Tools as a Bridge for Comprehensive Healthcare
As adoption of Connected Health systems increase, emerging technologies and platforms will be developed to address the most critical gaps in our existing healthcare infrastructure: telehealth for congestive heart failure, home healthcare for veterans, access to specialty physicians, and continuity of care with primary care providers, remote intensive care, and medication adherence. Further, increased mental health support, with accompanying medication adherence, will be critical to patients as a new normal is achieved following the outbreak of COVID-19.
Significant shifts have occurred in the way healthcare is delivered and the specific medical needs of patients in the aftermath of COVID-19. Social isolation, loss of economic gains, and increased workload were all contributing factors leading to a decline in mental health, particularly for women with young children. In fact, more than 83% of women reported a deterioration of mental health through 2020, compared to 36% of men in the same demographic.i For many of these patients, visits to their doctor were among the little contact they had during an isolating year.ii,iii This has spurred recognition that the relationship between doctor and patient can vastly improve healthcare outcomes, provided that the relationship is easily accessible and contact is on-demand. We’ve come full circle…and are now returning to the house call, albeit adapting the house call to a digital age.
Recognizing the shift toward remote health and big data in healthcare, Walmart recently announced the acquisition of telehealth provider MeMDiv,v, allowing the retail giant to improve patient engagement and improve healthcare equity and outcomes while lowering healthcare costs across all populations. Acquisitions and partnerships like this will provide customers with ready access to virtual, urgent, behavioral, and primary care just when it’s most needed.
These shifts in healthcare are more than just a temporary blip on the industry radar. With major players moving into telehealth, meaningful, cost-effective devices will be necessary to connect patients to physicians in real-time.
While autoinjectors can address the treatment of many chronic health conditions, it is only one tool available to physicians to ensure continuity in medical care within the safety and confines of a home environment. On-body wearable injectors (OBI) represent a meaningful platform to bridge the gap between autoinjectors and in-clinic care.
OBIs are device platforms with optional connectivity expected to fill important gaps in healthcare infrastructure and connected health services. OBIs are expected to experience a 16% compound annual growth rate through 2025vi, with growth potentially exceeding these figures as OBI is leveraged to treat acute COVID, as well as the after-effects of an illness.
Currently, a rise in chronic ailments stemming from COVID morbidity will partially fuel growth in the adoption of OBI solutions as patients with chronic pulmonary, cardiovascular, and neurological conditions begin to manage the long-term effects of the disease. Approximately 146 Million patients have recovered from COVID globally,vii with approximately 1/3 of these survivors requiring support for the treatment of conditions described as “long-haul”.viii Patients with chronic diseases are demanding a shift from clinic to at-home drug delivery to protect themselves from COVID exposure in the clinicix, and understanding that conditions like immune deficiency disorders result in not only vaccine resistance but also predispose patients to prolonged illness due to COVID.x
Infused therapies account for USD $35 Billion in the specialty drug market. It is estimated that shifting these treatments from hospital or clinic to home may confer 30-70% cost savings to both the patient and the healthcare payer.xi OBI solutions are particularly well-suited for infusion therapies, as the pumps are designed to deliver large doses over minutes, and even hours; biologics and high viscosity drugs, including chemotherapy, monoclonal antibodies, and drugs targeted to auto-immune, blood, and genetic disorders are commonly combined with OBI devices to support patient care at home and as an alternative to in-clinic care.
Patient-Centered Design
The creation of technology platforms to deliver remote care through combination devices isn’t sufficient to create winning strategies. Devices must be designed and manufactured to be simplified for efficacy and to mitigate use errors.xii Many OBIs have complex circuitry with batteries, pumps, and wiring. This not only raises the physical profile of the device and creates a noisy operation, which minimizes patient discretion, but this circuitry prevents the inclusion of additional operations, like connected health capabilities.
Emerging OBIs have found ways to eliminate the circuitry common to basic OBI operations.xiii These new devices and designs allow for lower profiles and more reliable operation; in theory, this streamlines FDA approval of any drug-device combination leveraging novel, circuit-free designs. The FDA is increasingly emphasizing human-factored design for drug-device combinations, including OBI platforms, understanding that devices tested in the laboratory may not have the same functionality and reliability when used in the home.xiv Devices designed with human factors in mind are often simplified, conferring patient discretion when wearing the device and device reliability and manufacturing robustness. Perhaps most important in the future of healthcare, simplification of OBI devices opens the device to greater flexibility in coupling with connected health functionality, as the device body is not already consumed by pumps and batteries.
A core component of patient-centered device design is the inclusion of connected health, not only so that patients can interact with their physicians but to allow them the discretion of controlling the OBI device with something they have on hand and use every day – their smartphones.xv Connecting OBIs to cloud data allows physicians and nurses to monitor patient data and medication adherence to regimens historically delivered in clinics or hospitals. In addition, this connected health format increases the frequency of physician-patient interaction, allowing opportunities to reward the patient for medication adherence through gamification or other incentives, providing the patient with both encouragement and accountability to improve medication adherence and healthcare outcomes. In this new area of space-age technology, we can leverage the combination of high tech to deliver medical care of a prior era – the house call – through the marriage of connected health and elegant and simplified platform devices, including the on-body wearable injector, as part of a comprehensive and innovative strategy that delivers a seamless series of connected devices to help people around the world lead happier, more productive, lives.xvi
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iii https://www.frontiersin.org/articles/10.3389/fgwh.2020.00001/full
ii sustained
iii https://www.cnet.com/features/our-mental-health-crashed-in-2020-recovery-could-take-years/
v https://www.auntminnie.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=132327
vi https://finance.yahoo.com/news/wearable-injectors-global-market-report-105400727.html
vii https://www.worldometers.info/coronavirus/
viii https://www.webmd.com/lung/news/20210219/a-third-of-covid-survivors-have-long-haul-symptoms#1
x https://www.washingtonpost.com/health/2021/05/18/immunocompromised-coronavirus-vaccines-response/
xii https://www.mddionline.com/digital-health/unlocking-future-patient-use-combination-devices
xiv https://drug-dev.com/the-rise-of-the-bolus-injector-a-new-device-class-enabling-long-duration-subcutaneousadministration-of-large-dose-volume-biologics/
xv https://www.ondrugdelivery.com/connected-health-future-effective-drug-delivery/
xvi https://www.marketplace.org/2021/05/19/pandemic-innovation-high-tech-family-doc-brings-back-the-housecall/