James Feindt, Marck Aghnatios and Alistair Fleming look at the benefits and opportunities of migrating care from hospital to the home environment, as well as the Medtech challenges it creates

Traditional healthcare is increasingly taking place in patients’ homes, as it offers the potential to reduce costs, deliver more flexible care, and provide better access for patients.

Pre-pandemic, significant indicators like the length of stay and inpatient visits per capita had been declining, while the number of outpatient visits were rising. Better treatment options have diminished the volume of invasive procedures and consequently the length of recovery time. Medical technology innovations have paved the way to continue this shift post-pandemic through connected devices which allow patients to be treated and monitored outside a hospital setting.

This shift in the point of care brings about complex challenges, including adapting solutions to a home setting, the absence of in-person clinical support, and increased reliance on the patient as a user and increasingly as a direct consumer. MedTech companies that can navigate these changes have an opportunity to be at the forefront of an emerging health care industry.

Rethink engagement to deliver directly to the new buyers
The hospital setting offers advantages for patients including continuous monitoring and immediate access to health professionals, but the pandemic has accelerated care into virtual and hybrid models. Remote care involves different health professionals and new ways of interacting, with more choice for patients who can now interact directly with product providers. Patient engagement and market access models are likely to continue to change as medical device companies develop new technologies that enable quality care to be delivered in a home setting.

For device developers, the opportunity exists for their products or services to be sold directly to the patient rather than providers. Patients are becoming increasingly savvy and educated on their care options, and a shift to patient-centric care is placing patient needs and wishes centre stage. MedTech will need to radically rethink existing business models to find ways to engage directly. This may involve approaches such as partnering with community clinics, providing leasing models, enriching solution provision with interaction and advice, and building more disease-centric offerings that entrain and retain loyalty.

The opportunity is for radical, not incremental change
Covid-19 was a catalyst for a marked step forward in remote health provision. It has been stated that telehealth uptake has been accelerated by around three-five years due to the pandemic. Before this, solutions were emerging around connected devices and digital support tools. Many of these represent small but significant steps, while some sit at the more disruptive end of the scale such as the implementation of data aggregation to predict hypoglycaemic events with Medtronic’s IBM collaboration project SugarIQ.

There are signs of dramatic shifts in the capabilities of communications, power and processing technologies that open a realm of new possibilities. Wider trends are also evident – a future home healthcare landscape may be hyperconnected, prevention-focused, precision targeted and holistically informed. We have also witnessed the pace of innovation increase significantly in the past 18 months.

As we look to the future, we believe that the opportunity exists for more fundamental change. By utilising future-sight strategic tools such as business wargaming or scenario planning, MedTech companies can place themselves in worlds five or ten years into the future, and explore how evolving technologies, markets and attitudes could shape their ability to meet the needs of tomorrow.

Value-based care and data sharing opportunities are promoting greater collaboration
The emphasis from governments and Insurers on optimising care provision through outcomes-based reimbursement is driving strategies focused on disease and patient rather than symptom and product. This mindset promotes preventive solutions, increased diagnostics and monitoring and better connectivity. In the context of transitioning point of care, MedTech can help to bridge the physical gaps between care settings by seeking deeper patient engagement across the care-pathway.

This might be achieved through the expansion of complementary services, acquisitions or partnerships to gain access to a more comprehensive coverage of disease stages. Improved visibility and influence over the patient journey should lead to better decisions, more effectively targeted interventions and more efficient allocation of resource.

It is equally important to consider the impact of vertical integration. We have seen an explosion in patient data generation in recent years, but our healthcare systems and regulations are still evolving to accommodate best use of the opportunities this offers. Such limitations are emphasised as care provision becomes more physically spread. Whereas historically, one provider may have been the originator and custodian of requisite patient data, in today’s world, this could be spread between primary and secondary care, local clinic, home care providers, patients and consumer health companies.

For MedTech companies, it can be a bewildering landscape to navigate. Data regulation is far from harmonised, and while there is a growing sector offering data translation between the electronic medical records and hospital information systems providers, challenges remain albeit with success stories. Once again, the pandemic has shown how a common purpose can unlock powerful collaborative networks such as the COVID-19 Clinical Research Coalition.

Looking forward
Technological innovation has opened a path forward to evolve our healthcare system and make significant improvements to patient care by transitioning from hospital to home. This transition will be increasingly complex as more care moves to a patient’s home, but it will also be the solution to improve healthcare coverage with increasing demand. The pandemic has forced regulatory, medical device, healthcare and pharma into action and these industries stand to benefit if they can meet the call to offer value in the new model for care.

Jointly authored by James Feindt, healthcare expert, and Marck Aghnatios and Alistair Fleming, MedTech experts at PA Consulting.