May 17, 2020

New archetypes are transforming healthcare, new PwC report finds

Health technology
Digital health
Catherine Sturman
4 min
PwC report
Escalating healthcare costs and consumer demands to gain greater control and accessibility over their healthcare management is impacting traditional ope...

Escalating healthcare costs and consumer demands to gain greater control and accessibility over their healthcare management is impacting traditional operations across the industry space.

A new report by PwC has highlighted four areas of disruption, which will seek to overhaul the US healthcare system. The industry is set to move from one which is typically siloed, to a model which will look similar to that of retail or hospitality. In last year alone, over 960 deals were finalised, with deal value rising by over 146% over 2016, the report has found.

Firstly, the use of vertical integration has grown apace, where companies are looking to source ways to maintain supply chain costs through increased acquisition. CVS Health, for example, will seek to drive this through its purchase of Aetna. By influencing more of the supply chain, the company will gain significant negotiating power to reduce costs for payers and patients, develop personalised solutions and improve overall patient outcomes.

By harnessing increased volumes of data, the use of vertical integration will also lead to the eradication of any delays in processes as a result of middle-men.

“By not having to go through a third party, you avoid a lot of frustration as an insurer about pricing transparency. I think you’re going to see further vertical integration to address that,” commented John Sivori, President and Chief Operating Officer of PBM company Envolve Pharmacy Solutions.

Consumers have long wanted employers to take greater interest in rising healthcare costs. The recent partnership between J. P. Morgan Chase & Co., Berkshire Hathaway Inc and Amazon came as a surprise to many, but the trio will seek to find ways to lower employee costs through implementing new technologies.

“To significantly drive down healthcare costs, companies will need to rethink how they purchase and deliver care. Options include creating massive purchasing groups capable of negotiating rates on a national scale; finding new innovations in care capable of treating the sickest patients more efficiently or prevent them from getting sick in the first place; or replacing existing health industry incumbents with more cost-effective alternatives,” the report added.

With this in mind, technology companies are increasingly moving into this space. Consumers have become accustomed accessing their financial data through the use of mobile apps and various digital tools, where they can access to this information information anytime, anywhere. Demands to gain access to healthcare information, therefore, is undergoing a seismic shift, so much so that over 76% of Fortune 50 companies are now engaging with the healthcare industry.

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From Amazon’s move into the pharmacy space, to Apple’s collaboration with a number of US hospitals to enable users to gain access to their electronic health records, even bottlenecks in health transportation have not gone unnoticed. Uber and Lyft have both subsequently partnered with healthcare services to support those in need to access to medical services.

“More than half of surveyed consumers said they believed technology companies could improve patient experience, reduce costs, make healthcare simpler and help them keep track of their health information. The majority also were willing to buy healthcare products and services from Technology Invaders,” the report noted.

“Changing consumer behaviours are creating new opportunities. In 2008, 11% of US consumers owned a smartphone and 17% of physicians had an EHR system. As of 2015, 79% of US consumers have a smartphone and 87% of physicians have an EHR system in place.”

However, a number of technology companies will seek to partner with existing healthcare companies to gain the required leverage, expertise and understanding of what is required to better build tools to ensure positive patient outcomes.

“You have to be fluent in healthcare. You have to be fluent in technology and you have to be fluent in media, driving discussions and having dialogues with patients to make them feel a certain way,” added Jeff Arnold, Chairman and CEO of Sharecare.

Lastly, with demands to gain access to healthcare anytime, anywhere, the use of health retailers and pharmacies has grown apace across the US, enabling consumers to visit such facilities of care at a time suitable for them.

This growth has enabled such establishments to partner with traditional healthcare and hospital providers to gain a deeper understanding of consumer purchasing habits and knowledge surrounding what patients need most.

“Consolidation and integration may put new pressures on existing healthcare organisations like pharmaceutical manufacturers, but they also might open up new opportunities, such as partnerships between providers and Health Retailers,” the report says.

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Jun 14, 2021

Long haul Covid, the brain and digital therapies

4 min
Neuroplasticity expert Ashok Gupta tells us about the symptoms of long Covid, how it affects the brain, and digital therapies

It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain. 

Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain. 

What is long Covid exactly? 

Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.

How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!

When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover. 

If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus. 

The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.

What symptoms does this cause? 

These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.

In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.

This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.

How does long-haul Covid affect mental health? 
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.

How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.” 

We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain. 

We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and  running half marathons again.

At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response. 

The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival. 

What digital therapies or apps are proving effective at treating long-haul Covid? 
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy. 

What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and  become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.

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