Delivering healthcare at the touch of a button - LEK Consulting

Page created by Glenn Robbins
 
CONTINUE READING
Delivering healthcare at the touch of a button - LEK Consulting
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
Delivering healthcare at the touch of a button - LEK Consulting
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
Delivering healthcare at the touch of a button - LEK Consulting
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 -   LaingBuisson
FIGURE 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 global
You can also read