owner of his/her EHR, and on behalf of the patient, health facilities and government bodies retain the data under trust. The collection and final use of the data shall take place through a process of consent. However, if it properly meets the standards so described, the anonymized data may be used for research purposes. The health facility is responsible for maintaining data protection, security, and confidentiality
  • Following the best principles of cooperative federalism while working with the states and union territories for the realization of the vision
  • Promoting medical research and health data analytics
  • Boosting the efficacy and quality of governance at all levels
  • Ensuring quality of healthcare
  • Leveraging the already existing knowledge systems in the health sector

Expected Outcomes

  • All people should be able to have secure access to their EHRs
  • Leveraging existing health record results of citizens, and not repeatedly undertaking medical testing unless warranted
  • In a single application (EHR), people should be able to aggregate health data from multiple agencies/departments/service providers where data is generated
  • NDHM can provide residents with quality care through primary, secondary, and tertiary care and public and private service providers
  • To facilitate the outreach of voice-based services, a framework for Unified Communication Centre will be established
  • NDHM will support the national portability of healthcare services
  • Privacy of personal and health data and consent-based access to EHRs will be the inviolable quality that all programs and stakeholders will compile.
  • NDHM will correspond to health-related SDGs
  • NDHM will allow evidence-based interventions in the field of public health
  • Most importantly, NDHM’s analytical capabilities will help data-driven decision-making and policy analysis

The government should consider working with the private sector to develop public infrastructure that can be open-sourced and potentially used at scale by both public and private entities to speed up the implementation of NDHB. Many of the NDHB’s core building blocks, such as the consent manager, health portal, etc, can be easily developed by the private sector and deployed as a public good by the government. This strategy would assist the government to move forward with overdrive in the execution of the NDHB vision.

References:-

Focusing on privacy and security in the coronavirus new normal

The COVID-19 pandemic has prompted data protection and enforcement to be re-examined by countries worldwide. Basically, in the light of regulatory constraints, since the times of Socrates and Plato, an ethical dilemma has been debated: at what stage are the rights of the citizen overridden by the needs of public protection and economic well-being? The answers to this question will differ widely based on country-specific regulations and cultural norms, as well as the state of infections with COVID-19 in each region, and will be a defining undercurrent as the “next normal” global economy re-emerges.

As several organizations and policymakers are working to develop track-and-trace applications to allow society to get back to normal, the implementation of these advanced screening capabilities should incorporate security concerns as well as data privacy regulations.

While it is tempting during a pandemic to prioritize health above all else, data privacy regulations do need to be enforced. In a time when personal safe health information (PHI) and special data categories are exchanged at an unprecedented pace, this can be difficult. Employers would need to follow a new set of policies globally that balance supporting the wellbeing of workers with allowing the organization to function at a sustainable pace. To fully understand how privacy laws relate to their activities has never been more critical for public and private organizations so that they can function safely in the next normal.

Data Privacy in the Next Normal

Organizations should create a comprehensive, ethical and sustainable approach to privacy and security for COVID-19 health considerations in creating a holistic approach to meeting privacy and security criteria around COVID-19 health considerations.

Key variables for enhancing productivity and effectiveness include:

  • Cross-functional executive support: Privacy and protection is a cross-functional topic requiring strong executive support and engagement in areas such as business, IT, HR, and legal issues.
  • Risk-based approach. Focusing on business risk and defining and prioritizing high-risk products (as opposed to simply compliance) will improve the value that privacy and security solutions can offer.
  • Data lifecycle: One first needs to understand where the sensitive data is and how it is used, from compilation to destruction, before one can understand how to enforce fair controls.

As the COVID-19 pandemic threatens to roil economies and confine people to the isolation of their homes, much of the public discussion of the pandemic focuses on identifying the “new normal.”Some of the behavioral norms and social expectations we take with us will be innocent, unconscious footnotes to the compendium of our moment.Others would need deliberation and debate long overdue. None may be more critical than our changing conceptions of data privacy and cybersecurity.

Today, there is growing public concern over how consumer data is used to consolidate economic gain among the few while steering public perception among the many — particularly at a time when privacy seems to be the price for ending public health emergencies.

But the COVID-19 outbreak is also highlighting how user data can improve consumer well-being and public health. While strict adherence to traditional notions of privacy may be ineffectual in a time of exponential technological growth, the history of our relationship to privacy and technology suggests regulatory policies can strike a balance between otherwise competing interests.

References:-

A Strategy to Make Pharma Supply Chains More Resilient

Pharmaceutical firms faced a moment of reality when Covid-19 squeezed off vital supplies of drug components from Asia. There was a dangerous risk in their dependency on far-flung supply chains. In the wake of Covid-19, pharma companies now understand the fundamental need to control supply chain risk, maintain network visibility, identify alternative sources of supply

COVID-19 disrupting the supply chain

Pharmaceutical companies have sought to reduce costs for more than a decade by relocating a significant proportion of their manufacturing capacities to China and India, especially in the small molecules market, which includes active pharmaceutical ingredients (API) and drug development and packaging. As a result, these countries’ production volumes increased much faster than demand. According to US FDA data, nearly 40 percent of registered manufacturing sites for APIs were in India or China in 2019.

The transfer to Asia for pharma sourcing and manufacturing has directly affected the stability of the supply chain. FDA data indicates that drug shortages are growing due to many causes, including quality problems and disruptive events. In February 2020, the US FDA announced that “the COVID-19 outbreak would likely impact the supply chain of medical products, including potential supply disruptions or shortages of critical medical products.”

Subsequently, COVID-19 led the FDA to classify 20 drugs manufactured in China which, including protease inhibitors, paracetamol, and generics, may be subject to supply chain disruption. As a result, more than 180 pharmaceutical companies were required by the FDA to audit their supply chains and products made in China, as well as their relations with 63 Chinese manufacturers manufacturing important medical devices.

Mitigating supply chain risk in a global pandemic

The FDA proposed four measures to address supply chain risk caused by the COVID-19 pandemic:

  • Lengthen expiration dates to alleviate shortages of critical human drugs
  • Reinforce critical infrastructure by requiring plans for risk management
  • Improve critical infrastructure by enhanced data exchange and sharing of more detailed knowledge about the supply chain
  • Create reporting requirements for device manufacturers

Building resilient pharma supply chains

The stability of current supply chains can be improved by a more realistic two-step method.First, companies need a more complete understanding of the risks that span the entire supply chain. To increase transparency, leadership teams map production sites, distribution centers, and material flows (including APIs, excipients, and packaging) against potential hazards.They take into account geopolitical developments (such as trade wars, natural disasters, epidemics, and strikes) that could affect supply and demand and lead to drug shortages.

Second, leadership teams build new supply chain plans by reducing risk exposure or by increasing resilience capacities, or by doing both, based on the outcomes of risk assessments. Four critical components should be used in effective strategies:-

  1. Redundancy:Building capacity buffers in manufacturing facilities helps businesses to rapidly increase or decrease the amount of production. These buffers include safety inventories of essential drug materials, versatile extra-capacity production lines, and shift models designed to respond rapidly, such as night shifts when required, including a mix of staff and temporary staff. Via flexible contracts with suppliers and manufacturers, leaders build an agile manufacturing environment so that they can adjust the volume and location of production as required across a wide range of options.
  2. Adaptability: A modular production approach allows businesses to move production to other sites around the globe as required. Adaptability is also strengthened by rising production line digitization and automation. That, in turn, helps operators when they need to make fast adjustments to deal with disruption. Developing specific response plans to various situations is the third facet of adaptability.
  1. Prediction:Technology for control towers and solutions for artificial intelligence offer leadership teams dramatically enhanced visibility across the entire network; they also help predict fluctuations and risks in demand. Leaders use these resources to provide consumers as well as suppliers with greater visibility, exchanging real-time product demand and stock data.
  2. Empowerment: Effective organizations improve problem-solving capabilities within their enterprise and at production sites to get the most from resilient supply chains. Importantly, in the middle of a crisis, they empower local organizations to make decisions that will maintain business sustainability.

In pharma supply chain strategies, Covid-19 has triggered a pivotal change. Resilient networks will be the key to managing an increasingly turbulent market over the coming decade. Pharmaceutical companies that incorporate versatility and redundancy into the entire value chain and enhance visibility would be better placed to effectively anticipate and react to chain disruptions quickly.

References:-

Prediction For Post-Pandemic Merger & Acquisition Boom In Healthcare Consolidation

Many small businesses are struggling to thrive in times of chaos and this pandemic has launched Merger & Acquisition (M&A) through many sectors, one of which is healthcare. Small businesses may initially attempt to preserve their independence sometimes, but they ultimately see that maybe the best thing for their patients is to become part of a larger whole.

Over the last decade, providers have been consolidating as businesses embrace economies of scale and vertically and horizontally grow. Post-Covid-19, larger healthcare groups, and investors are expected to increase their acquisitions of smaller hospitals, physicians’ practices, and alternative care locations.

A recent industry insider study by Bain & Company said that strained finances and a sharp drop in volumes of procedures have forced organizations hard hit by the pandemic to entertain acquisition offers.

The key highlights of the report were:-

  • 50% of hospital administrators said their institutions are highly likely to make one or more acquisitions in the next 2 years
  • Almost 70% of physicians in independent practices were agreeable to the thought of acquisition
  • Physicians advocated acquisition by organizations that offered financial security and yet provided autonomy for them

The results were consistent across surgical specialties (74%), primary care practitioners (69%), and other office-based procedures (67%). Surgeons and office-based doctors were both prepared to consider an acquisition.

According to Bain research, 30 percent of physicians who owned practices in 2019 reported that they will sell their practice in the next two years. Today, physicians support the acquisition of organizations that offer greater financial stability but also provide autonomy for physicians, namely by other physician practices.

Large healthcare organizations, including hospital associations, expect further acquisitions and mergers to be made. 50% of hospital managers said that their institutions are very likely to make one or more acquisitions to achieve greater growth in the next two years. Alternative treatment locations, including ambulatory surgery centers, emergency care facilities, and pharmacy in-store clinics, were on the priority list of administrators considering M&A.

Independent physician practices were the next most common target, followed by standalone hospitals. Home health companies that offer medical services in the home have continued to gain market share over the last few years, fuelled by lower prices and patient comfort, and investors have taken advantage of this development.

They are expected to invest in digital technologies as healthcare providers consolidate. As digital natives such as Amazon and Google join the fray, the move is increasingly relevant. Leading providers are developing digital capabilities that improve care delivery and reinforce patient engagement, such as applications to connect directly with patients.

Consolidation is expected to pick up in MedTech, too. Medtech companies with category leadership roles will be in the best place to succeed in the subsequent flight to quality as provider networks merge suppliers. Despite the slowdown, well-capitalized, larger MedTech firms will be able to invest to gain market share through organic and inorganic growth as demand returns.

What does this mean for health systems that are considering M&A?

To reinvent themselves, innovate care delivery, and thrive in the future, health systems should understand how they can utilize the instruments of M&A-acquisitions, mergers, integration, and divestments. To position their company for the future, executives should take the following approach:

  • Determine an optimal asset portfolio: The portfolio should fit with the long-term plan and patterns of the company. This will mean that organizations will need a wider portfolio of non-inpatient care services-the best combination of clinics, ambulatory, virtual health, and other care delivery environments that will ensure their community’s equity, prevention, and well-being.
  • Develop a buy, build, partner analysis to fill in gaps: In their current asset portfolio, companies can recognize holes and develop a strategy to build, acquire, or combine. This will allow creative ways to gain new skills or enter new markets or geographies. Partnerships with technology providers, disruptors, and those in the community will all help create new models and capabilities for the delivery of treatment or non-healthcare services that a company could not have achieved alone. Divestitures can be an essential instrument, too.
  • Maximize and integrate the organization’s current assets: Current assets in technology, community, branding, leadership, and clinical delivery should be in alignment. To ensure alignment, legacy acquisitions or newly constructed properties should be reassessed. Divestitures, shuttering, and repurposing properties can also be considered

With rapid consolidation anticipated in almost every industry and to manage one’s destiny, health systems should immediately begin strategic planning to position themselves for potential success.

The pandemic may have had an unforeseen effect. However, progress is expected to be a constant in the health care industry even as we set out on the road to recovery. The delivery of treatment is shifting. Business models at hospitals are evolving. The theory of scale is shifting. Leaders should be prudent on how they get there.

References:-

Digital Health Adoption Challenges

During the COVID-19 pandemic, the inclusion of telehealth services shone a spotlight on the use of emerging technology in healthcare. Telehealth systems have linked patients and physicians remotely, but the rise of telehealth has overshadowed a wider trend that has already been underway for some time: the use of digital health to transform treatment. There should be no doubt about the pandemic’s disruptive effect and the rush to digitize that it has ignited. But as with all rushes, there will be winners and losers, successes, and errors.

COVID-19 has moved digital health forward, but there exist areas that still face challenges

At the HIMSS & Health 2.0 European Conference, experts discussed the impact of digital technologies on the COVID-19 responses in Europe and some existing challenges in pushing digital health further. Some challenges were noted by Dr. Pravene Nath, MD, Global Head, Digital Health Strategy, Personalized Health Care, Roche, US, especially in the areas of access and administration, operations, and personalization.

  • Telehealth has been common in terms of access and administration over a short period, but it is still very uneven in terms of addressing all communities and the real smooth experience required to minimize uncertainty at a time when there is a limited supply
  • In operations, he said that demand forecasting, supply chain management, capacity management, and technology are important and ready for that. If these technological tools can be distributed to healthcare providers, they can make tactical decisions with real data in real-time
  • Finally, Dr. Nath noted that there is still some way to go in digitally activated, condition-focused (personalized) care, such as remote patient monitoring when combined with a care delivery model that enables moving beyondthe encounter

Hospitals are behind the digital health adoption curve

According to new research from Unisys Corporation, close to two-thirds of healthcare providers rate themselves as being behind the curve on their digital health implementation initiatives. HIMSS surveyed 220 health IT decision-makers/influencers in U.S. hospitals and health systems on behalf of Unisys and asked them to rate their company based on how they utilize digital and mobile technology to enhance patient service, lower the cost of delivering treatment and increase the performance of clinicians/staff. Then they were ranked as ahead of the curve (early adopters/early majority) or behind the curve (late majority/laggards).

Survey results found that 64%rated themselves as being behind the curve, including 20% who were rated as laggards. Notably, when it came to new technology adoption and deployment, only 11% of organizations were rated as early adopters.

Four obstacles to digital health adoption in hospital & health systems

Behind the curve, respondents cited digital health adoption challenges when asked about the obstacles to advancing digital health initiatives:

  1. Resistance of the clinician in introducing new solutions (51%)
  2. Difficulties with combining legacy systems with modern digital/mobile technologies (50%)
  3. Availability of experienced IT personnel (48%)
  4. Cybersecurity hazard identification/remedialization (45%)

Some potential challenges associated with the rapid, mass adoption of digital healthcare technology are:-

  1. The limitations of remote care

Another revealing statistic to come out of the pandemic is that there was reported to be a 42% drop in Attendances and Emergency (A&E) attendances in May 2020 as compared to May 2019 (according to NHS performance summary report Apr-May 2020). There are likely a multitude of reasons for this, including less trauma because of, for example, significantly reduced vehicle use and less contact sports being played, as well as less (non-COVID) illness and disease circulating in the community because of reduced societal contacts. However, there is undoubtedly a cohort of people who will have been too frightened to attend A&E and who may be finding other ways of getting treated without going to hospital, for example via video consultations with their GP.

  1. Digital Exclusion

Also, those that are most likely to encounter chronic health conditions such as diabetes, cardiopulmonary disease, hypertension, obesity, as well as poor mental health are the same groups who are least likely to interact with digital healthcare. For such groups, the rush to digital may well worsen health inequality and increased isolation as a visit to the GP becomes more difficult, if not impossible.

  1. Commercialising Data

Although patients may be prepared to support the use and promotion of anonymized health data for the good of a larger community, the use of data, which is lacking in accountability and intended to advance corporate interests and shareholder returns, may be less accommodating for them. The potential for their data to be exploited by insurance providers or in cases where it could result in other types of data-driven discrimination is another Red Line issue for patients.

  1. Data driven discrimination

Some may presume that grubby human bias would inherently be more impartial and less likely to tarnish the algorithms and machine learning that underpin many digital health solutions. That however may not be the case. Broadly speaking, algorithms are nothing more than encoded procedures or instructions, but it is knowledge that is the basis of all and information can discriminate just as much as individuals because, for instance, it is incomplete, poorly chosen, unrepresentative, obsolete, or just plain wrong and algorithms can also perpetuate prejudices.

  1. Legal liability

What happens when a decision is made or alerted by AI that causes patient damage, is a pertinent problem for digital health. In the end, where does liability for unintended harm lie? Should those who supply or curate the data sets on which the AI depends be held responsible or those who construct and code the AI; those who validate it; those who run it; or those clinicians whose decisions are supported by it?

The way health services are delivered and consumed has been altered through digital health, and COVID-19 has accentuated some of the benefits and possibilities of innovation in this sector.Yet these new healthcare delivery media present new problems, risks, and threats that cut to the very root of who we are as individuals and communities, and itwould be wise not to lose sight of some of the constraints of digital care, and the need to take everyone along on this journey.

References:-

  1. https://www.healtheuropa.eu/rapid-mass-adoption-of-digital-health-technology/103842/
  2. https://www.healthcareitnews.com/news/emea/covid-19-has-pushed-digital-health-forward-challenges-still-persist
  3. https://hitconsultant.net/2019/04/08/digital-health-adoption-barriers-hospitals/
  4. https://www2.stardust-testing.com/en/the-digital-transformation-trends-and-challenges-in-healthcare

FDA Launches the Digital Health Center of Excellence

The Digital Health Center of Excellence (DHCoE) has recently been launched by the US Food and Drug Administration (FDA), strengthening the digital change that the healthcare industry has already embraced.

In the future, within the Center for Devices and Radiological Health (CDRH) of the department, the program will serve as a coordination platform to help with relevant regulatory activities and to provide the FDA as a whole with digital health policy expertise.

As the new center’s first director, the agency named Bakul Patel, who has helped lead the FDA’s regulatory and scientific efforts covering digital health devices since 2010.

The DHCoE is tasked with providing expertise to help accelerate access to digital health tools that are secure and reliable. In this sense, the Digital Health Center of Excellence is building a network of digital health practitioners and is participating in Collaborative Communities to share expertise and experience with FDA workers on digital health issues and goals.

Despite strong overtures in this market, digital health continues to face major challenges, including data consistency, assessment of the reliability of treatment outcomes, and issues of integration between innovative parties.

In digital health exploration, the DHCoE is a much-needed catalyst and aims to overcome these challenges by reducing risk and connecting the innovation dots across the digital health space that encompasses consumer health and wellness wearables, digital health technology, mobile health technology, medical device software (SaMD), and medical product testing technologies.

In addition to providing technical guidance, organizing and encouraging work across the FDA, advancing best practices, and reimagining digital health device oversight, DHCoE’s goal is to enable both internal and external stakeholders to advance health care by facilitating responsible and high-quality digital health innovation.

The Digital Health Center of Excellence has the following objectives:

  • Connect and build alliances to drive developments in digital health
  • Connect and build partnerships to accelerate digital health advancements
  • Share knowledge to increase understanding and awareness, drive synergy, and encourage best practices
  • Innovate regulatory approachesto provide efficient and least burdensome oversight while meeting the FDA standards for safe and effective products

The FDA anticipates the following developments in digital health by achieving the above objectives:-

  • Strategically advance science and evidence for digital health technologies that meetS the needs of stakeholders
  • Efficient access to highly specialized expertise, knowledge, and tools to accelerate access to digital health technology
  • Aligned regulatory approach to harmonize international regulatory expectations and industry standards
  • Increased awareness and understanding of digital health trends
  • Consistent application of digital health technology policy and oversight approaches
  • Reimagined medical device regulatory paradigm tailored for digital health technologies

Since the beginning of the Covid-19 pandemic, the FDA has also taken steps to expand access to digital health resources. For example, the agency temporarily waived certain limitations on the use of software tools for mental health, allowing low-risk digital health products to be sold without a 510(k) premarket warning to the public. But certain quality controls, including software testing and cybersecurity standards, also had to be satisfied.

As part of an effort to modernize digital health policies and regulatory approaches and provide efficient access to highly specialized expertise, information, and resources to accelerate access to secure and effective digital health technologies, the FDA will continue to develop and formalize the organizing framework and operations of the Digital Health Center of Excellence.

References:-

Fundamental Lessons Learned from COVID-19 Pandemic

As the pandemic is gradually loosening its grip across the globe, there are several reforms underway. Learning from the pandemic and adopting new ways of thinking are imperative to move on the road ahead. Here are some common lessons learned during the COVID-19 pandemic:-

Lesson One: Build Resilient Health Systems

To fight pandemics as they break out, future healthcare systems should be war-prepared. We have near-complete awarenessof tackling big killers such as heart disease, cancer, lifestyle disorders, AIDS, etc., but not a virus. We also need to look at our healthcare setting, particularly, the critical care section.

A resilient health system for rapid identification, evaluation, reporting, and response to novel outbreaks is the most critical aspect of pandemic preparedness. All countries are mandated by the International Health Regulations regulating pandemic response to have core health system capabilities, including surveillance, laboratories, human resources, and risk communication. Health services also need to include the ability to screen, diagnose and treat infectious diseases.

While high-income countries have strong health systems, they often lacked the adequate capacity to treat large numbers of patients with COVID-19 or to protect health workers from infection. If hospitals become overwhelmed, resilient health systems need expanded capacity to deal with health emergencies.

Lesson Two: We Need To Set ‘Early Warning Systems’ In Place In The Society

Unlike in the past, Viruses are not only ‘hyperactive’ in the 21st century, but often leave their tales of destruction with ‘viral speed’. This is due to globalization. The second lesson, therefore, is that the globalization of air-connected countries cannot be stopped, but when an unknown virus breaches its walls and leaps on humans, alarm bells should come early enough. That did not happen in the case of COVID-19. The virus might have been contained in small pockets if an early warning system had been in place and if nations had separated themselves.

Lesson Three: Invest in Biomedical Research and Development

Science’s credibility is necessary but inadequate. Governments must invest in biomedical research and development on a sustainable basis, not only during the health crisis but also during the interpandemic period. The Commission on the Public Health Risk System for the Future, following the West African Ebola outbreak, proposed an incremental increase of $1 billion a year to promote the research and development of emerging medical technologies. Given the economic destruction of the pandemic, even $1 billion annually is far too poor, with the World Bank forecasting a 5.2% contraction in global GDP in 2020. The R&D Blueprint for COVID-19, a World Health Organization (WHO) project, illustrates the enormous undertaking needed to produce safe and efficient therapeutics and vaccines.

Lesson Four: Many Enterprises Don’t Truly Understand Their Supply Chains

Some organizations may have noticed that in their supply chains there were crucial points of vulnerability that were not known until the pandemic strained them. Supply chain management strategies were not adequate for COVID-19’s volatile climate, including demand fluctuations, partners who unexpectedly halted or suspended operations, and unexpected shortages of materials and goods.

Lesson Five: There’s No Hiding From COVID-19

Enterprises cannot easily replace any third party whose output has been affected by COVID-19, as the vast majority of suppliers have been affected in any given sector or industry. For many companies, this has brought supply chain resilience to the foresometimes in painful ways. The World Economic Forum commented on its website, “The COVID-19 pandemic has changed the business environment for many organizations around the globe, highlighting the importance of being able to respond, adapt and set up crisis management mechanisms to cope with uncertain weather conditions.”

Enterprises can’t simply replace every third-party whose performance was impacted by COVID-19, because the vast majority of suppliers in any given sector or industry were affected. This brought supply chain resilience to the fore for many organizations … often in painful ways.  On its website, the World Economic Forum commented, “The COVID-19 pandemic has changed the business environment for many organizations around the globe, and has highlighted the importance of being able to react, adapt and set up crisis management mechanisms to weather situations of uncertainty.”

Many enterprises are now seeking new ways of thinking and partnering with their third parties to be more resilient in the future, after surviving and recovering from supply chain challenges and disturbances during the pandemic.

Lesson Six: It’s All About The Ecosystem

At the beginning of the pandemic, the supply chain problems showed the need to change the buyer-seller relationship from “transactional” to “symbiotic.” Even the term “supply chain” seems obsolete, since the modern extended business is an ecosystem of relationships across third, fourth, and even fifth parties, rather than a single one-to-one relationship chain.

Some companies do not fit well into the current extended business ecosystem. For example, conventional distributors that traditionally operate at low margins may be less reliant, leaving them dramatically vulnerable during disruptive events. Instead, the connections between buyers and suppliers may be more direct and the importance of near geographical proximity may be more concentrated.

Lesson Seven: Build A Circle Of Trust

When they are struggling, suppliers need to be able to connect more freely with purchasers, and not fear that this transparency will cause them to be left out of the supply chain. Enterprises need to shift the dialogue with suppliers by making it clear that by helping distressed suppliers recover, they can “take on a bit of risk to manage risk.” This may include offering guidance on management and operation or even financial support.

Lesson Eight: Embrace Technology For Faster Response

The need for (and lack of) real-time, actionable third-party risk management (TPRM) data was exposed by the pandemic. At the start of a crisis, this type of data helps organizations to rapidly “connect the dots” and make important, educated decisions. To build this kind of real-time TPRM data platform, few organizations have invested in the infrastructure and master data management (MDM) processes needed.

Some valuable lessons on supply chain resilience have been taught by COVID-19, and organizations that put those lessons into action will be better equipped to survive the next big disruptive event. In a crisis scenario that was part of the beginning of the COVID-19 pandemic, anyone that can adapt their approach to third parties and implement technology in a way that provides genuine, real-time visibility into the extended business environment will be able to prevent uncertainty in supply chains around best practice. The major question that companies should now ask is if they have learned from these experiences and are making the necessary adjustments to improve themselves and be better prepared.

References:-

  1. https://jamanetwork.com/channels/health-forum/fullarticle/2769600
  2. https://www2.deloitte.com/global/en/blog/responsible-business-blog/2020/five-lessons-learned-from-covid-19-recovery.html
  3. https://www.expresshealthcare.in/blogs/eight-key-lessons-to-learn-from-covid-19-pandemic/419184/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264722/
  5. https://www.global-solutions-initiative.org/press-news/fundamental-lessons-from-the-covid-19-pandemic-global-solutions-summit-2020-opening-address/