With 2020 thankfully behind us, we are ready to welcome the new year, which seems to be one of enormous potential for digital health. Although the past year has been mainly devoted to COVID-19 and its impact throughout the world, there have been other important developments, many of which were a direct (positive) result of the pandemic.

Below you will find nine lessons learned from digital health in 2020, which also give a glimpse of what the future holds for the evolution of the sector.

1. Proteus may have failed but digital pill technology is here to stay

Having developed the very first FDA-approved digital pill, Proteus made history with a new product full of potential. Founded in 2017, the fledgling company was valued at $1.5 billion in 2019, but a year later, following a disastrous turn of events, Proteus filed for bankruptcy. The rapid decline of this digital unicorn was attributed to a series of factors ranging from poor management to overpriced pills, making it unlikely to ever become a viable technological solution offeror. 

However, Proteus was not the only company working on the development of this pioneering technology, etectRx and Infármate are also actively developing their own digital pills, while Otsuka Pharmaceutical, Proteus’ former partner, acquired the digital healthcare unicorn, in a strategic move indicating the potential of digital pills in the pharmaceutical sector. As studies have shown that digital pills help improve adherence among people with adherence problems, there is no doubt that the fall of Proteus does not mean the fall of the entire technology, although it does mean a tougher road ahead for those who want to get their pills to market.

2. Digital contact tracing did not produce the expected results 

Alarmed by the rampant transmission rate of COVID-19, governments around the world have looked to technology to help contain the virus. The emergency solution came in the form of contact tracing applications. Downloadable by citizens, they had the potential to help health authorities get an indication of an infected person’s contacts, ideally to prevent them from exposing even more people to the virus. But in the days of the GDPR, the hasty implementation of these applications led to an immense risk for privacy and data security. Sensitive or even embarrassing information about South Korean citizens came to light while Moscow’s QR system was labelled as a “cyber-gulag” for monitoring citizens’ movements as part of its containment efforts. 

The U.K and Qatar, also face troubleshooting putting the data provided within the apps at risk of being hacked.

 In line with the massive investments that have been made in the health technology industry for 2020, hundreds of thousands of dollars have been invested in the development of these applications while, unfortunately, the adoption rate among the world’s population has remained low. To put things into perspective, only 5% of New Yorkers have downloaded the COVID Alert NY application, while researchers at Oxford University estimated that about 60% of the population would need to use the applications to even be effective. Our growing awareness of the repercussions of mishandling data has come about because we are not prepared to have our privacy violated, even for the public good.

3. COVID-19 boosted investment in healthtech

A record year for investment in the industry, 2020 was marked by an urgent need to accelerate the growth of the health technology industry. In the third quarter of 2020, investment amounted to $9.4 billion. This amount exceeds the $8.1 billion annual amount in 2018, which was previously the record year.

With COVID-19 being a priority for investors, financing was mainly focused on companies offering on-demand and remote healthcare services, solutions addressing concrete needs in the midst of the pandemic.

4. Virtual events have become the norm

Thousands of in-person medical conference organisers around the world have turned to technology to make their conferences happen. The need for social distancing has forced the postponement, even cancellation, of in-person medical events in 2020; among the physical events that have taken place in 2020, several recorded COVID-19 infections of participants. But this setback also gave medical events the window of opportunity to adapt to the changing times, shifting from trivial PowerPoints to the digital age.

Not only did virtual events allow the events to take place, but they also enhanced the overall experience.  If well designed, they can be more inclusive, more appealing and more visually insightful than traditional events can be.

5. The FDA has remained strict in granting access to its list of approved medical AIs.

The first open access online database of FDA-approved AI algorithms was introduced by the authors of a study published by the renowned Medical Futurist Institute (TMFI) in September 2020. Perfectly synchronised with the booming medical A.I. market, such a comprehensive database will become increasingly important. Surprisingly, the major regulatory bodies have yet to publish one themselves. The FDA, which took the initiative to regulate this technology, has not proposed one, which explains its use as an example in the study.

As the authors of the TMFI study strive to keep the database up to date, regulators are encouraged to take it over or launch their own, given that they have the resources to better maintain such a tool.

However, none of the major regulators have expressed an intention to do so.

The FDA Digital Team has publicly addressed the issue by indicating that it manages an A.I. consortium but has stressed that it will not take over the database, which appears to continue to be maintained by the original authors. Perhaps 2021 will further underline the importance of such a database, which is set to grow at a very high rate.

6. Telemedicine is now the way to go

The unprecedented measures imposed by COVID-19, such as lockdowns and social distancing while striving to maintain sufficient access to health care, have given rise to the accelerated development of telemedicine as an accepted method of medical practice. 

With only 18% of Americans using telemedicine services pre-pandemic, the service increased its engagement by more than 158% mid-pandemic. This habit change has demonstrated that physical hospital visits can often be avoided and may lead the way to a decrease in hospital overcrowding.

7. Digital health responds to globalisation 

One of the most important aspects of digital health is the facilitation of its access. Companies are striving to democratise healthcare by offering quality healthtech services, such as health monitoring apps, home microbiological testing and telemedicine, to patients wherever they are in the world.

Patients are rapidly adapting to the times as they turn to digital health solutions, regardless of the company’s geographical location.  Cancer patients are continuing their treatment via telemedicine, while demand for health monitoring apps and wearables has skyrocketed. Even the elderly has adapted to this new way of looking after their health and this trend is certain to last. However, strict regulations must continue to govern this new way of doing things to ensure performance quality and data protection.

8. Not all digital health technologies experience their market breakthrough.

Although health technologies are the top investment sector for 2020, with technologies such as telemedicine and health monitoring applications now being part of everyday life, not all technologies have been brought to the market this year. 3D printed casts are a promising innovation that continues not to be as widespread. They outperform traditional plaster casts in many ways, as they are customizable, waterproof, easily removable and prevent infection and muscle atrophy. However, they are still not a common option.

Many factors may explain why 3D casts have not yet been penetrated the market. Indeed, research on the effectiveness of 3D printed casts is rather poor, with no clear indication of their advantages over traditional casts. 

Their production is also slow compared to traditional casts, making them less appealing to investors looking for a cost-effective investment. In addition, the costs associated with them are rather unattractive. 100 euros for a CastPrint mould may not be affordable en masse. 

However, as 3D printers are gradually becoming the norm in hospitals hit by a wave of demand requiring in-house production of equipment, 3D casts may be on the rise. While companies such as Xkelet and CastPrint are also developing solutions to improve traditional plaster casts.

9. “Smartwatch patients” point to the need for cultural transformation

The widespread availability of self-monitoring technology is also accompanied by limitations, both for the patient and for doctors. Indeed, an abnormal cardiac measurement signalled by an alert on our smartphone often leads to a visit to the hospital and turns out to be a false alarm. Such a situation can provide an argument that self-monitoring may in fact be more of a burden to the healthcare system than a solution. However, this is not the case if we change our perspective. 

On the contrary, a cultural shift may highlight the potential and overall benefits of the trend of self-monitoring which has grown over the past year. Indeed, we should understand that these patients are not at fault, and neither is the technology, and we should focus instead on getting physicians to adopt this new technology by inviting them to guide patients in terms of when to take action and when to seek treatment. A culture change, even if it involves a considerable learning curve, could lead to these digital solutions reaching their full potential.