The Post-Pandemic Future of Diagnostics | Deloitte US has been saved
By Chris Park, principal, Deloitte Consulting LLP
Medical devices and diagnostics are at the heart of the Future of HealthTM that Deloitte envisions. Later this month, I will be at AdvaMed’s annual Medtech Conference in Boston where I will moderate a panel on the post-pandemic future of diagnostics. The panel will explore the profound impact COVID-19 had on accelerating trends in the industry.
The pandemic highlighted an overall lack of readiness for managing major health emergencies. Public health policies and infrastructure—combined with various private-sector issues—put us behind the curve as the virus spread. The pandemic also underscored the importance of virtual health and alternative sites of care and helped to accelerate the adoption of connected medical devices, digital triaging, and remote patient monitoring.
As my colleague Glenn Snyder noted in a blog, many early-stage innovators are designing products and solutions for use in outpatient locations and in the home. These innovations have the potential to increase consumer satisfaction, improve patient outcomes, incentivize medication adherence, and help consumers track and monitor their health (including signs and symptoms that may alert them to the need for additional care). Early detection and diagnosis can lead to better patient outcomes for all types of illnesses and diseases, which can also help drive down costs. It can also help to make health care more accessible and equitable. Diagnostics and testing are on the front line of prevention, diagnosis, and actionable treatment.
According to our recent survey of US health care consumers, a growing number of people use wearables, apps, digital assistants, and smart devices to measure their fitness and health-improvement goals (49% in 2022 vs. 42% in 2018) and to monitor health issues (34% in 2022 vs. 27% in 2018) such as physical activity, weight, and blood pressure. Among people who use these devices, 78% say it has an impact on their behavior, according to our survey results. In addition, 85% of consumers told us they are comfortable using diagnostic tests (e.g., a stool sample to identify bacteria in their gut or genetic tests to identify current or future health risks) to assess their health and health risks. (See our new report, Tapping virtual health’s potential.)
Industry regulators have yet to fully rationalize the differences between consumer health devices and professional medical devices. However, regulators played a critical role in speeding transformation of diagnostics and testing, with fast-track reviews, emergency-use authorizations, and demonstrated flexibility in balancing public heath and safety with rapid innovation.
The future of diagnostics
Innovative diagnostic technologies—aided by advances in computing power, sensor innovation, connectivity, and miniaturization—are transforming imaging and most other diagnostic services, including where imaging takes place. While adoption of these innovations has been slow and rarely at scale, the pandemic has helped to accelerate the pace.
Our colleagues in the United Kingdom recently published a report on The future of diagnostics, which focuses on the European Medicines Agency (EMA). The Deloitte Center for Health Solutions will follow-up with a companion piece on the US markets. Here is a look as some of the trends US and UK researchers have identified that are shaping the future of diagnostics:
- Focus on convenience, adoption, and access: The availability of virtual health and connected devices is making it possible for more people to receive health information, diagnoses, and care outside of professional clinical locations. Many retail clinics, pharmacies, and community-based sites have made diagnostic tests available to consumers, and a growing number of employers have made on-site diagnostic testing available. Some medtech companies are making diagnostic tests more convenient for patients. Roche, for example, recently introduced a self-sampling device for human papillomavirus (HPV) screening that lets the patient privately collect their own sample.1 Some blood tests can now be done outside of the clinical setting or at home. For example, Dried Blood Spot cards are being used to send and test small samples of blood collected by the patient.2
- Continuous information and monitoring: Technological advances like wearables make it possible to continually monitor a person’s condition while also collecting real-world data in real-time. Miniaturized wearable form factors are expanding. Philips, for example, has developed a wearable patch that can help detect heart rhythm irregularities to help prevent strokes. The patches, combined with cloud-based AI can compare a patient’s heart rhythms with 20 million ECG recordings.3 The ability to monitor conditions and perform tests at home or outside of a traditional clinical setting could encourage consumers to be more proactive in maintaining their health. However, there are concerns around the reliability of at-home tests and wearables, for which results are provided without the oversight of a trained specialist. As more patient data flows from medical devices, the industry will need to define which information is clinically relevant. The sector will also need to determine who owns the data, how it will be aggregated and used, and how privacy will be protected.
- Artificial intelligence: Model-based AI approaches are helping to enhance workflows, provide more accurate analyses and images, and are providing clinicians with supplemental medical decision-making. Workflow and productivity software are now categorized as AI solutions. AI is also being used to detect diagnostic errors and process data more efficiently (see Lessons from an experienced medtech innovator/investor). The continuing debate on human vs AI accuracy will likely shape how medical diagnoses and treatment choices are made for the foreseeable future.
- Health equity: The moral imperative for health equity is undeniable, but there are also business reasons for this focus. Many medtech companies understand that improving health equity, and making products more broadly accessible, could bolster their commercial success while also saving lives and delivering more value to the individuals and communities they serve. In his recent blog, my colleague Drew Wilkins estimates some of our life sciences clients could see at least a 10-to-1 return on investment by supporting access to care in underserved markets and by working to ensure that all patients—regardless of race, ethnicity, age, sex, or socioeconomic status—have access to the devices and therapies they need (see The business case for health equity). The availability of more at-home diagnostics could help eliminate some barriers as long as the products are affordable and accessible. Diagnostics and testing could be the best, fastest, and least-costly method for shifting health care spending from late-treatment and chronic care to wellness, early detection, and prevention. With a focus on health equity and access, certain underserved populations could leap-frog the traditional health care investment curves by radically reducing the need for later-stage acute and chronic care.
- Investor and industry interest: Private equity firms and venture capitalists have become increasingly interested in medtech. During the first half of 2021, investors pumped nearly $15 billion dollars into 372 digital health care deals during the first half of 2021. That tops investments for all of 2020. A decade ago, digital health investments were a fraction of what they are now (fewer than 100 deals and just $1.1 billion in investments). However, many medtech companies are navigating on-going supply chain issues and a tight labor market. According to Deloitte’s recent analysis of medtech venture capital funding, in-vitro diagnostics have seen the most VC funding over the past decade (from 2012-2021). Many large companies outside of health care (e.g., retail, consumer products, high-tech manufacturing) are making major investments that are disrupting and changing the traditional landscape. (See COVID Fueled Health Tech Investment; Can The Momentum Last?)
- Public/private collaborations and solutions: The pandemic showed that the public and private sectors can move rapidly when the need arises. For example, the National Institutes of Health, the Centers for Disease Control & Prevention, the Food and Drug Administration, and other agencies were deeply involved in facilitating and accelerating research. They helped to ensure funding, and regulatory flexibility as well as overseeing testing, vaccination, treatment, and recovery. While the response was not perfect, the speed with which issues were addressed is a strong example of public-private partnerships.
One of the main ideas we’ve gathered through our interviews is that innovation in medtech will continue, and likely accelerate. But there are big questions about how the new technology will be integrated into existing clinical workflows and, perhaps more importantly, how they will be paid for. This will most certainly be discussed during my session (and likely many other sessions) at this year’s AdvaMed conference.
Endnotes:
1 Roche launches a human papillomavirus (HPV) self-sampling solution, expanding cervical cancer screening options, Roche press release, June 16, 2022
2 5 things you should know about at-home diagnostic testing, MedCity News, June 10, 2022
3 Health care and long been a place you go to. What if it came to you instead? Philips press release, September 5, 2022
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