Innovation 2023:
Digital Health

Annie Sznajder, Webinar Host

Hi, everybody. Welcome to the “Innovation 2023: Digital Health” webinar! Over the next hour, our speakers will delve into diverse facets of digital health and explore cutting-edge advancements shaping healthcare's future, from the patient's journey to emerging technology to trends and insights for startups and entrepreneurs. 

We have a great line ... a great webinar lined up for you today, but before we get started, I do want to go over some housekeeping, so we can make sure that this webinar stays interactive for everybody. So first, if you're accessing this from your desktop, I invite you all to take a look at the bottom right-hand corner of your screen and just take a look at the icons you have there. You have a chat feature, so in case you bump into any technical difficulties during the webinar, feel free to send a message there—it'll go straight to the webinar hosts. 

And also, there's the Q&A feature. So, if you have any questions that you have for the audience or for our speakers, please drop them in there, and we have the last 10 minutes of the webinar dedicated to Q&A. So please send as many questions as you have.

And also, throughout the webinar, we will have polling questions pop up. So just take a minute—we'd love to hear your input throughout the webinar. And, with that being said, let's bring up our speakers.

So first, I'd like to introduce our moderator, Gareth Presch, who currently serves as the CEO and founder of the World Health Innovation Summit and has worked to create a global healthcare platform to move from disease management to prevention. He also serves as an advisor for G20 and T20 to bring international economic cooperation.

And now to introduce our two panelists—both are from the LG NOVA team. Let me introduce Atul Singh, general manager of Digital Health. He leads the strategy, execution and delivery of digital health solutions focused on acute and post-acute care settings. Prior to joining LG Nova, Atul has 25 years of experience in healthcare with a commitment to services that improve patient health. 

Now let me introduce Darren Sabo, director of New Ventures at LG NOVA with a focus on remote patient monitoring solutions, and throughout his career, Darren has made a commitment to using product innovation as a force for good by delivering solutions that shape how fast-growing companies strengthen communities, society and the environment. 

Well, we're looking forward to hearing from you all, and Gareth, I turn it over to you.

 

Gareth Presch, Moderator, CEO and founder of the World Health Innovation Summit 

Thanks very much, Annie. Hi everyone. Pleasure to join you this morning. We're gonna have a fabulous webinar. Really looking forward to today's session. Darren and Atul will give us a great insight into the future. Let me just set the scene for people so that everyone's aware of the current situation that we face, and the challenges and the opportunities.

We're all pretty much aware that the current health system—healthcare systems—tend to be based predominantly on a sick care model. The system is essentially one that waits until we’ve fallen ill, and we face unprecedented challenges with global staff shortages predicted to be around 18 million by 2030.

As we've all seen, healthcare costs continue to rise. We're currently at about 10 percent of global GDP, and that's about $8.3 trillion that we spend on healthcare spending, and this has been rapidly rising over the last few decades. And also, just to look at, if we look at the spend in the future, you know, diseases like obesity and cancer, we're looking at about $47 trillion by 2030. 

I mean, this is clearly unsustainable, and increased costs can be largely attributed to the growth in human population, along with a diverse population that results in higher incidence of chronic and multiple conditions as well as this, you know, this one-size-fits-all approach to health just simply doesn't work, and we're seeing both consumer preferences for convenience and affordability are shifting as well as the demand for a more efficient and personalized delivery model of healthcare is growing.

I think coronavirus has clearly showed, you know, that the system is not sustainable, and also it unveiled the health inequalities that exist in our society across the world. So, the situation is that the health system is in a fragile state, and we do need to find solutions. 

Over the next hour, I'll be putting questions to Darren and Atul about how digital health can help and support our health services while enabling our communities to manage their own health and well-being. I firmly believe this is a big opportunity. 

Let's just start by having a quick overview of the current situation in our hospitals from Atul. So, Atul, where are the challenges, and what are the opportunities for digital health adoption?

 

Atul Singh, Panelist, General Manager of Digital Health

Thank you, Gareth, and welcome everyone to this exciting webinar. We have a lot of ground to cover in the next hour, so let's jump right in. So Gareth, regarding digital health services that pose challenges and definite opportunities in the hospitals and post-acute care facilities, I'll cover some of them briefly and in no particular order.

The first one, which has come up more and more in recent years, is interoperability, and the challenge really is the lack of integration across different digital health platforms. Over the last few years, with the expansion and explosion of all the digital health services, hospitals have purchased a lot of point solutions. What they are now realizing is these point solutions don't talk to each other, and it's resulting in inefficient care delivery models. So, what the need of the moment is for hospitals is to put together all these different digital health platforms that can talk to each other.

The next, which is very closely tied to interoperability, is data privacy and security, and here, the issue is safeguarding patient data with the always-looming cybersecurity threats. This is a big, big issue for hospitals. How can they manage patient safety in terms of the data and keeping it private [while] at the same time, relying and basically being compliant with privacy regulations? Now the CURES Act that was recently passed last year—that helps a lot in that direction, but still, a lot more needs to be done in terms of data privacy and security.

The third area I want to just briefly mention is digital infrastructure. As you can imagine, these hospitals were built over the last few decades, so the infrastructure within the hospitals is not necessarily the most robust to support increased demand for digital services. And this could be anything from high-speed internet or secured networks or even scalable platforms to handle large volumes of patient data that may be coming directly from the patient or from the devices that they may be using.

The next area, briefly, I'll touch is the regulatory environment. So this is something that is kind of out of balance because digital health services generally tend to outpace the regulatory frameworks. So the hospitals have always this balance they need to strike between innovation and patient safety, and it's an ongoing issue that they have to navigate.

And last but not least: staff shortage and burnout. You mentioned in your opening it's a very critical issue for hospitals and long-term care facilities, especially the nursing shortage that is impacting all aspects of care delivery right now. 

And just to address that one particular need, here's a quick promotional plug: LG has introduced a new product and partnership with Amwell called Carepoint TV Kit that leverages existing TVs in the hospital rooms and allows providers to remotely engage, monitor and even discharge patients. This reduces the workload on the healthcare professionals as well as the burnout. 

So that was a quick overview on what we are seeing in the hospital and post-acute facilities. And back to you, Gareth.

 

Gareth Presch 

Thanks, Atul. Great insight into what's happening in the acute setting. And then if we look at the community setting, Darren, could you give us an insight? I think, you know, there's a massive opportunity with virtual wards and various sort of sectors in the community. Can you share with the audience, you know, the opportunities but I suppose also the challenges that you see in this sector?

 

Darren Sabo, Panelist, Director of New Ventures

Absolutely, so I'll quickly go over some of the issues that Atul brought up about challenges faced within the healthcare environment. So, in particular, the shortage of healthcare workers in the U.S.—I mean, there is estimates that there's going to be shortages of like 3.2 million healthcare workers by 2026; 48,000 of those are going to be the PCPs, the primary care physicians, and half a million of the shortage of the health care workers are going to be in home health aides. 

I think there's definitely a need, and a trend and a preference to start receiving care at home where you live versus having to go to a healthcare facility. Obviously, hospitals and healthcare providers are always going to be necessary for acute care and critical care conditions. However, when you think about longer-term care or recovery states, a lot of patients prefer to, you know, receive care from their home environment and where they live, and I think there's a need for the health systems to really meet patients where they're at and provide that care in the home.

And we're seeing trends moving in this direction. Obviously, it started with—there was a huge explosion of interest and investment in the space because of the COVID pandemic. There was a necessity to move care to the home, and the regulatory environment allowed that to happen. And health systems really quickly adopted technology, such as telemedicine, to start providing care at home because that was the only option really. The hospital wards were just overrun with patients, and they had no other option. 

So you saw some leading health systems really embrace this and become, you know, the first hospitals in the country to experiment with sending acute patients home for remote care, and we started seeing that beginning in 2020—probably late 2020. Currently, CMS has a list of almost 300 hospitals across 125 health systems that are approved to provide such programs: so acute care in the home setting.

And CMS has also opened up new CPT codes or reimbursement codes to allow hospitals to bill for those services, whereas prior to the pandemic, if a health system wanted to provide care at home, it almost became a cost center for them. They had to provide that as just a benefit to the patient, but they couldn't actually get reimbursed for those services, so there were a lot of questions around how they made money or how they got reimbursed for those costs. So now there's a variety of additional channels to do so.

Hopefully a lot of these pandemic-area waivers are gonna remain in place beyond 2024, but currently, you know, they're set to expire at the end of next year. But I think those waivers are going to extend far beyond 2024 ‘cause, you know, hospitals are seeing savings on this as well of anywhere from 15-20 percent for, you know, treating patients. 

And if you look at the profitability of hospitals—there's something like over half of hospitals across the United States just lose money. They're not able to keep their head above water, so by embracing these technologies, it helps them economically, provides better care and it helps patients. So that's a trend that really excites me, and I think is a great place to play in terms of digital health.

 

Gareth Presch 

I just wanted to pick up on something that Atul said, and I suppose this applies also to the community, Darren, is around the infrastructure, Atul, within their hospital system because you got a lot of legacy there and a lot of—shall we say—infrastructure, which is of old standard. And so, you know, for example, I give you—please don't laugh—but I'm aware, some systems, you know, are using Windows 7, you know, which is not even supported anymore within hospital settings. 

So, do you see that as an opportunity, Atul, where, you know, we can look to the future and we can bring in the infrastructure, which makes it easy for that interoperability? 

And then, you know, back to Darren, do you think that that's an opportunity for the community to grasp in terms of like that understanding of how the patient journey moves from the hospital into the community? But then also, it improves the quality of life of that individual because, ultimately, that's what we're trying to do.

 

Atul Singh

Yeah, exactly. I think this is something that the hospitals will have to undertake at some point in time in terms of upgrading the infrastructure. But keep in mind, as Darren pointed out, that these hospitals are struggling in terms of the financial ... the availability of the finances to run their operations, and changing out the infrastructure is a capital expense that is quite a significant impact to the bottom line, and this is something that hospitals don't take lightly, and they have to plan out two or three years ahead in order to make such investments. 

So yes, it's needed. It's very much needed in order for the newer digital technologies to be adopted and utilized rightly, but, at the same time, we have to understand the challenges that the hospitals are facing in terms of switching these overnight. And that's where what I said early on is creating the problem: that the hospitals have purchased these point solutions, but there's no way for them to integrate and have them talk to each other. 

So, for all the startups that are on the webinar listening in, if you can work on a technology that can connect all the different point solutions, that'll be a huge success in the hospital and post-acute environments.

 

Gareth Presch 

Great. Darren, from your perspective, like, I mean, this is when you look to the future and interoperability. I mean, you know, at the moment, the whole system is leveraged. You know, pretty much 90 percent of the budget goes towards the hospital system. You know, what we need to see is that transition into the community. Is this a way and a means for a change?

 

Darren Sabo

So, in my previous position, I worked for a global fellow communications company, Orange. I did a lot of work in healthcare access across Africa and the Middle East—in particular, West Africa and North Africa—and in a lot of ways, it was easier to deploy healthcare solutions in those regions because they didn't have infrastructure. 

So you would have ... so you'd work with the government to raise a development bond to put in some telecommunications infrastructure, and then you could layer on digital tools on top of that. ‘Cause you’re starting from basically nothing, right? You're talking about, you know, a doctor in a village to have to drive from village to village and so on and so forth. You don't have very robust health systems and aging infrastructure to worry about like you do in the United States.

In the U.S., it's really challenging to deploy cutting-edge solutions because, like Atul was mentioning, just budgetary requirements. Sometimes it's easier to work with the health systems at building a brand-new hospital than work with an older, well-established hospital because they have to spend millions and millions and millions just running new wires through their walls to support updating their technologies. 

So I see a lot of opportunity to improve the connectivity within the communities for a variety of areas—again, things I was seeing in emerging countries in terms of providing just quality healthcare but also education, and allowing for remote work, and upskilling and so on and so forth. 

So I think you're seeing the government get involved and providing grants to the states and to certain areas to improve broadband access, which would be enablers for these types of cutting-edge technologies to move from the healthcare environment into the home. So passing some of those costs of upgrading the infrastructure on to municipalities and offloading it from the, you know, the patient or the provider, I think is gonna help a lot, and we're starting to see that, especially in rural communities. 

I think there's a lot of opportunity to provide healthcare to rural communities once that infrastructure is upgraded, which will also improve equitable access to healthcare, which is something we saw during the pandemic as well, like those with access—better access—to healthcare had better outcomes during the pandemic, whereas those in less-fortunate communities had poorer outcomes. 

So, I think digital tools and upgrading infrastructure will make huge strides in terms of enabling better equity within these communities, Gareth.

 

Gareth Presch

Yeah, absolutely, and I think it's an important point to be made. I think that there's a lot of legacy systems out there in Western society, shall we say, and this is a big opportunity for lower- and middle-income countries who can connect to new means—you know, Starlink and all these new internet providers that are out there. So, huge opportunity in the future. 

Let me come now to a bit of a topical ... very ... should we say everyone's talking about AI at the moment. And I think this is very exciting times for the health sector because, you know, I was at a conference—a digital conference—at the weekend, and, believe it or not, it takes about 17 years for the health system to actually adopt, sort of, new technologies. 

AI moves at such a rapid pace, you know, so let me just ask Atul, you know, from a hospital perspective: AI, will it change the face of hospitals in the future? And, I suppose, one area to ask you about is this huge elective surgery backlog that we face, you know. So globally, you know, we've about 28 million people missed elective surgery. So, is there the opportunity for AI to accelerate that process to help our physicians who are under pressure? 

So, Atul, AI in the hospital ...

 

Atul Singh

That's a loaded question, Gareth. The short answer is: I don't think hospitals have a choice with staff shortages and more shortages predicted over the next 5-10 years. I think they have to move towards utilizing the AI techniques to augment the services that the nurses and clinicians are providing currently. We are already seeing a lot of these implemented in narrow use cases within the hospitals—for example, the use of analyzing medical images for detection and diagnosis to speed up [detection of] cancer or cardiovascular or detection of neurological disorders, so that is already happening. It's not broad-based, but we are seeing movement towards that. 

Similarly, with the launch of the ChatGPT that everybody's talking about, we are seeing a lot of chatbots being deployed. This is less of a hospital use case, but more of a patient empowerment and engagement tool, where it allows an average person now to be able to better understand the symptoms and the conditions they have—to better understand how to treat them and what their treatment protocol looks like.

This does not relieve the doctor of the burden of writing up the care plan, doing the diagnostics, and the treatment plan and so on, but it allows the patients to now participate fully in their own care.

Then, some of the other things that are happening on the side—things like clinical decision support systems, so this is an area where I think the hospitals can truly benefit because imagine the algorithm being able to analyze the patient data, the medical records and the clinical diet and guidelines, and then be able to offer evidence-based recommendations to the clinicians so that they are better informed as they are putting together the care plan.

In terms of the surgeries that you mentioned that have been elective surgeries that have been deferred for the last couple of years: There is a play for robotics and surgical assistance provided by AI, but that is something that is still very new and cutting-edge, and a very limited number of hospitals—mostly research and educational institutions—are participating in it, where they are using robotics to assist surgeons during complex procedures or enhancing the precision of the surgery or minimizing invasiveness or how much they have to cut. So, they are starting to use it over time. I suppose this will become a lot more commonplace.

But the one that is not as sexy to talk about where you see AI being utilized most in the hospitals is in the operations and administration, where it's been utilized to reduce the workloads by scheduling, workflow management, reducing wait times for the patients at check-in, resource allocation and then billing. Those are the areas where AI is being utilized today, even though nobody talks about it because it's all back-end operations, but that's an area, like I said, that's being actively worked on.

 

Gareth Presch

Yeah, and of course, don't forget the huge opportunity for training with the virtual reality glasses. Like, I’m aware the virtual surgeon in London, for example, does incredible work to be able to train colleagues. Instead of having, you know, six surgeons who are training in theater, you can have 6,000 in the audience who can log in. That's an amazing opportunity.

Darren, community settings—I mean, when we look at the numbers and the challenges in the health system, and one of the things that I try and see is like, this opportunity in the community is massive in terms of alleviating pressure and, for digital health, a massive enablement opportunity.

 

Darren Sabo 

Absolutely, and so, the opportunities for AI in the community or providing remote care are ...  You know, there's some similarities with, you know, in clinic use cases, like Atul was mentioning, workflow enablement, workforce enablement, imagery, analytics—those are great. 

I think what we need to do is perhaps rebrand AI. I think there's some stigma attached to artificial intelligence. Like, do you want something artificial doing a diagnosis on your health? Probably not.

I saw an interesting ... I think the AMA, the American Medical Association, started calling it, like, augmented intelligence, which is the concept of using AI for assistive purposes, so, in other words, to enhance the intelligence of clinicians, not replace them. I think that's more palatable to a patient than telling them, you know, there's gonna be this AI, and it's gonna enable ... You know, you're going to be working with a robot, or you're gonna be working with an algorithm to provide care in your home within your community. There's no human being behind there.

So talking about AI in terms of augmentation or assistance versus replacement, I think is a good starting point.

Additionally, you were talking about training. So training is interesting. And VR ... we do a lot of work looking at VR and AR applications, and I think that's a great application for VR and AR in the healthcare space: training. And not just for physicians and the surgical context, but also think about nurse practitioners or folks within the community that need training on how to care for their aging neighbor or so on and so forth. It's really hard to get those folks into, like, an educational environment to get real hands-on training for how to deal with different situations. 

So, as care moves into the home, I think you're right, we need to lean more on community members, and I think there can be, potentially, another class of care. Being like ... Think of neighborhood watch, but for healthcare, where your communities are getting more involved in the care of their fellow community members, and we're providing distributed models of training, not to be a doctor, but to provide a baseline quality of engagement and understanding of when to escalate and when to bring in a healthcare professional. 

As we distribute the care model, I think a lot of that's gonna be necessary. And also understanding, you know, SDLH, social determinants of health, and how the community—how different elements of your community affect your health beyond just, you know, your genetics or, you know, what you eat, I think is gonna be really important as well and modifying those factors—those community factors.

 

Gareth Presch

I think that leads us very nicely into the next segment here in terms of the patient's journey and digital health and particularly within the acute sector, Atul, like, you know, demonstrating, you know, quality of care and also quality of life for the patient, how they manage their conditions from a chronic illness perspective ... is that ... Again, I mean, you know, there is challenges within the systems, and then, of course, there's opportunities. Do you have any pointers in terms of the patient journey and the outcomes for them?

 

Atul Singh

Absolutely. I think that’s a very interesting topic, Gareth, because access to care is fundamentally ... what fundamentally determines the health outcomes. Availability, accessibility, convenience—all those factors matter. And, as Darren was pointing out whether it's socioeconomic factors or health disparities, they play a huge role in how care is received by a patient. 

And with digital tools, you can definitely improve care coordination among the healthcare providers as well as empower the patient to participate in their own care—be able to be more educated about their own condition, what the treatment plan looks like, share decision-making with the providers. So they are not an outside observer in the management of their own care, but they are an active participant. 

Same thing applies with the treatment plans and whether it's related to genetics, lifestyle and so on. The digital tools that are currently available allow the providers and patients to be able to prescribe some of these tools that can clearly improve the quality and the health outcomes for the patient. 

And one important factor that sometimes still gets lost is the transitions of care. Once the patient leaves the acute setting and are moving to a post-actue location or their home, there is not an efficient way to manage and monitor that patient across that journey, and that results in significant overhead and burden on the hospital systems, meaning we see a lot of readmissions, and the conditions further deteriorating and having the patient being readmitted to the hospitals within the first 30 days. 

Now there are certain incentives as well as some policies that have been put in place both by the insurers and the CMS to prevent some of that, but it's a big issue, and there is not a good solution out there yet on how to manage the continuity of care with the patients. Again, it goes back to the idea of, the more involved the patient is in their own care, the better off they are in terms of receiving care quality as well as their own health outcome.

 

Gareth Presch

Thanks, Atul. Just to mention, anyone listening in here who wants to put a question to myself or Darren and Atul, we've got about 20 minutes before we’ll hit the questions. 

Darren, just on the patient journey, I mean, so we're trying to move like from disease management, which is the current health system—a sick care model. You know, we get sick and we treat. Prevention is, you know, the future in terms of making a sustainable model of healthcare because population growth, you know, lack of resources ... We're gonna have, you know, 10 billion people on the planet in the next few years, you know. Current system is just overwhelmed. 

Is this an opportunity for technology also to leverage the economic value from the community's perspective? Do you see that as a massive opportunity here?

 

Darren Sabo

Absolutely. When we think about prevention, the difficult thing ... OK, so the trick is getting someone to be involved in the state of their health when they're not yet sick, or not showing or not symptomatic is very difficult. And, a lot of times, that's when it could be most crucial: catching certain disease states before they're taking a toll on the patient. How do you encourage folks to do their annual wellness visits, or get their check-ins or just be interested in the general state of their health?

Even after they're diagnosed, we see a drop-off in engagement as well after, you know, acute visits. So, I think there's an enormous opportunity to help with prevention, and we're seeing a shift in business models from, you know ... towards more of a value-based model versus care-based model. There's still a lot of work that needs to be done in that regard, especially in terms of reimbursement models.

Historically, patients have been, you know, financially on the hook for a lot of preventative tools. It's been very much consumer-driven, like a direct-to-consumer model or a B2C model, where we've expected the consumer to be so engaged with prevention and early detection that they're gonna pay out of pocket for these types of services. 

But I think what we're starting to see more and more is payer appetite to start encouraging the population to be more involved in prevention because they see a clear ROI in terms of, if you engage with the patient early, if you provide, let's say digital tools to a patient to be more engaged with their nutrition, be more engaged with early detection of, let's say, skin anomalies before it becomes a real issue—they're seeing a real cost savings longer term.

And I hate to bring everything down to economic value, but that's unfortunately where we're at in a lot of cases. You know, like, who's paying? Who’s paying for the care? How much is the care gonna cost? How much can we save on providing care? But fortunately, the downstream benefits are better outcomes. So if the economic incentives are in place, if we engage with the patients to be more proactive in their disease prevention or health prevention, we are going to see better outcomes in the longer term. 

And I think there's enormous opportunity for—if you're looking at disease states—diabetes control. Just look at the big cost drivers for the health system: cardiometabolic states. So, if you look at your hypertension, high cholesterol, diabetes, obesity—these are things that are completely manageable and preventable in many cases just using digital tools, right? 

So advice in terms of what to eat, or how to be more active or how to improve cardiovascular health, I think could make huge strides in reducing the cost burden on both the health system and preventing ... providing a better just quality of life for patients in the longer term.

 

Gareth Presch 

So this is something that I think is really important for people to understand, and, you know, in terms of cost savings but also generating value for communities and, even from a government perspective, this is the sort of work that we're very much focused on. 

So, just to give people an understanding of the context here. In the UK, you have about 2.5 million people ill—sick—at the moment. And this has a drag on the economy of about 7 percent of GDP, which is an enormous figure. And in the States, it would be something similar, if not higher. So you're not talking about ... you're talking about billions of dollars and, you know, potentially a lot more in terms of the envelope for the economy. 

And we've seen through COVID, when we all stopped working, shall we say, the economy basically just stopped. So health is wealth. So we very much have to ... and this is this new investment model. We recently—I recently spoke at a conference in Abu Dhabi at the annual investment meeting to lobby and to start to push towards this value-based care, where we can show the economic value of keeping people fit and well.

This kind of leads us on very nicely to kind of our final kind of topical area, which is the future of healthcare, and this is kind of very exciting from a digital perspective. And Atul, I'm really looking forward to seeing your perspective in the future of medicine, you know, in terms of in the acute setting because it's probably gonna be the most disrupted is in the acute setting because there's so much pressure on the system at the moment, and the acute setting is where that pressure is being felt. It needs the help from the community.

You know, where do you see the opportunities and the challenges in the next, you know, few years, for digital health in our hospital settings?

 

Atul Singh

Yeah, Gareth, you're absolutely right. There are so many opportunities, and the future does look bright for digital health and the technologies that are on the horizon. The one that is top of mind for everybody is AI and machine learning. I won't touch on that because I think there's enough literature out there that everybody's talking about.

Some of the lesser-known ones I can surface here that may be relevant to the audience ... the one is blockchain. So, this had its prime maybe three or four years ago, but the blockchain actually works. It allows for secure, tamperproof storage and sharing of healthcare data, and this improves interoperability, data integrity and privacy, and hospitals are investing in this technology. Nobody wants to talk about it because again, this is one of the back-end work that they are doing. 

Another area that is gaining a lot of steam is 3D printing. This is in the reference of customized prosthetics or implants. This has a direct impact on reducing costs for both the hospitals as well as the patients. And just-in-time printing of the devices or the prosthetics that are needed for the patient ...  

Nanotechnology is something that is also being actively worked on. So, this is utilized in precise delivery of drugs for targeted therapies, and it also improves the diagnostic tools in terms of the sensitivity and the measurement capabilities.

Other areas—we touched briefly on robotics, where robotic-assisted surgeries are happening. Genomics is another area that—where advances in genomics, including the next-generation sequencing ... So this is advancing how we can get to personalized medicine: targeted therapies based on individuals’ genetic profile. That's an interesting area. 

Bioprinting or tissue reengineering, as it's called, so creating live tissues and organs—this has a huge impact on hospitals because they are always facing organ shortages. This is something that is more cutting-edge than widely adopted right now, but this is on the horizon that hospitals are very acutely looking at.

And last, which is a little bit out there—maybe five or 10 years out—is quantum computing. So, this is the area which would allow hospitals to be able to accelerate complex data analysis. As I said, they have so many solutions within the hospital setting, and each of them is capturing enormous amounts of data, but right now, they lack a coherent way to analyze the complex data, and quantum computing would allow them to do that: simulate biological systems, direct delivery process and so on. 

So these are some of the exciting technologies that are on the horizon that the hospitals are very closely looking at.

 

Gareth Presch 

Brilliant, Atul. What a great summary there as well. Like I think ... fascinating to see how much is happening at the moment, and you didn't even mention the metaverse! 

 

Atul Singh

There you go!

 

Gareth Presch

That's another topical conversation for us. But Darren, community settings, I mean, when we look at the pressures that are coming on the system, and like, keep in mind, we haven't even mentioned the likes of Alzheimer’s, obesity, all these conditions that are manifesting in the future—huge costs as well.

Community is gonna be a real focal point, and, you know, where do you see the challenges, you know, from a capacity-building perspective? But then also, you know, where are the opportunities for the community to leverage digital technology from your perspective in the future?

 

Darren Sabo

So, a lot of the same trends hold in the community from what Atul brought up. So I'll try and find some gap—some things that I might be able to add to that. That was quite a comprehensive list of emerging technologies in the health space. 

So by ... he touched on personalization. And I think that's really, really important, you know, this focus on treating the individual versus just doing ... just general population health based on bloodwork, lifestyle, genetics, SDLH, that we were talking about earlier. But that would really, I think, improve engagement in outcomes both in the healthcare contact—the clinical setting—as well as within the community. 

I think that there's a lot of really interesting trends happening with digital twins, especially related to drug development. You were talking about 3D printing of organs using virtual organs to better understand progression of certain diseases and the impact that has on the patient. Surgical procedure planning—I think digital twins is really interesting in that space as well. 

One of the challenges that are faced within the community is this ... is the fact that EHR or the electronic health record data is really fragmented across multiple systems. You have the insurance. You have information at the GPs. 

 

Gareth Presch 

I think we might have just lost Darren as he was getting into the insurance. Yeah, we just lost Darren, but he'll join us—he'll come back into the session. 

Atul, just finally, we just, you might want to pick up on that—the interoperability that Darren's describing between the community and the acute hospital. I personally feel that's an opportunity really. I mean, if we can come up with the technology, which is in place, and we can have that adoption, I think it's really convincing the clinicians that there is time to treat here. 

And the, you know, from your perspective, trying to make that argument to the clinicians, you know, because keep in mind clinicians, their job is to treat patients, you know ... So, do you see that as an opportunity for the sector—for digital health as a community?

 

Atul Singh 

Yeah, absolutely, and as I mentioned earlier with the CURES Act that recently got passed, it makes it a lot easier. In fact, it mandates that patient records now need to be made available not only to the patient but whoever the patient deems necessary to have access.

Right now, that is—even though it's the law—but still, practically, it's not implemented in the sense that hospitals, community settings and other care settings don't necessarily talk to each other and are able to transfer patient records seamlessly. And it's still a burden. So the opportunity exists. 

Now, there are a variety of reasons why that has happened because of the way—again, back to aging infrastructure and things like that—but right now, the opportunity is very near and real for anyone who wants to get into this space and build platforms that can connect with FHIR APIs or HL7 and be able to pass the electronic records from different disparate systems so that the clinician, who's actually treating the patient, and the patient who's being treated both have the same access to their—to the records.

So, this is something that has to be fixed before we can talk about things around value-based care models and so on, and this will get further highlighted once the care setting moves to the home because in home, it'll become even more critical for all data sets to be talking to each other. Because now, the patient and the provider are removed by geographic distance, so there's no choice but for all participants in the healthcare setting to be able to exchange data seamlessly.

 

Gareth Presch 

Brilliant. Thanks, Atul. And Darren's rejoined us. Great to have you back, Darren, and you were just—I mean, Atul just stepped in and gave us a great understanding of what needs to happen between interoperability between the community and hospitals, as you were explaining.

Do you just want to finish that point? And then what we'll do is we'll jump into the questions. We've quite a few questions here, but we'll try and get through them as quickly as we possibly can.

 

Darren Sabo

Yeah, so I don't know what ... I don't want to repeat what Atul was just saying, but the point I was trying to make is healthcare data is just all over the place, and in order to take advantage of emerging technologies in AI or personalized medicine, we really need ways to share that data and bring that infrastructure together—that back-end infrastructure together—or else the technology just won't be as valuable. 

And this is gonna require participation both on the technology side but also on the health provider and the payer side as well. Everyone's gonna have to work together and form agreements to be able to access each other's data. And I think in doing so, it's really gonna be a calculus of, you know, one plus one equals five versus one plus one equals two, or, you know, some folks saying, “If I share my data, I'm losing economic value. You know, I have economic value associated with this data.” But really, changing the mindset from I'm giving something to I'm gaining something, and ultimately, the patient and the outcomes are gaining something and improving in the long term as well. So we need to change that mindset here in the United States.

 

Gareth Presch 

Brilliant. Well, look, that leads me nicely, and we've got about 10 minutes left, and I think we've got just over 10 or 11 questions to go through here. So let's try and get to these nice and sharp. And what I'll do is I'll put the questions to kind of both of you, and we can keep it nice and sharp and get on top of this so that we make sure everyone feels we've got through their questions. 

So firstly, I'll start with you, Atul. What's your definition of digital health?

 

Atul Singh 

Very simply, technology-enabled solutions that allow a provider to deliver care to the patient and the patient to receive care in a meaningful way. And this could take any form or shape. It can be a device-based solution. It could be a software-based solution. It could be a solution that is offered through existing devices that you might have in your home. It could be a fridge. It could be a microwave. It could be anything that is intelligent and smart that can talk to other devices [and] be able to deliver value to you in a way so that it allows the patient to improve or recover from their episode and to get back to wellness.

 

Gareth Presch 

Brilliant, brilliant, and Darren, from your perspective, what's your definition?

 

Darren Sabo 

Digital health: It’s an extremely broad definition but anything using technology to better

deliver care to patients. I think what we're gonna see is this breakdown of terminology of digital health to just health. I think we're getting to that inflection point where digital tools are starting to become so prevalent in the healthcare space that it's just delivery of healthcare.

Look at telemedicine adoption, you know. Digital health tool, you know, it really took hold over the past few years, and it's just, it's not a nice-to-have anymore. It's a need-to-have, and this is becoming an integral part of health systems’ tool kits in treating patients. 

So, is that digital health or is that just health? I like to think, you know, we're gonna have this confluence of technology and delivery, and it's all gonna be one, and we could provide a unified experience for both the patient and provider and payer, for that matter.

 

Gareth Presch 

Excellent. So my definition would be technology that enables a patient to improve their quality of life. That’s it—nice and simple, but that's kind of my take on it. 

And I wanna just touch on a couple of things that I think is very topical, and again, like, from the healthcare acute space and community: environmental factors. So, digital health can really play an important role here around air quality because, you know, we have with ... that actually costs about, you know, $8 billion a day in terms of ... and about 13 million lives a year. 

So, Atul, do you see environmental factors becoming more prevalent as we move forward from a digital health perspective? And the same question to you, Darren.

 

Atul Singh

Absolutely, and digital health can have a very positive impact in terms of monitoring, measuring, alerting individuals based on their unique needs around environmental factors. With temperatures rising, whether it's the forest fires that we are experiencing ... the smoke in the U.S. region in the air and the quality of air itself or simple things, like pollen during the springtime ... anything around that. The quality of water, the cleanliness and other factors—they are all very primed to be used and applied digital tools to in order to monitor them.

There are lots of sensor technologies that are now available that can not only monitor air particles, but they can also look at strains of the virus at the bacteria level; they can monitor the bacterial growth. So those type of technologies, the more and more they are rightly deployed, the more they can provide feedback to our systems in order to create a much more safe environment for humans.

 

Gareth Presch

Go ahead, Darren. Your perspective?

 

Darren Sabo

Yeah, and to just build on that, I would say, with climate change, our environments are changing, and we have to understand that and how that's going to affect our health. And digital tools are really good at helping us do that, whether it be just air quality, like Autl was mentioning, or temperature or water quality. These are things that are easily measurable. The sensors exist right now, and it's just a matter of connecting the data and providing ...  layering in the appropriate analytics and tying that back to actual, you know, health states. 

But also, we can't forget to provide recommendations. We have to not only just alert patients that they’re in a zone with poor air quality and this could potentially have a negative impact on their health, but we have to be very thoughtful about our interventions and provide patients with options on how to improve their environment or their choices to improve the state of their health. 

You know, that makes me think of the “quantified self” movement, you know, about a decade ago, where everyone was measuring everything, and you had all these devices out there that would give you all this data and all these trend lines, and customers or patients were like, what does it mean? And no one knew. And that kind of, like, fell flat, but now you're seeing a resurgence of, obviously, wearables, but in like healthcare-focused wearables, and doctors are trying to make sense of the data and provide that back to the patient. 

So I think it's not just, like, tracking the environment and changes to the environment, but it's like the, “so what?” is really important. I think there's enormous opportunity there for up-and-coming startups to really answer the “so what?” and really help with engagement with the patients.

 

Gareth Presch 

OK, thanks for that, Darren and Atul. Listen, we've only got about two, three minutes left, so I'm going to split up some of the questions here, and let's do it nice and quickly and see if we can get some of these answers in. 

So, I'll come to you, Atul, you know, in terms of, like, what is the next big thing that people aren't talking about yet in terms of digital health?

 

Atul Singh 

I think one of the areas that is getting a lot of hype but is not seeing a lot of underlying value is extended reality or mixed reality. That area is prime to disrupt digital health—or healthcare as Darren put it—because of the application of XR and so many different use cases both in the hospitals from a training, and surgery and education standpoint to simple use cases around pain management, for example, or recovering from surgery or physical therapy. 

There are so many areas that can be impacted by it, and it would be great to see more innovation in that space. Even though everybody talks about AI, I think XR should also be looked at equally closely.

 

Gareth Presch

So watch that space. And Darren, just finally to you—OK, we're just running out of time—and, you know, what is the one tip you have for startups interested in digital health?

 

Darren Sabo 

Focus on the business model. Understand the money flow. Understand how reimbursements work. Talk to customers. Talk to health systems. 

I've worked with hundreds and hundreds—maybe a thousand—startups over the past two decades, and one thing I see time and time again: They develop interesting technology, but no one pays for it. Or they don't understand who's gonna pay for it or who the customer is ultimately. And they have lots of challenges and have to pivot. And a lot don't survive even though they have amazing technology. So really understand the business model and the environment and understand how you're gonna get money.

 

Gareth Presch

Yeah, well, that’s brilliant. I mean, I hope everyone's really enjoyed this webinar today. I mean, we've had such a jam-packed hour. I think we could have gone on for a considerable amount of time, but we've just come to the end of the hour. You know, I've thoroughly enjoyed the discussion, and Darren, Atul, thank you very much. It's just been fascinating to get an insight into digital health. 

I think we can say that the future is about digital enablement, and education will play such an important role. I think if you look at emerging factors—certainly environmental factors are gonna play a huge role with climate change, and then, the business models and the value proposition is certainly changing. 

I think existing models will begin to be changed, and the evidence will need to be proven in terms of preventative medicine, but I think once that model shifts, you'll see a massive swing, you know from—as I said, 90 percent of the budget effectively goes on disease management—to a preventative model, which, hopefully, will take maybe 20, 30 percent of the budget in the next few years,

So that again will bring exciting opportunities for new jobs. How do we strengthen health systems post-COVID? How do we create new and meaningful jobs as well in the future of digital health? 

So, from my perspective, I'll close if everyone's happy with that, and I hope you can join us at our next session. So thanks from me, and Atul and Darren.

 

Atul Singh

Thank you.

 

Darren Sabo 

Thank you very much. Thanks, Gareth. Thanks, Atul.

 

Annie Sznajder, Webinar Host

Yeah, and thank you, everyone. And with that, we conclude this insightful session. So thank you to our moderator, Gareth Presch of the World Health Innovation Summit, and for our panelists from LG NOVA, Darren Sabo and Atul Singh. 

And thank you to our audience for your participation today. We hope that you have gained valuable knowledge and insights on digital health. 

And before you jump off this webinar, we just want to remind you to stay connected with LG NOVA and LG Digital Health. So, if you aren’t already following us on LinkedIn, please do so. We'll be sharing additional information about webinars, our upcoming Innovation Fest and other news. So thank you again for being here with us today.