Innovations in Care Delivery

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Let´s Start with the Definition

The integrated management and delivery of quality and safe health services to people in need, along the continuum of disease prevention, diagnosis, treatment, disease-management, rehabilitation and palliative care services, through the different levels and sites of care within the health system, is the universally accepted to the definition of care delivery. (WHO)

The goal of any health care delivery system should be to foster optimal health outcomes by providing cost-effective, patient-centered, quality care with a service emphasis. Health care delivery systems should be designed to motivate patients and health care providers to make decisions consistent with this goal. (AFPP)

In this article we will view five innovations that have changed the care delivery paradigm and have the potential to revolutionize the way care is being delivered.

Wearables (NY Times)

Fitness trackers have become a commodity today, being the most common wearables. Wearables are IoT based devices (devices that when connected with internet enable the transfer of data without human intervention) incorporated into items that can be comfortably worn on a body used for tracking and sharing vital health information on real time basis. Some of the notable wearables are

  • Ava – a night only ovulation tracking bracelet to track a woman´s menstrual cycle, fertility, pregnancy and overall health
  • IB-Stim – a prescription only hearing-aid like nerve stimulator to relieve pain in children with irritable bowel syndrome
  • KardiaMobile – a personal 6-lead ECG system that collects and analyses medical grade ambulatory ECGs to monitor patient´s cardiac health and prognose the risk of cardiovascular and neurological events
  • Monarch eTNS – a iPad like device with a band-aid like sensor, it is a FDA approved device for the treatment of ADHD in children who are not currently taking any ADHD medication
  • Owlet – a smart sock that monitors infant heart rate, sleep cycles and oxygen levels

More consumer oriented wearables such as Apple watch, Fitbit, GymWatch etc. that monitor day to day vitals and workout paces (Link) are gaining popularity and becoming a norm. The quick adoption of such wearables is largely due to the promise of wellness.

The BIG potential of wearables, however, lies in the possibility of early diagnosis and instigating preventive measures. These simple gadgets present huge opportunity to deliver care when and where it is necessary especially in preventive care.

On Demand Delivery (NY Times)

Imagine! access to doctors, prescription drugs and wellness programs as fast and easy as hailing an Uber cab. Yes, the healthcare is being explored for such opportunities. Long gone will be the days when you anxiously and sometimes in pain wait to hear “The doctor will see you now”.

Already dozens of health and wellness companies are tapping into application-based healthcare delivery. Heal, DispatchHealth, MedZed, Dose Healthcare and Pager are some of the apps which will send a doctor or a nurse practitioner to a person’s home or workplace to treat non-emergency problems e.g. sprained ankle. I.V. Doc offers in-home intravenous treatments for conditions like jet lag, hangovers and food poisoning and Capsule delivers prescriptions to your doorstep.

Insurers in US have started to add on-demand services to their plans and building partnerships with these start-ups for chronic conditions, like hypertension and diabetes. The companies are hoping to cut down on hospital or emergency room visits and subsequent costs. On-demand care delivery has the potential to revolutionize health services industry that is struggling with soaring costs and reduced access to care benefitting patients, physicians, and payers.

Point-of-care (POC) diagnostics  (NCBI)

I am sure most of us have seen a portable blood sugar or blood pressure monitoring device. Simply put, POC devices allow medical testing outside of a laboratory setting. These devices combine portability, convenience, speed, connectivity and quality assurance in early detection, prevention and management of chronic conditions.

Smartphone‐based imaging and sensing platforms are the next generation alternatives in POC monitoring and management. Few such technologies are already commercialized such as Dario and iHealth Align portable glucometer, Qardio Arm for blood pressure. Advances in biosensors and lab‐on‐a‐chip technologies combined with novel analytical techniques, all enabled by an underlying connectivity will help in ushering in the next generation POC diagnostics.

More than 66 percent of the world has cellular/mobile devices (phones, tablets etc.) and more than 35 percent world population has a Smartphone (Data Ref.) indicating the potentially broad  access to sophisticated POC diagnostics. POC diagnostics can also be leveraged to improve population health in developing economies. The ability to quickly diagnose and dispose treatment will help specially in containing infectious diseases.

Virtual Reality  (VRlink)


Photo: Marius Becker/picture alliance via Getty Images used by Forbes

For most of us Virtual Reality or VR is a ‘buzzword’ in context of entertainment. This technology has also found various uses in healthcare industry. VR allows patients to be taken through their surgical plan by enabling a virtual reconstruction of their anatomy & pathology. The result – enhanced understanding of the treatment and consequently, higher patient satisfaction. As per one stats, more than 240 hospitals in the United States are using virtual reality to assist various health-related procedures and help patients visualize and understand their treatment plans. Here are some examples of VR in healthcare

  • Start-up Floreo uses mobile VR to instigate social interactions with autistic kids by spurring virtual “live” characters in a scene e.g. instead of interacting with toys on a table, children that need therapy can see a giraffe in a virtual safari park and interaction with them situation-appropriately.
  • Pain management is one of the key areas where VR based interventions are particularly useful. Project Farmoo helps gamify the pain distraction experience for hospitalized patients with a special focus on teenage cancer patients. Karuna Labs offers a Virtual Embodiment product that teaches chronic pain sufferers how pain, rehabilitates them, and eventually allows them to live a normal, less painful, life again through their virtual engagement programs.
  • Low vision is a visual impairment that can have significantly adverse effect on an individual´s quality of life. IrisVision is an easy-to-use headset that helps patients regain their sight via a VR experience. It gives patients a way to magnify desired objects in the visual scene without losing awareness of the overall environment around them.

These are just a few examples how Virtual reality can be applied to improve patient lives.

In 2017, a US headquartered trade association, by the name “The Digital Therapeutics Alliance” (DTx Alliance) was formed with the mission of broadening the understanding, adoption, and integration of clinically-validated digital therapeutics into mainstream healthcare through education, advocacy, and research. DTA members include companies and organizations engaged in the manufacture, support, and utilization of digital therapeutics. Healthcare providers, patient groups, and payers are actively engaged in DTA’s work and mission. They have recently released a comprehensive white paper covering the integration of digital technologies with evidence based medicine into best practices for healthcare organizations to review, try, adopt and improve upon.

Social Media Platforms  (Patient engagement)

Social media platforms like Twitter and Facebook provide a never-before opportunity for patient engagement by providing access to healthcare information and educational resources.

Communication is the key offering of the various social media platforms. Patients can be given general health information and/or be guided to secure channels for more personalised information related to their health condition.

Healthcare organizations can also leverage the available social media platforms to build patient communities. Connecting patients at the same care facility or with common health goals builds a community that supports each other for better health. Having an ambassador to manage patient query in focussed groups or communities indeed make the healthcare organization far more accessible and patient friendly.

80 percent of patients are using the internet to get healthcare information. Often overwhelming or ill construed information on internet can very well be put to perspective by healthcare organizations more reliably. I imagine a secure page that hosts my health information, vitals, dietary plans, habits, dos and don’ts, all personalised to my health objectives. Add to that a query window that answers my query based on my health situation followed by a link to my primary physician. All this at one place, one-click away.


The increasing incidence of diseases and technological intervention are key drivers for adoption of digital technologies in healthcare. Most treatment and patient care were personalized as best as the “office” model allowed. Technology at the point of care, wireless communication and increasingly sophisticated analytics will take this personalization to the next level. I imagine a world in not-too-distant future, in which healthcare will transform from “sick care” as it is today, to truly care of health. What are the economic implications of that paradigm? That´s a blog for another day.

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Richa Agrawal
Richa Agrawal
Richa leads the biosimilar practice at RAS. Having followed the evolution of biosimilar industry in last five years, she has acquired relevant understanding of this space which she like to share in her posts.

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