But the healthcare market in North America, which accounts for 42 per cent of a US$11.9 trillion global industry, is complex and highly fragmented.

The federal government in the US and state authorities had taken different approaches to tackle the spread of Covid-19, says Andrew Rebhan, a consultant with Advisory Board, a health IT advisory firm based in Washington D.C.

Andrew Rebhan, health IT consultant with Advisory Board

“I wish that the United States had taken some lessons from you guys,” said Rebhan, who was addressing a New Zealand Trade & Enterprise webinar held yesterday on digital health trends.

“We’re in a bad place, we’re actually having a bit of a double-dip and a sense that a lot of our states opened up early, and now they’re actually having to close back up again,” he said of US efforts to grapple with coronavirus infections.

“So that’s unfortunate news.”

But it also signalled an opportunity for health tech providers with digital solutions that could assist US healthcare providers as they settled in for a lengthier period of dealing with community transmission of the virus until effective vaccines and antiviral treatments were developed and made available.

A seller’s market

“It is a seller’s market in a lot of regards,” said Rebhan.

“I would just say offhand, that there’s plenty of providers out there who are scanning the market to see what they can leverage appropriately to be prepared for the next iteration of this pandemic.”

Covid-19 had become a proving ground for emerging health tech that suddenly came into its own due to the need for social distancing and the strain on the hospitals and clinics, particularly in places like New York and Detroit, which became hotspots for virus infections and fatalities.

Virtual and text-based discussions with therapists had taken off, as well as the use of AI-enabled chatbots and symptom trackers for patient screening and virtual triage. 3D printing had been employed across the US to manufacture face masks and respirator values. Data and analytics dashboards had come into their own for capacity planning, patient flow analysis and financial impact analysis.

At a higher level, health agencies were employing population health surveillance and tracking technology, such as the use of smart thermometers to track regional flu spikes and using GPS data from smartphones.

One of the immediate areas of opportunity had been in telehealth. Blue Cross Shield of Massachusetts, a major health insurance provider in the state, reported a 3500 per cent increase in telehealth claims between February and March.

Rebhan said patients had adapted to remote consultations with doctors and specialists 

“Once they try it, even if they’re hesitant at first, they do find that there is at least a significant amount of their care that they can receive virtually if they have all the right pieces in place,” he said.

Source: Advisory Board

Telehealth uptick

But even for the richest country in the world, getting those pieces in place was a challenge. A digital divide still holds back telehealth across the US.

“It doesn’t do a whole lot if you don’t have an internet connection, or the appropriate broadband access, right,” added Rebhan. 

“So those vendors who are in the telecom space, vendors that are pushing 5g, vendors that are in the cloud computing space, they’re also going to be very crucial.”

There were other barriers to the uptake of telehealth. Many physicians, particularly in the early stages of the pandemic, hadn’t been authorised, for legal reasons, to conduct consultancies with patients outside their own state.

There was also an insurance issue that needed resolving. While most insurers were covering patients for Covid-19-related telehealth sessions, this was largely a temporary measure. Rebhan said there is a strong case for “reimbursement parity” that also held opportunities for health IT providers. 

If insurance providers could see data that showed telehealth was a viable care delivery channel that can help “meet payers’ and purchasers’ business objectives”, that could see insurance coverage extended to telehealth on a permanent basis.

So what is the way into this vast market in for New Zealand health tech companies ready to do business?

“Circumvent the White House,” quipped Rebhan.

Leverage medical records platforms

“The federal government has kind of taken a bit of a hands-off approach here, and has kind of let states do what they want to do as far as testing as far as development,” he explained.

A better approach than getting involved directly with public health agencies and providers, was to try and partner with the big US health tech providers, complementing their offerings with high-value services and technologies that offer a better approach to delivering healthcare.

“They are a more accessible channel to really partner up with versus going straight for the federal government and trying to tap into some of these systems that are just a bit more difficult to navigate,” he said.

At the heart of healthcare providers’ systems sat EHR (electronic health records), also referred to as EMR (electronic medical records) software that attempts to interface with other medical systems to give a comprehensive view of a patient’s clinical information. 

Creating software that is interoperable with and leverages EHR systems was crucial to success in the US market for those health tech providers looking to work at the heart of systems running hospitals and clinics.

“These EMR vendors, of course, they’re making plays. They want to take up as much of the market as they can,” said Rebhan. 

A deep understanding of the EMR system was needed in tackling the US market. Sais Rebhan:

“There’s so many variables with respect to their level of technological sophistication, the size and scope of their operations, the types of populations that they treat.”