Is virtual care the key to better, more equitable health outcomes?

It wasn’t so long ago that the idea of taking a doctor’s appointment over Zoom was unfathomable — and even unappealing — to the bulk of consumers.

Times, of course, have changed.

In early 2020, just 7% of people in the U.S. had met with a healthcare provider virtually; by mid-2021, that number had jumped to 32%, according to a survey by Accenture. A quarter of respondents said their access to healthcare had improved since the onset of the pandemic, and more than 20% expressed interest in digital services.

“Through the past two years, people really got accustomed to remote services, really because they had to,” says Ellen Kelsay, CEO of Business Group on Health, a nonprofit that works with large employers to advocate for better solutions and innovation in healthcare. “But now we have to look at these solutions long-term, and make sure they are actually improving outcomes and reducing costs.”

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The surge of tech-based solutions in healthcare has moved far beyond virtual visits. From advancements in remote patient monitoring to actual treatment delivered through new modalities, innovation continues to disrupt the healthcare space, bringing welcome change.

For folks battling chronic musculoskeletal (MSK) conditions, for example, Kaia Health is using technology in an effort to improve both access and care. The digital therapeutics company’s primary offering is an app that delivers virtual, artificial intelligence-based physical therapy. For a world that’s become accustomed to screen time, the offering is simple to adopt: log in on a smart device, prop it against a wall, and get to work. The day’s exercises will be demonstrated first, and once a user starts moving through the program, the app — with the help of the smart device’s camera — tracks 23 key points on the body, and will alert the user if they need to make any physical adjustments in real time.

“As it relates to MSK, in my mind, we’re achieving the holy grail of healthcare: delivering high quality care at reduced costs,” says Nigel Ohrenstein, president at Kaia Health, noting that the employer-provided program currently has 1.2 million active users. “You can’t do that by scaling people. You can only do that by scaling the tech piece with the human wrapper.”

Kaia’s app will provide physical therapy instructions and offer corrections in real-time.

That “human wrapper” is Kaia’s ability to connect patients with in-person treatment if necessary, even coordinating a session with a local provider in the user’s home. That can certainly appeal to anyone who favors human interaction. Still, Ohrenstein says, the benefits of digital therapies stretch well beyond convenience, and are positioned to create even greater change in healthcare.

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“I happen to live in the Bronx, and the life expectancy there is five years less than it is a mile and a half south in Manhattan, and one of the reasons is access to cash and access to quality care,” Ohrenstein says. “But the thing about digital therapeutics is, the camera doesn’t distinguish between ethnicity, and it doesn’t distinguish between wealth. It doesn’t get tired, it doesn’t get irritated, it doesn’t go to check on the patient next door and leave you doing exercises alone.”

Kelsay agrees that technology has certainly boosted access to care for most populations, pushing the industry in the direction of more equitable treatment. But technology, she stresses, is not a quick or singular fix.

“Technology is one of many ways to deliver care, and it shouldn’t be a complete replacement for other delivery models,” she says. “Think of pockets of communities or rural locations where broadband is not widely accessible, or of individuals who may live in shelters, where a video visit won’t be comfortable for them. We have to keep a watchful eye on the embrace of technology and make sure we’re not overlooking any groups or communities.”

That’s where employers have plenty of power, she says. The pandemic forced consumers to get comfortable with digital care, but as we emerge from the COVID-19 crisis, there must be an impetus to keep improving.

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“Employers are now asking a lot of hard questions of their vendor partners on outcomes and data before they implement solutions,” Kelsay says. “They’re being intentional about what their expectations are — and there’s a need and a hunger for serving unique populations.”

For Kaia’s part, they are looking to expand by finding new ways to serve and treat additional conditions and patient communities. In addition to its MSK solution, Kaia has also created a digital therapy to support people suffering from chronic obstructive pulmonary disease (COPD). The program is currently available in Germany and a U.S. rollout is expected in 2022. Unlike the MSK offering, which relies on visual tech capabilities, the COPD solution utilizes a smart device’s microphone to help a user strengthen lung health through breathing exercises.

That ease of use, as Ohrenstein sees it, is vital to get folks to embrace new technologies, and to stick with them. He’s seen firsthand the impact that can have on a patient’s progress, and is hopeful that Kaia — and the industry at large Kaia’s app will provide physical therapy instructions and offer corrections in real-time. — will continue on this trending path.

“I spoke to a patient and a Kaia user earlier, and she said it used to take her three hours to go back and forth to physical therapy, so she would go to two or three sessions and then stop,” Ohrenstein says. “But now, she’s a year into remaining highly compliant with our therapy because she can do it anytime that suits her. That’s putting her on a path to a better life with less pain and more mobility.”

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