In this second installment, we will be looking at digitalization in health and the new role of the patient, both of which are topics tied to the digital transformation the sector has been experiencing, but which the pandemic has made us rethink. 

LESSON 1: DIGITALIZATION IN HEALTH IS HERE TO STAY

The changes and the digital transformation that the industry has been through have been accelerated by the pandemic: virtual health care; patient follow-up through apps; deals struck in meetings on Google Meet or Zoom; trainings for physicians on how to use devices through virtual-reality sessions; the list goes on. However, despite having advanced a great deal in the way patients receive treatment and the way the health system helps keep everything running, there is still much to be done.

In one of our studies conducted through HospiScope, we classified telehealth (TH) into four main categories: participation in TH when the hospital has a telehealth program; TH centers when there is a center with specialists that the hospitals connect to, such as centers of excellence in other disciplines; medical monitoring (spoke TH), when the hospital has a system connected to the service provided by the TH center at which the specialists are located; and international TH, when the hospital takes part in international TH.

In HospiScope we have extensive data about equipment and technology for almost 90% of hospitals in Latin America, so our figures should be fairly representative of the resources available in the region.

According to our analysis, approximately:

• 15% of hospitals in Latin America have a telehealth (TH) program

• 9% of hospitals in Latin America are connected to a TH center

• 6% of hospitals in Latin America provide that service to patients through a system of medical monitoring

• 1% of hospitals in Latin America form part of international TH

These data remained stable between 2020 and 2021. There is clearly a big opportunity in this segment. In line with our analysis, Meet Technology Review has conducted a survey in which 95% of those interviewed say that telehealth is a fundamental element to take into account in the transformation.

Health and technology have been working together for some time, but the need to speed up these processes in order to expand access to health has led to the automation of tasks, which meant that human involvement could be used in cases where it is necessary. So, for example, apps have been created to provide monitoring on patients with non–life threatening illnesses, and improvements have been seen in user experiences with regard to chronic patient monitoring and hospital appointment systems. This in turn meant that health-care personnel, nurses and doctors, would provide their time and knowledge to those who really needed it.

Another of the opportunities we have identified in the health digitalization process is the use of analytics (data analysis), key to information-based decision making, which in many cases is generated by the patients themselves.  However, we still have a long way to go: for example, according to data from Global Health Intelligence (GHI), 36% of health companies in Latin America already have some kind of strategy for prevention and vigilance, while the other 64% are still at the initial stages of developing this strategy.

We have a great window of opportunities before us for technology companies to start out on a pathway we have already seen in several sectors. Xsensio has developed a device for monitoring athletes’ sweat and detecting potential health problems, while HEMOTUNE promises to regenerate blood to prevent the death of patients from infections and intoxication. Despite these advances, as we mentioned in the first article in this series, to achieve an effective health system in the long term, the focus of attention must be on preventive diagnosis and a primary-care strategy. In addition to heavy investment in development, data are key when it comes to knowing where to make investments.

At GHI we believe there are great opportunities, as health digitalization is one of the most important links in the chain moving forward, and the transformation should not become a missed opportunity. However, our data unfortunately show that, for many organizations, TH has just been a band-aid that has helped at a difficult time, rather than an opportunity to bring about real change. Time will tell why a qualitative leap could not be achieved, but at a glance it appears that it could be down to our cultural habits. 

LESSON 2: THE PATIENT IS NO LONGER A SPECTATOR AND NOW PLAYS A LEADING ROLE IN THEIR OWN MEDICAL HISTORY

The patient has taken on an active role, both in their diagnosis and their treatment, and their empowerment forces us to change our communication strategy. The ways in which organizations and physicians relate to patients are completely different than what we were used to.

Today, it is easy to google a symptom and draw conclusions about it—as an enormous number of people do—but the misuse of tools can lead to a number of problems. Are we ready to assume this change?  Is the excess of information positive or negative? 

Integrating the technology and the patient into health systems speeds up the clinical investigation process, achieving greater efficiency and increasing the development of medical devices and drugs that cover unmet needs. On the other hand, along with technology we are seeing the rise of medfluencers (social influencers concerned with medical topics), a new channel in which different health professionals share their knowledge through the various social networks.

At GHI, we have found that most multinational health companies have patient-education programs and campaigns ranging from fundamental topics like obesity to more technical questions such as laparoscopic procedures. These programs tend to be long-term, as their main goal is to change habits, and none of them are carried out in isolation. People in the industry talk about the 5 Ps: Patient, Physician, Purchase Manager, Payer, and Policymaker. The most successful patient-education programs look for points of contact with each of these players.

For a long time, the patient was not part of the conversation about their own health, and one of the main challenges today is for doctors, who feel they have power over the health of their patients and do not want to let go of it, to release medical histories and allow the digitalization of medical files.

Patients nowadays want to have a bigger role within the health sector, not only to give their opinion about their own condition, but also to help and protect those who are newly diagnosed.  In this context they have set up groups to share experiences and lessons learned, generating a space for positive exchange that challenges traditional medical care. 

We are clearly at a pivotal moment with respect to the health sector that has never been so exposed. The industry needs new standards, and technology can provide that leap of quality and integration that is required by putting the patient center stage and reinforcing ethical considerations. 

Next Steps

Contact us if you are interested in exploring further how these lessons are being applied, perhaps through a personalized study that will help you outline new strategies for your business or create new initiatives. We can also provide you with subscriptions to our data services, such as HospiScope, SurgiScope, LatAm Hospital Monitoring, and others.

In this first article we highlight two issues that have come to the fore over the course of the COVID-19 pandemic: crises in the health system, and opportunities that have arisen in the midst of the turbulence.

LESSON 1: Focusing on Preventive Diagnosis and a Primary Care Strategy to Have a Robust Healthcare System in the Long Term

The onset of the pandemic has shown us that our health systems were not ready to face a health crisis. The countries with most development or a greater capacity to respond—economically or technologically—managed to recover relatively quickly, but even so, they have reconsidered their health care and investment strategies, focusing heavily on developing primary-care systems with prevention and awareness-raising campaigns, replanning the health system, both public and private, and emphasizing preventive diagnosis. Latin America has suffered heavy human and economic losses through a lack of investment, which has been plain to see, and so this is now part of the agenda for governments and even private businesses.

In this regard, through HospiScope, GHI has come up with some very interesting data, confirming that in Latin America the total number of beds grew by 2.2% a year in 2020 and 2021, to reach nearly 1M beds in the region. Beds for outpatient use, on the other hand, have seen annual growth of 5.7% in 2020 and 2021, and beds for use in intensive care have grown by 16.4% annually in 2020 and 2021, to reach 90,000 beds at regional level. With respect to surgery beds, annual growth in 2020 and 2021 was 3.7%.

In addition, with regard to diagnostic apparatus, both in primary diagnosis and advanced-imaging diagnosis, the annual growth in 2020 and 2021 looks like this:

Our data show that the investment was in those diagnostic-imaging apparatus that are much more precise and give more specific results when it comes to determining pathologies. This is a sign of the way the industry has changed, and where the opportunities for growth and investment lie. We might say, then, that although primary diagnosis is a key strategy for addressing the population’s health, hospitals and clinics have invested more in high-tech, high-cost, precision apparatus. The growth of ventilators and patient monitoring is linked directly to needs resulting from COVID.

Preventive diagnosis has been shown to help better work with pathologies requiring lengthy treatments, thereby minimizing emergency procedures. This helps focus efforts in situations of crisis, as the chronic side of the illness is relatively controlled. In parallel, the strategy looks to primary care. We know that the initial moments of care are vital to preventing further complications. This is why it is indispensable to have a robust system for this kind of treatment, as it prevents preexisting illnesses from worsening. Above all, it helps reduce costs and make the system more efficient. And in this respect, the pandemic has taught us an important lesson and has left us with a tremendous opportunity to develop telehealth (TH) as a primary-care tool with enormous reach. GHI has produced extremely interesting data about the adoption of this system in second- and third-level centers. At the end of 2021, 15% of hospitals in the region had TH programs; 9% were “hubs” (hospitals where the experts are), while 6% were “spokes” (where the patients are), and just 1% offer international TH.  As you can see, the opportunity is still considerably large.

To conclude, we might say that the biggest lessons in this respect have been the need to:

• Fortify primary health care through by shoring up care strategies like telehealth, reaching more people, more quickly and efficiently.
  
• Equip hospitals and clinics with beds for different types of care (intensive, intermediate, and outpatient care) by establishing priorities in care based on pathologies and staging.
  
• Enhance care centers with equipment that facilitates quick and precise diagnosis, working almost exclusively with specialist-equipment diagnosis and/or treatment.
  
• Plan strategies for purchasing, equipment procurement, and investment in technology, to take advantage of opportunities that the pandemic has opened up, and advances in virtual care.

LESSON 2: Approaching the Crisis as a Moment of Opportunity

The crisis generated as a consequence of the Pandemic has brought opportunities for companies whose products were listed as first-necessity, or those that were able to launch onto the market products needed to combat the Pandemic. The most emblematic example of this is the PCR test in its various models: rapid test, self-test, and laboratory test being the among the most widely known.

However, in most cases the medical-device industry has seen a considerable drop in sales of its products and services, due to the low demand for so-called elective procedures, and it has led them to rethink a large part of their business. In this respect, the rupture has occurred not only in the ways of doing business—both in the strategy and in the sales of each market—but above all in pricing.

To remain competitive, many companies have reconsidered their pricing strategy based on direct sales, which has posed a challenge to the role of distributors—somewhat of an adjustment variable for most businesses finding themselves in an economic crunch. Distributors are key, and they play a very important role for companies that need to develop a market, or launch a product in many places at the same time, especially when the company has no local presence in markets spanning large expanses of territory. But they are also the adjustment variable in a crisis. This is nothing new, and it is often the case that the relationship with them is like a pendulum.

During the Pandemic, companies have focused on their larger clients, dropping business that takes considerable effort to develop. This has led to a better knowledge of the needs of important clients, and to improved revenues in the midst of the crisis. The key lies in understanding that critical moments drive us to create changes. In this case, there will be better opportunities for those who achieve the best balance to maintain strong relationships with direct clients, that are sustainable over time, and grow with minimal in-house efforts by working collaboratively with distributors who are aligned with the ways in which each company works.

But the question is, have we taken full advantage of the opportunities that have arisen? Have we been able to transform our businesses by leveraging the technological advances that have come about through the digitalization the world has experienced, particularly between March and October of 2020? Our next article on Lessons Learned from the Pandemic will include a look inside this topic.

At GHI, we always approach subjects from a constructive angle in an attempt to generate productive debate. Find out more about our solutions here.

You can also contact us directly if you are interested in exploring the possibility of a personalized market study to help your business understand the market better, whether this is on a general level or in a key segment of a specific country.

TM has been a topic of debate in the big international health forums since 2003, and some large strides have been made since those opening conversations. However, data show that we still have a huge opportunity to develop this sector of the industry that will form part of primary health care in the near future. To point to one successful case, according to a report by the Pan American Health Organization (PAHO), Brazil’s Telessaúde Brasil program, whose goal is to offer primary health-care professionals a second opinion, using electronic consultations or electronic referrals, has demonstrated that one out of two patients offered electronic consultations does not get referred to other services. Its reports show that, on average, 60% of electronic consultations led to a change in the originally planned approach, thereby reducing costs, especially with treatment outside the home, resulting in a higher case-resolution rate.

Since 2015, at Global Health Intelligence (GHI) we have been using our proprietary HospiScope database, which gathers information about the installed base equipment in hospitals in 17 Latin American countries. HospiScope has allowed us to do a variety of analyses on the development of demographic indicators, hospital equipment, beds, clinical specialties, medical personnel, information systems, type of care, and other key areas. As a result of the pandemic, we began gathering data on TM, which we have sorted into four main categories:

1. Participation in TM, when the hospital has a telemedicine program
2. A TM center, when there is a dedicated center with specialists to which the hospitals can connect, such as centers of excellence in other fields
3. Medical monitoring (spoke TM), when the hospital has a system connected to the service provided by the TM center where the specialists are located
4. International TM, when the hospital is involved in international TM

Our analysis, which is based on the strategic data we have gathered over the years, was based on data from hospitals in 17 Latin American countries that was compiled between 2018 and 2021.

Roughly 15% of the hospitals included in our analysis have a TM program; 9% are connected to a TM center; just 6% provide that service to patients through a medical monitoring system, and 1% are part of international TM. These data remained stable between 2020 and 2021.

Analyzing the data from hospitals with a TM program, the percentage of these relative to the total amount of hospitals in the region varies between 11% and 19%, leaving a large opportunity for the development of this service. Zooming in on the most relevant data, Colombia has the most development in the service, while Chile is the only country to have made a strategic investment in infrastructure, installed capacity, and specialist telehealth personnel, distinguishing itself from the other countries in the region.

In terms of connectedness to TM centers, 38% of hospitals have this service in Colombia. However, Argentina, which comes next in the ranking, has just a 9% share, showing that there is significant opportunity for investment in this service too. The situation is similar for medical monitoring. In Colombia, 65% of hospitals have the service, followed by Chile with just 9%, then Argentina, Mexico and others, respectively with 3%.

Lastly, we see significant opportunity in terms of international TM, where the total percentage share among hospitals is 1%. Colombia leads the region in this category with 8% penetration, followed by Chile at 1%, and Argentina and Mexico, with 0%, respectively.

TM is a service that is here to stay, and the data show there is a development opportunity, in terms of both infrastructure and service, that needs attention.

Contact us to find out more how our team can conduct a market study for the Latin American country of your choice so you can gain a greater understanding of telemedicine penetration and where the strongest opportunities lie.

Enter telemedicine, a growing technology that closes the gap between facilities for the patients who need the care the most. In a nutshell, telemedicine allows doctors, often specialists such as cardiologists, oncologists and the like, to examine patients in other facilities remotely. This might involve hospitals in big cities like Mexico City or Buenos Aires partnering with smaller towns around the country. Or hospitals in the U.S. and Europe can also take part in order to help these smaller communities.

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It’s a novel, cutting-edge idea that’s not only a great partnership for medical facilities, but also a vital tool for the health and well-being of patients.

Many healthcare providers and institutions have caught on to this. As a result, the Latin American telemedicine market’s value is projected to grow with a CAGR of 17.2% between now and 2020 to reach US$2.5 billion—more than double its 2015 value of US$1.13 billion.

The growth of telemedicine is not altogether surprising given that many other high-tech sectors of LatAm healthcare are also expanding, including devices and electronic medical records (EMR).

Taking Advantage of the Telemedicine Boom in LatAm

For manufacturers that provide telemedicine equipment and devices, it’s easy to determine what areas might be interested in your goods and services. Global Health Intelligence provides a rich database of hospitals and other medical centers throughout Latin America that either presently use telemedicine or have the need for telemedicine equipment.

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And this opportunity is not simply a good one for manufacturers of the equipment. If hospitals in the U.S. or other parts of the world are interested in partnering with a Latin American facility, for example, the GHI database can help with this, as well. Many facilities have telemedicine equipment but are lacking in good partnerships, so this is a great opportunity for North American or European hospitals to get involved.

Finally, once a facility has telemedicine, they may be interested in other high-tech equipment such as PACs (picture archiving and communication systems), PET scanners and other devices to provide their patients with the best care possible. This is yet another sales opportunity for equipment manufacturers.

Explore More

Contact GHI today for a free demo of HospiScope, our Latin American hospitals database, which covers nearly 90% of the region.

A quick tour will let you see how to take advantage of the telemedicine trend to identify a wide array of new prospects among institutions that are likely to need high-tech equipment.

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