We live in a time of rapidly progressing change, with technology transforming industries and directly affecting lives. One way in which technology is enabling improved healthcare is through telemedicine:
Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. (Wikipedia)
Historical research has shown the importance telemedicine can play in the healthcare setting. A 2001 pilot study conducted in nursing homes suggested that use of telemedicine decreased the number of visits to the Accidents and Emergency Department by 9% and decreased the admissions to the acute care hospital setting by 11%. And that’s in 2001!
Technology has advanced heavily since then and has provided a stronger case for the benefits of telemedicine in both clinical practice and clinical development settings.
Patients living in even the most remote locations have the ability to directly access reputable physicians. Coupling telemedicine with today’s mobile technology health devices (e.g. ECG monitor) gives patients the ability to be remotely monitored and managed. Why run the risk of catching a nasty infection when it can be avoided in the comfort of your home?
You can imagine patients obtaining health information from multiple providers within the same window display (think hospital patient rounds in a Google Hangout-like format); providers avoid having to waste time duplicating discussions offline and have the ability capture critical health information up-front rather than amending their decisions downstream.
According to Rashid L. Bashshur, director of telemedicine at the University of Michigan Health System:
We are at the threshold of a new environment in which telemedicine, broadly defined, must be an essential part of mainstream healthcare if patients are to receive the appropriate care, at the appropriate site, by the appropriate provider while avoiding duplication and waste.
How can telemedicine provide value in the healthcare setting?
Here’s a list of some of the strengths telemedicine brings to our world:
- On-demand access to reputable healthcare providers outside the clinic (e.g. HealthTap-like characteristics) or within a clinic (e.g. Robo-docs)
- Multiple healthcare providers (primary care physician, pharmacist, nurse, etc.) coordinated in one visual screen (Google Hangout-like experience) to make decisions up-front rather than make corrections downstream
- Decreased “white coat” effect and thereby more accurate objective data (e.g. blood pressure values become more real-world – unlike face to face doctor interactions where anxiety can perturb true results)
- Decreased travel costs and increased convenience, especially beneficial for disabled patients
How can telemedicine be used in clinical trials?
The items mentioned above add value within the clinical trial space as well. For instance, telemedicine provides a means for various clinical trial checkpoints to be conducted within the comfort of your home. In an age where real-world evidence is becoming more important for product access decisions, telemedicine provides an inlet into accessing clinical trial participants outside of the clinics and in the real-world setting.
With the advances of wearable devices and mobile health technology, patients have the ability to capture data throughout the day. If your digital health device alerts you of a risky situation, it’s a matter of the participant and investigator connecting digitally.
And let’s not forget about adverse event reporting. Did the participant obtain a rash through one of the interventions and how severe is the rash? It’s a matter of jumping onto your preferred telemedicine streaming device to share raw video footage of the rash directly with your investigator. The adverse event becomes properly assessed and delivered to MedWatch in almost real time.
Use of telemedicine in clinical trials is happening now. Similar to Lilly-COI’s initiative, Transparency Life Sciences CEO, Tomasz Sablinski vows to introduce a new, disruptive, model of drug development that utilizes computer sciences, technology, and new communication and knowledge generation patterns.
The emerging clinical development crisis requires a re-thinking of the entire process. Those organizations flexible enough to adapt by redesigning the way clinical trials are conceived and conducted using advances in communications and telemedicine, along with open innovation principles, will, I believe, prevail in the long run.
Technology has been and continues to be an enabler of new advances in the healthcare space. As we at Lilly COI are committed to developing innovative methods within the clinical development space, your thoughts and feedback are instrumental in how we position ourselves to transform the drug development process.