Remote healthcare ready to seize tectonic Covid-19 moment

"This is a time of tectonic shifts," said Jonathan Adiri, co-founder and CEO of Healthy.io during a panel on digital health hosted on Sunday by Hagar Ravet as part of Google and Calcalist’s Startup Week. "We are experiencing extreme acceleration and as an industry, we are reaching a moment of natural selection. Those companies that were ready to scale will grow and those who weren't won't. Our focus has always been on our kit for home urine testing and while six months ago we had to explain why such a test needed to be done from home, the question now is why would anyone go to a lab? This dynamic has tripled our usage rate in less than six months."

Adiri explained that remote medicine has experienced an inverted U-shape growth. "There was great growth from March to May, but then a big drop off as people learned how to live with Covid-19," he said. "meanwhile, our growth has continued as the need for home testing hasn't dropped among pregnant women or those we don't want visiting labs because of their weak immune system. As with any period of natural selection, this requires a lot of adaptation. For example, our cooperation with retail pharmacy company Walgreens Boots, with its 1,400 branches was erased in a single day due to the lockdown. So in one day, we created a partnership with a delivery company that provided our service directly to the customer's home."

We were promised a new normal and that we won't need to visit doctors anymore but that hasn't happened.

"We can call it an upgraded normal," said Dr. Yaron Daniely, Head of aMoon Alpha at the VC fund. "We are looking at this like a tsunami that washed ashore and is now retreating and we are left with the question of what has survived on the beach. We know that remote medicine is dropping back to around 20% from something like 60% to 70% at the height of the lockdown. But prior to Covid-19 remote medicine only accounted for single-digit percentages. In an ocean of an industry like healthcare, which has a market of trillions of dollars, this increase creates massive value."

Esti Shelly, Director of Digital Health at Israel's Ministry of Health, explained the challenges caregivers face with remote medicine. "We saw a really big rise caused by the emergency restrictions and the big challenge then was to make the adaptation from a professional standpoint. How do doctors and caregivers take this leap and believe that they are giving the patient good service through remote medicine? This means risk management and the ability to communicate with a patient and knowing in what cases you can provide a complete response remotely and in many cases, it requires having the right tools to provide a service that isn't inferior to physica meeting the doctor.”

Is this also a case of providing appropriate training for doctors?

"Absolutely. They don't teach remote healthcare in medicine school. They teach you to touch and look in the patients’ eyes, which is part of the ethos of the profession. We are beginning to see a change and are supporting it in recent months. We have set up a professional community of remote medicine to support it."

"Health is one of the most searched sectors on google," said Uri Bielski, Industry Head of eGaming and Healthcare at Google. "According to research we conducted we have seen that over 80% of the people want to research before making a decision. People are looking for reviews and recommendations and are of course interested in different ailments. This is a sector that grew by 15% a year prior to Covid-19 and this year has grown by 40%. Many of the new searches are related to coronavirus. It has slightly settled down and now we are seeing the strengthening of trends we exhibited beforehand, like receiving home care. People are looking for home solutions and what has increased the most is searches for advice from home."

So far we have spoken about remote medicine as a whole, but the Israeli health system is very different from other health systems across the world. Does this help it in adopting remote medicine?

"It is like comparing oranges and kangaroos," said Daniely. "In the U.S. the health system is very distributed with a large client base. There is something very challenging in that the stakeholders in this sector are different. There is a big difference between the city and the towns and between public and private insurance.

"In the Israeli health system, the medical service is extraordinary, you have a single payment and it is run well. But there is friction with the political echelon. What we are seeing during the second wave of Covid-19 in Israel compared to the first wave is the opposite of what we saw in the British system, with which we work very closely. In Britain, the political echelon had great difficulty working with the medical establishment during the first wave and that resulted in many deaths, compared to the preparations they have made for the winter which were done in full harmony. There is a very big challenge, even for countries that have a good healthcare infrastructure like Israel, if there isn't trust and efficiency with the political echelon. What we are seeing now in England ahead of the winter is long-term planning and processes taking a few months instead of a decade. Scaling in medicine isn't about technology but trust. If you have wonderful technology but doctors don't believe in it you have done nothing."

Shelly said that the ministry has transferred over NIS 1 billion (approximately $290 million) to the local HMOs to prepare for the winter. "A large portion of that money, over 40%, is meant for remote medicine and home care. Regulators have also provided quite a bit of relief. If remote care is just an addition to a physical visit we have done nothing, especially in a packed public system like in Israel."