A Conversation with IRIS’s CEO: Understanding Pandemic-Spurred Patient Needs
After two years of sporadic lockdowns, social distancing, and mask-wearing, the COVID-19 pandemic has affected nearly every aspect of our society.
Healthcare explicitly has had to adapt to serve a world full of COVID-conscious consumers by finding ways to provide care that protects both patients and healthcare workers.
As a result, COVID-19 has expedited some of the endeavors that previously marked the future of healthcare, making them a reality sooner rather than later. Solutions like telehealth, convenient-care ventures, and more have quickly developed to keep up with the increased demand for safe, socially-distanced healthcare options.
In the following blog, IRIS CEO Steve Martin sheds light on some of the care trends we can expect to see in the coming years as we continue to transition out of the pandemic and actualize the significant shifts in healthcare that have emerged from it.
A Higher Undiagnosed Patient Population
IRIS CEO, Steve Martin, highlights the effects of the pandemic on vulnerable patient populations,
“For the last two years, people, because of the fear of going into primary care or… into the healthcare system, have simply just chosen to delay those types of diagnostic screenings that are so important.”
Anxiety surrounding COVID has led to dramatic decreases in inpatient hospital visits, with one study finding Kaiser Permanente experienced a 50% drop in heart attack-related appointments.
Significant rates of decreases in visits to doctor’s offices continue to be reported by different healthcare organizations across the country today, meaning post-COVID, primary care offices can expect an influx of patients with undiagnosed or untreated illnesses once pandemic restrictions ease.
“It’s the same thing that we’re seeing in the diabetic population, particularly those diagnosed with diabetic retinopathy. It’s the leading cause of blindness in the U.S. before the beginning of COVID, it continues to be the leading cause of blindness during COVID, and unfortunately, it’s going to continue to lead to cases post-COVID,” says Martin.
When combining a larger care-seeking population with an already vulnerable healthcare system (partially due to pandemic understaffing and healthcare office restrictions), not only is population health as a whole compromised, but the quality of care provided to those who need it most decreases as well.
“It’s not that people haven’t been sick over the last two years, they’ve just gone undiagnosed. Unfortunately, they’re still sick; they just don’t know it yet. That is something care providers are going to need to prepare for.”
More Convenient Healthcare Provisions
Before the onset of the pandemic, healthcare was moving toward meeting patients in locations convenient to them. However, this process expanded and flourished amid COVID-19.
Now, major healthcare organizations have changed their structures to include more convenient care initiatives that transform how patients interact with their care system. That care can look like providing services in easily accessible locations like close to work, in urban hubs, or directly at home.
“There is a movement now in healthcare where much of the care is moving outside of the four walls of primary care and into other settings, whether that be due to some larger retail players getting into healthcare or organizations themselves shifting toward more convenient service options. But we’ve especially seen economic investments in organizations that are providing care at home,” stated Martin.
Today, the U.S. has a population of 300,000,000, with around 40% of that population battling chronic conditions. Diabetes is one of the most prevalent of these conditions, with 10.5% of the population diagnosed as diabetic and close to 3% unaware of their diagnosis. Still, diabetic retinopathy screening compliance rates remain incredibly low, often due to the inconvenience of traditional care measures.
Home-based care initiatives seek to mitigate these low compliance rates by going directly to the consumer.
Through some of its key partnerships, IRIS has already implemented its diabetic retinopathy screening technology into home visits, allowing for the administration of diabetic retinopathy exams, right out of the home, with no extra effort to the consumer.
“We are seeing this trend of at-home care gain traction with our existing clients. Through our two largest partners, we screen about 7,000 individuals per month inside their own home,” says Martin.
Martin went on to highlight the longevity of in-home care. Even as COVID cases lessen and populations readjust to a new normal, home-based care and its convenience will continue to occupy the healthcare space.
However, access to screenings goes beyond the home and focuses on meeting the diabetic population in their day-to-day life.
According to Martin, “Only 40% of diabetics get their annual [diabetic retinopathy] screening. If we’re ever going to get that number up to 80 or 100%, we have to go where the diabetics are to perform these exams. Working populations don’t always have time to make it to the doctor’s office. Instead, they’re at home, or they’re at work, and that’s where we need to reach them.”
Work, home life, and other responsibilities keep 44% of diabetics from following through with diabetic retinopathy screenings. Instead of forcing patients into inconvenient DR exam appointments, IRIS seeks to bring DR screening technology directly to the diabetic population. That may look like equipping pharmacies, laboratories, or primary care offices with diabetic retinopathy screening capabilities.
“All of these highly-trafficked locations are captive geographic hubs in the healthcare landscape where providers could easily and quickly perform a diabetic eye exam… patients going about their day are our largest footprint within the healthcare continuum,” says Martin.
Telehealth is Ever-Evolving and Here to Stay
Telehealth refers to any internet-based healthcare service that allows patients to call, video chat, or message their primary care providers without physically going to the hospital.
Although a relatively new way to approach healthcare, telehealth was already gaining traction pre-pandemic, with nearly 840,000 Americans utilizing their organization’s telehealth option in 2019. COVID-19 and the hospital anxiety that followed skyrocketed these values, with 52.7 million Americans choosing their provider’s telehealth option in 2020. Furthermore, between February and April 2020, telehealth usage for outpatient care was 78 times higher than ever before.
Two years after the onset of COVID, patients continue to choose telehealth over in-person healthcare services. Because of this popularity, several states have already expanded Medicaid coverage of telehealth services and are considering implementing permanent coverage standards.
According to Martin, “Telehealth was starting to find its niche in healthcare previously, but people began reconsidering it during COVID. Now, telehealth is here to stay.”
As one of the fastest-growing forms of remote healthcare, telehealth is an excellent example of the changing mindset of organizations and consumers’ desire for easily accessible care that is still effective, within reason.
“I can see telehealth evolving and becoming integrated with devices that are in the home,” says Martin. “For solutions like IRIS, telehealth integration could lead to expanded patient access to diabetic eye care through in-home care providers or even home-screening devices in the future. That is the type of connectivity we are going to see.”
Integration of Medical IoT
The medical Internet of Things (IoT), sometimes referred to as the healthcare IoT, is the army of medical devices embedded with technology that monitor patients in real time and relay the collected data to healthcare clouds.
These advanced monitoring devices foster communication between software to provide more efficient service both in and out of traditional care environments.
However, post-COVID, IRIS CEO Steve Martin envisions a future where devices work in tandem with telehealth for more inclusive healthcare settings.
“You’re going to see more of these marriages between healthcare devices in the home and telehealth. When implemented correctly, they go hand-in-hand and work to serve the patient and healthcare provider better.”
In the diabetic care space, IRIS can effortlessly be implemented into home-care initiatives since data is easily collected and transferred to professionals through the IRIS cloud.
Furthermore, as home-based care grows, we can expect equipment to evolve alongside those measures. Martin hypothesizes some physical changes to home-care devices, primarily smaller, lighter cameras for retinopathy testing, which will allow home-technicians more ease of transport.
By providing a solution focused on connectivity between its moving parts, i.e., providers, equipment, cloud storage, and image graders, the IRIS solution creates the potential for complete, accessible diabetic retinopathy care. In considering the future healthcare, connectivity via the MIoT is a growing trend that shows no signs of slowing.
Emergence of FQHCs
In 2020, the U.S. saw an impoverished population of close to 38 million Americans, the majority of which were in minority communities disproportionately affected by COVID and income disparities.
Inadequate access to clean air and water, healthy food options, and generally safe living standards can cause impoverished communities to experience a greater number of adverse health outcomes. Furthermore, the leading causes of death in the U.S., which includes diabetes, experience higher death rates in impoverished communities when compared to their counterparts.
Similarly, diabetic retinopathy, as the leading cause of blindness in the U.S., disproportionately affects poorer communities because of several social determinants, including diminished access to DR screenings. Out of the minority groups present in the United States, Hispanic, African American, and even Native American populations are at the greatest risk of blindness due to DR.
According to Martin,
“We are seeing diabetic retinopathy grow at a much faster rate in Latino, African American, and Asian communities. The question now is how do we solve this lack of access to care for socioeconomic and minority populations? By making it easier for diabetics in these communities to get care, which is what FQHCs can help with.”
Federally Qualified Health Centers (FQHCs) are community-based health centers funded by Federal and State government efforts to provide care to under-served communities. FQHCs provide primary care services regardless of patient income, ensuring that social minority groups receive high-quality preventative care.
By making healthcare easily accessible, FQHCs encourage diabetic populations in impoverished communities to seek treatment. As FQHCs gain popularity, government-supported efforts to increase healthcare compliance in these communities will likely follow.
“There is a large push to help these underserved communities. Population health screenings and necessary quality measures are a big part of the mantra for FQHCs, so I think we’re going to see more government funding poured into these organizations to assist them in meeting those quality measures.”
The flexibility of IRIS software, with several camera integration options and the ability to receive DR screening results through the IRIS Reading Center, lends itself greatly to dynamic healthcare settings like FQHCs. Meanwhile, IRIS has already worked alongside Prisma Health and other large organizations to ensure that underserved communities receive the care they deserve.
“We’ve seen much growth in FQHCs in our business recently and will continue to see it over the next few years,” says Martin.
While today there are only about 1,400 FQHCs nationwide, look-alike hospitals and service sites continue to be implemented across the country in places of need. Both IRIS and the FQHC initiative ensure that these unique needs are slowly but surely being met.
Diabetic Care Post-Pandemic
“How many of these diabetics know that they have to get their annual screening?” questions Steve, “The healthcare community [has] to go out there and educate the diabetics that if they don’t get this screening, they can severely impact their eyesight… it’s not one person in the healthcare landscape that’s got to provide this education; it’s everybody. We’re all in this for the ultimate goal of providing patients with better quality care.”
Diabetic retinopathy screening compliance rates are already incredibly low, and as patients continue to avoid hospitals and primary care centers post-pandemic, it is almost sure that without intervention, this trend will continue. In fact, less than 50% of patients receive their annual DR exam.
“Just referring patients to the ophthalmologist is not going to fix the low compliance rates for DR screenings— we have a 30-year track record of that. To get diabetic patients to take this seriously, we need to meet them in the spaces that they are in,” says Martin.
As healthcare organizations seek innovative solutions to support a post-pandemic world, it is increasingly important to understand the needs of patient populations and what organizations can do to support those needs.
“IRIS technology provides a modern solution for a modern society.”
Not only can IRIS software be easily integrated into several healthcare settings, but it provides the convenience that diabetic populations seek. Meeting consumers in spaces accessible and convenient to them means creating a future where patients seek care without a second thought.
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