PwC's Tech While You Trek: Telehealth Trends

Tune into another episode of Tech While You Trek to hear PwC Managing Director Ben Isgur discuss how the COVID-19 pandemic has accelerated the evolution of healthcare technology, resulting in an increase in telehealth visits. 

Transcript

Tech While You Trek - Telehealth Trends
Guest:  Ben Isgur
Release Date:   May 3, 2021

Adam (00:07):
Hello, everyone. And welcome back to another episode of PwC's Tech While You Trek. I am your host, Adam. And today I have with me, Ben Isgur, head of PwCs Health Research Institute to talk about telehealth trends, specifically how the COVID-19 pandemic has accelerated the evolution of healthcare technology and to see what changes are here to stay. Hello, Ben, how are you today?

Ben Isgur (00:30):
I'm doing great, Adam. Thanks for having me.

Adam (00:32):Absolutely. Please introduce yourself. Tell us a little bit about your background and what got you to PwC.

Ben Isgur (00:38):
Sure. Well, I'm Ben Isgur, as you mentioned, I lead PwC's Health Research Institute. So looking at health trends that face the whole ecosystem of providers, payers, pharma life science companies, and technology companies, employers, government. I got to PwC starting out in health policy. So I used to work in a state government and the state legislature and did some government relations work and then made my way over to healthcare consulting and ultimately, running this healthcare think tank.

Adam (01:06):
So Ben, you've reported that there's been an explosion of telehealth since the pandemic crisis began and PwC's Health Research Institute has done a lot of research on this over the past year. I'm wondering, why are we seeing such a huge increase in telehealth?

Ben Isgur (01:22):
Well, Adam, there's actually a couple of things going on simultaneously and really the pandemic was the accelerator. So if we kind of backed up a moment, we have a lot of technology and innovation changes that allow virtual and telehealth visits, but the real change was the pandemic and the reason it had such an incredible influence on virtual and telehealth is because simply people could not get in to see the doctor. They couldn't get into clinics. They couldn't get into hospitals. The pandemic had an effect about a year ago, shut down a lot of that access. When that became shut down, there was really only one way to go and that was virtually. And so we saw an incredible use. In fact, our own research showed about 17 million consumers use telehealth for the very first time during the beginning of the pandemic. So incredible numbers of first-time users. About an 88% of users tell us they'll use it again. They had a good experience and they're willing to do that, and 53% of consumers who have not used it said that they would like to.

Adam (02:29):
So specifically, what types of platforms or technologies are we talking about here?

Ben Isgur (02:33):
So it could just be a simple conversation with a nurse or a physician. There are video visits. So now you've got the interaction a little bit more in person, right? That better ability to actually see the patient and see some of their issues. But there's also things like texting and chatting, as well. So a lot of ways to communicate information digitally. And I know for many of your tech listeners, they may be listening to that and saying like, "Hey, what's the big deal there." But we do have to remember that healthcare has always been delivered in person with very, very few exceptions to that. So now, we've got a lot of technologies in front of us that we can use for those interactions. We also have things that are called remote monitoring. So you could have a device at home or in another location that's monitoring your heart rate or maybe your blood glucose, your blood oxygen, and that can provide a data stream back to the clinicians that are taking care of you.

So that provides, again, a more of an insight virtually into what your health looks like. And last but not least, we're also moving into the world where we might have more diagnosis by virtual health means. So right now, a lot of our smartphones, they have very powerful cameras. If you have a rash or something on your skin, actually a physician sitting in another state could look at that very well, using a smartphone and actually help provide a diagnosis.

When you expand access, it does give more people a chance to have those interactions. But one of the things that we did see with lack of access at the beginning of the pandemic, and frankly, some of that is stretching on now, it's about a third of consumers told us last spring that they were foregoing care. They just simply weren't getting their visits done. And so the question becomes, if you have that barrier, does it ultimately end up in people actually being more sick than they would have been otherwise? So important stuff to think about.

Adam (04:32):
You've done a really good job, kind of painting a picture of what some of these technologies are. Where do you find these innovations and technologies stemming from? Where are they coming from? Who's doing the innovating?

Ben Isgur (04:44):
I think there's a technology piece to that. And we've seen a lot more collaborations between the traditional healthcare companies and technology companies. And simply if you're outside the health system, you may look at these gaps and say, "Well, why aren't these being filled?” And tech companies and more consumer focused companies have done that. So we see a lot of standalone startup telehealth, virtual health companies that are out there. Many of them are coming from outside "the traditional health system", the traditional large hospital systems, physician offices, and things of that nature. So the other place we see innovation are actually with US businesses, employers by actually including telehealth and virtual health as a benefit for the health insurance. So their angle is, "Hey, we want to keep you healthy. We want to keep you working and in the office or working productively, if you're working at home and not dealing with the health system and waiting in line and being sick.” And telehealth and virtual health is a way to give you that access really quickly and really easily.

So a lot of US employers have been funding this. It's been part of everyone's benefit packages. In fact, during the pandemic, we saw about a 10% increase in employers saying, well, we've added a telehealth benefit.

Adam (06:06):
So then this is all going swimmingly?

Ben Isgur (06:08):
Generally, yes, but there are some problems that we've discovered. And we shouldn't look at this as being a one and done, we've solved the problem. We can wash our hands of it. Actually the reality around virtual health is we've unearthed quite a few gaps that need to be solved, but we think we can do that. So about 53% of consumers that we surveyed said they had some sort of challenge with their virtual visit. Now, some of those can probably be worked out pretty quickly, some of those are just technology issues and as people get more used to them over time, as clinicians get more used to it, we think some of that will go away, but there's some other issues that might be a little bit more difficult to solve.

So some of the consumers said, "Hey, we didn't really understand what the follow-up was from that telehealth visit." It's a little bit different when you're in person, you kind of have that warm handoff of where you go next. We didn't understand where to go. Another issue that we hear about are my problem wasn't solved. Let's face it, not everything is made for a virtual health visit and so that can be a challenge. So I think, look, the bottom line there, Adam, is not everything has gone perfectly, but the challenges are identified and many of them are solvable.

Adam (07:23):
So then what can we expect to see more of? And are there any other kind of longer term issues that should be considered as this technology moves forward?

Ben Isgur (07:33):
About 92% of executives who run our hospitals and health systems say, "Hey, we're using this technology right now for primary care." It's kind of that first interaction when someone's got a sore throat or a fever or any kind of problem like that. But only 17% said they're using it for ongoing care management. So we look at that as a potential big gap that's out there. Why is that a big gap? Because a lot of people suffer from chronic conditions. They've got diabetes, they have a heart condition, they have a condition that is essentially a lifelong condition, but if it's controlled, they can live a healthy and productive life.

We see that as a huge opportunity, let's move our virtual health focus, just to be a primary care focus, but also for ongoing care management. The second area we see a lot of growth is going to be around mental and behavioral health care. Interesting thing about telehealth, people like the mental health visits to be virtual rather than in-person. And so we're seeing lower no-show rates for those appointments. We're seeing very high satisfaction. We think we may be seeing a permanent change where about 85 to 90% of mental health visits are going to be done virtually going forward.

Adam (08:54):
I have to say my own personal experience of the pandemic, were it not for virtual mental health consultations, I don't know what I would have done. And to your point, one of the biggest hurdles in mental health is that comfort level. Even though you're telling yourself like, "This is meant to be about me, this is meant to be a conversation that's about me gaining higher understanding," having to go somewhere else to someone else's office, to someone else's space, even a professional space is a big hurdle. And being able to overcome that from the very get by being in your own home, in your own pajamas, if that's what you need, that was absolutely the thing I needed to get the ball rolling. It was an absolute game changer for me during this past year.

Ben Isgur (09:37):
I think you're sharing a really important story what's happened during the pandemic is more than half of US households have said, "We have someone in our household is having some mental issues right now." And frankly, a lot of the stigma around mental health care is going away because the brain is an organ like any other organ. And we have to take care of it. We have to treat it. The pandemic has really brought those issues to the front. Now, the challenge has always been that it's been very difficult to get mental health care. Behavioral health specialists are in short supply. Often they have long wait lists. Guess what virtual does? It makes it more efficient for them too, they can interact with more of us during the day virtually than when we're coming in in person. So it's really a win-win for everyone.

The other thing I wanted to bring up is that it is technology based and we have to be careful that we don't create a digital divide. There are some people who are very comfortable with technology and they've got it at their fingertips. There are others, depending on what zip code you live in, you may not have broadband. You may not have smart devices. And so we're seeing the health system have to address that Adam, where we're seeing some health systems are in fact, providing tablets to some of their community as a quick one-stop way to, here's how you can get a telehealth visit. You don't even have to have your own device.

Adam (11:00):
That to me just sounds so simple and yet, so revolutionary.

Ben Isgur (11:04):
Yeah, absolutely. If we went back to the origins of telehealth, this is something that's been around since the 1950s, but just really hadn't taken off. We've always used it in rural areas, the space program, the scientists and Antarctica, but it really hadn't taken off in a widespread manner. And so it is, I hate to use this phrase, but in some ways it's a little bit of a silver lining of the pandemic. It showed us that we have this ability and this technology, is it going to solve everything? No, but it does just give us another tool in the tool chest to help people improve their health.

Adam (11:47):
Before I let you get out of here, I want to ask you the question I've been asking all of my guests this season. Are you ready?

Ben Isgur (11:54):
Ready!

Adam (11:55):
What technology or piece of technology would the you of 20 years ago be most surprised that the you of today is using?

Ben Isgur (12:02):
For healthcare interactions, the smartphone. No one, no one thought of this one. If you went back 20 years ago, we were talking about these big technology boxes that were going to go in areas. Essentially, we were creating everything in the world when we actually had it already on us in our pockets, the smartphone.

Adam (12:25):
I remember what an intrusion, a cell phone felt like the first time someone put one in my hands and smartphones now, it's multiple generations of evolution.

Ben Isgur (12:34):
And it's revolutionizing the way that we deliver health care and we get data and it's a two way street. And that's one thing that I think a lot of people forget about.  It's not just about us receiving care through it, it's also a way for us to send data, to participate in clinical trials, to update how we're feeling during the pandemic. So there's this incredible kind of data analytics layer that's being created because of it. So the world's really the limit. We haven't seen it all yet. In some ways we're just in the baby steps where this is going to go.

Adam (13:05):
Ben Isgur, thank you so much for your time, for your expertise and for chatting with us today.

Ben Isgur (13:11):
My pleasure, Adam.

Adam (13:12):
Thank you all for listening to another episode of Tech While You Trek. I have been your host Adam, and we will talk to you again next time.

Speaker 3 (13:23):
This podcast is brought to you by PwC. All rights reserved. PwC refers to the US member firm or one of its subsidiaries or affiliates, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. This podcast is for general information purposes only and should not be used as a substitute for consultation with professional advisors.