On 2 November 2021, the ISPOR 2021 Patient Representatives Roundtable – Asia Pacific convened 30 stakeholders from 12 Asia Pacific countries, representing multiple perspectives (chronic and rare disease patient organizations, researchers, health technology assessment bodies, and government agencies). Topics of discussion included the value and use of digital health for chronic disease management, ways to improve access to care and accelerate health equity, lessons learned from the COVID-19 pandemic, and how different stakeholders evaluate the value and effectiveness of telemedicine.
Survey on Utilization of Virtual Care:
Roundtable participants were surveyed prior to the roundtable event to assess the use and impact of virtual care as a response to the COVID-19 pandemic. Eighty percent of respondents answered that they expect the utilization of virtual care would continue to increase post-pandemic, while noting a few barriers and opportunities. Barriers included slow internet connectivity, lack of telemedicine training both in the undergraduate and postgraduate curricula for health professions education, lack of standards for quality of care, reimbursement and equipment/readiness , certain medical conditions that are still better to be discussed in-person visits. Opportunities included convenient and accessibility of care, saved time and resources that could have otherwise been spent on waiting (queues, traffic, etc.), some screening and initial assessments are suitable for virtual care . Virtual care is a very good solution for follow-up visits where patients only need to discuss their conditions once they are discharged.
Presentations on Lessons Learned from the COVID-19 Pandemic:
Speakers from a major global health data and science company and a patient organization provided attendees with presentations on lessons learned from the COVID-10 pandemic. From a data science perspective, the speaker discussed the use of digital health to increase access, as well as the digital innovation and integration of digital devices with medicine. The speaker mentioned downfalls, including how the health care industry has not yet caught up with this increase in digital health, and that there is a lack of standard operating protocols. Additionally, the speaker touched on electronic health records, the importance of data sharing, and how this is making clinical trial more feasible and accessible.
From a patient organization perspective, the speaker highlighted that digital health provides unlimited opportunities for patient engagement, but it is important to consider digital equity including being careful to not exacerbate current inequities and not layer digital solutions onto already poor infrastructure. It is imperative that patients are involved in digital solutions to understand why data and information matters (i.e. data usage, purpose for data collection, type of data being collected, where it is being stored, and who it is being shared with). It was noted that there is a gap in the patient community of understanding what health data means and the digital implications from the pandemic.
Considerations When Evaluating Virtual Care:
Advantages
- Access to specialist care
- No waiting time in queues
- Convenience and accessibility of care
- Reduced cost for patients and clinicians without necessarily decreasing quality of care
- If connected to the same clinicians, better care throughout the continuum of care
- Increased opportunity for monitoring patient lifestyle and compliance with expected behavior change targets
- Symptoms are triaged in real-time
- Hospital readmissions reduced
Disadvantages
- Ambiguous reimbursement third-party payer policies
- Need for virtual care-related peripherals in patient homes that may not necessarily be cost-effective for patients or institutions
- No tactile or olfactory input elicited during patient assessment and interaction
- If not connected to the same clinicians, disconnected care
- Infrastructure for telemedicine in patient homes is expensive and may not be affordable for patients
- Use of equipment for virtual care may be difficult to navigate for older patients
Conclusions:
Virtual care is here to stay in a post-pandemic world. There is variability in how digital health is understood in the Asia Pacific region, especially in the patient community; more education and capacity building are needed in this area. Further discussion is merited for considerations in how to measure the clinical effectiveness of virtual care and how to ensure that virtual care is of the highest quality. To measure the quality of virtual care, associated metrics in how to assess this would need to be defined and designed. Key multistakeholder perspectives should be considered, factoring in the cost of virtual care into payer mechanisms, patient involvement in digital solutions, and policy decisions on moving to more cost-effective care and embracing preventive approaches.
Additional Information:
The ISPOR Patient Representatives Roundtable provides a platform for patient representatives to discuss issues and challenges of patient involvement in the health care research and decision-making processes with other key stakeholders such as researchers, HTA bodies, payers, decision and policy makers, as well as representatives from the pharmaceutical industry. To learn more about ISPOR's Patient Engagement in Health Economics and Outcomes Research (HEOR) initiative, visit our website.