Delivering healthcare at the touch of a button - LEK Consulting
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Indepth
The Covid pandemic has forced healthcare providers and patients into the
remote world of virtual consultations and telehealth, but it has also accelerated
the move to direct-to-consumer diagnostic testing, as L.E.K Consulting partners
Klaus Boehncke, Guillaume Duparc and Leah Ralph explain
Delivering healthcare at
the touch of a button
A
s Covid ravaged countries consultations over a two-month period, But it is not just telehealth that has
around the world, a dramatic while the number of publicly funded boomed as a result of Covid. The impact
transformation of the traditional teleconsultations in Australia reached of Covid’s requirement for care-at-a-dis-
healthcare system began to around 10 million in just two months of tance combined with other healthcare
take place. No longer could patients get launching. Globally, 50‒80% of patients trends is heralding the fourth wave of
a face-to-face consultation with their GP; and doctors tried telemedicine for the digital health. This is characterised by
instead, symptoms and sickness were first time during the pandemic.1 growing, consumer-centric business
discussed over the phone, via video call Face-to-face consultations have re- models, the burgeoning interest of tech
and through apps. turned as Covid restrictions have eased. firms in health and the rise of user-gen-
Covid did what the digital revolution However, the use of telehealth has con- erated data, where artificial intelligence
has currently struggled to do – it marked tinued and remains at a level higher than and data analytics also come to the
the tipping point where telehealth sud- before the pandemic. It’s not going to fore. It takes us beyond a health-system,
denly became mainstream. disappear back into the woodwork either provider-centric focus on eHealth to an
The accelerated use of virtual consul- because, for the most part, healthcare era where the patient sits firmly in the
tations is nothing short of momentous. providers and patients have found virtual centre, where healthcare is delivered
In the US, telemedicine provider Amwell consultations work well and are very remotely rather than in the traditional
reported a 3,000% growth of remote convenient. healthcare setting.
30 | AUGUST/SEPTEMBER 2021 | HM
UK - LaingBuisson
FIGURE ONE
OUR CURRENT FOURTH WAVE OF DIGITAL HEALTH WILL BE CHARACTERISED BY REMOTE CARE, GREATER PATIENT
CENTRICITY AND IS NOT LIMITED TO ‘SICK CARE’
1st Wave 2nd Wave 3rd Wave 4th Wave
Technology in Health ICT eHealth Digital Health
Health
distanceisisno
Care at aa distance nolonger
longer
Industry Healthcare setting/ Health system focus confined to thep
the physical
hysicalc care setting
are setting
agnostic organisation focused Shared health records and (e.g.
(e.g.hhome
omet testing, telemedicine,
esting, telemedicine,
Pervasiveness of digital health in society
Corporate Practice management information exchange remote monitoring)
monitoring)
functions systems Patient following but still Citizen and
and consumer
consumercentric
centric
(accounting, Clinical systems - large provider centric (choose where and
(choose where andhowhowtotoengage
engage
payroll) integrated systems, best of HCPs, whereetos
HCPs, wher to store data,who
tore data, whototo
Governments as key players share
Mainframes breed systems share itit with,
with, and
and service
servicemodels)
models
Healthcare as a process
Corporate applications for New entrants (startups, big tech,
Data still provider originated insurance, other industries)
logistics and performance
and
management Industry and role convergence
provider
Health service provider (health service boundaries
controlled
centric overlapping with others)
Emerging -server Origin of data outside of traditional
care settings
AI and data analytics play major roles
and enable new capabilities (digital
twin) and models of care
Broader than health (lifestyle,
prevention, mental health, social
services, disability, aged care)
c.1950–1960 c.1970–2005 c.2005–2020 c.2020 and beyond
(and ongoing) (and ongoing) (and ongoing)
SOURCE DAVID ROWLANDS, L.E.K. RESEARCH AND ANALYSIS
In this wave, healthcare also becomes plex, the samples can be sent off to the Direct-to-consumer diagnostic testing
more than just about sickness – it lab by the patients themselves or can is merely an extension of this trend that
becomes about lifestyle, mental health, be collected from patients’ homes by a leverages telemedicine. Our research
social situation, prevention and self-care. courier for analysis. This tends to be for and analyses show that typically in a
more sophisticated tests such as saliva telemedicine consultation 50‒80% of
samples, genetic tests, sexually trans- patients will be issued a prescription. In
The rise of D2C testing mitted infection tests, nasal swab tests 10‒20% of these cases the medication
Within this new landscape, we are now like the Covid PCR test and stool tests. will be delivered straight to the patient’s
witnessing the rise of direct-to-consumer Results are then provided to the patient home, and in the remaining cases, the
(D2C) diagnostic testing. This market either directly in digital format or via a medication has to be picked up from a
was already growing pre-pandemic, medical professional (see Figure Two). pharmacy by the patients themselves.
and this has now accelerated, driving In contrast, 40‒50% of telemedicine
annual growth of c.26% CAGR to reach appointments resulted in a diagnostic
more than $30bn globally in the next ten
The maximisation of test requirement, and only 3‒5% of pa-
years.2 convenience tients were sent a home testing kit.
D2C diagnostic testing allows consum- This shows that there is considerable
ers to use test kits at home that can be Direct-to-consumer diagnostic testing potential for a better overall telemedicine
bought from a pharmacist, ordered on- is part of a bigger trend that we refer to experience with both prescription drug
line, or delivered to the home following a as the ‘maximisation of convenience’. delivery as well as at-home-testing. As a
telemedicine consultation. They can then Over the past few years there has been result, we are seeing many companies
carry out the required examination by significant growth in digital home deliv- jumping on the bandwagon and incor-
themselves in the comfort and conveni- ery. Think Amazon, Deliveroo, and online porating testing as part of their offering,
ence of their home. Simple tests that are grocery shopping, where you shop online and a broad range of D2C testing busi-
well known include those for Covid-19 from the comfort of your home then wait ness models.
(lateral flow), pregnancy and urinary tract for the doorbell and your delivery. For instance, many traditional lab and
infections. Results are delivered very This convenient home shopping trend diagnostic firms have, even before Covid,
quickly either through the test kit itself was dramatically accelerated during set up consumer arms, while a raft of
or via an accompanying smartphone app Covid, and as a result, for example, 48% D2C start-ups have entered the space.
(e.g. by taking a photo of a testing strip of UK consumers purchased a product In the US, LabCorp has a consumer di-
that is then analysed by the software). online during the pandemic that they had vision, Pixel, that offers home collection
If the diagnostic tests are more com- never purchased online before.3 tests for colorectal cancer and Covid that
laingbuissonnews.com | AUGUST/SEPTEMBER 2021 | 31
Indepth
FIGURE TWO
IN THE MARKET TODAY, A VARIETY OF HOME COLLECTION SAMPLING METHODS CAN BE USED TO TEST FOR A VARIETY OF
CONDITIONS
Blood prick Urine sample Stool sample Saliva sample Nasal swab
l Diabetes l Chronic kidney l Colorectal cancer l Genetic testing l Covid-19
l Cholesterol disease l Calprotectin (IBS) l Covid-19 l Influenza
monitoring
l Thyroid function l Peptic ulcers
l STI
l Kidney health l Clostridium
l PrEP monitoring difficile toxin
l HIV
l Iodine level
l Hepatitis
l Hormone
l Pregnancy
NOTE NON-EXHAUSTIVE
SOURCE COMPANY WEBSITES; L.E.K. RESEARCH
can be purchased out of pocket without introduced at home genome and blood Apple Watch, Google Fitbit and others
a doctor’s visit. Competitor QuestDirect testing for its AI supported personalised broaden this to include measurements
offers diabetes, colorectal cancer and nutrition service.4 such as heart rate, ECG, blood oxygen,
Covid home collection tests that can be In addition, large eCommerce and sleep quality. Blood glucose is likely
purchased online. platforms have started to specialise in to be the next big step in this list5 which
healthcare products in recent years, of- will have a significant quality of life and
fering an alternative to products bought healthcare outcome impact on many of
The entrance of non- in traditional brick and mortar pharma- the 400m+ patients with diabetes in the
traditional companies cies. Pharmacy2U and Zur Rose are both world. Startups are also ‘following the
good examples of this. Delivery compa- money’ and entering the digital diag-
In recent years, we have also wit- nies, including Uber and Deliveroo, are nostics and digital therapeutics space
nessed another trend in this space – the taking advantage of the D2C trends, and which is increasingly being reimbursed
entrance of non-traditional diagnostic provide same-day delivery. by payors.
companies including dedicated D2C Meanwhile, telemedicine leaders For example, last year Germany
testing start-ups, many of which are including HealthHero, Kry, Teladoc and became one of the first countries in the
centred in the wellness space and who Babylon continue to look for opportuni- world to fund approved digital mobile
offer additional products. For instance, ties to expand their business offerings healthcare apps through statutory (pub-
wellness firm Lykon in Europe combines and are increasingly creating or partner- lic) health insurance.
the use of blood and saliva genome ing with health platforms, governments,
lab tests to offer personalised nutrition insurers and large corporates, which will
and supplements. In the US, Vivoo is a further drive this trend.
Finding a path forward
wellness assistant that focuses on nutri- Alongside these developments, there In the future, we expect the D2C
tion and lifestyle and uses patient data is also substantial growth in testing for testing marketplace to become increas-
from urine tests to provide personalised digital biomarkers driven by the larger ingly complex with a larger variety of
advice, while Numan describes itself as tech players. The ubiquity of smart- players and business models. How the
a ‘digital health company for men’, offer- phones already allows people to meas- landscape develops will also depend on
ing blood tests alongside personalised ure movement, walking balance and how companies approach the challenges
supplements. In Japan in 2018, Nestle activity data, and wearables such as the presented by telehealth and D2C testing.
32 | AUGUST/SEPTEMBER 2021 | HM UK - LaingBuissonFIGURE THREE
TELEMEDICINE PROVIDERS TODAY ARE ALREADY DOING MANY CONSULTATIONS THAT EITHER REQUIRE PRESCRIPTIONS
AND/OR TESTING, D2C TESTING IS EXPECTED TO GROW RAPIDLY
Our current view of the market of D2C prescribing and testing
Remote consultations and e-prescriptions (2020)
Percent (%)
Other l According to a recent report, the globalYou can also read
