2024 Healthcare, Consumer & Wellness Magazine

24 Healthcare, Consumer &Wellness • 25 insurance apps for staying healthy. Saurabh R. Gupta, Global Sales Head of Healthcare, Consumer & Wellness for Citi Treasury and Trade Solutions (TTS) agrees, adding that “treatment of chronic diseases involves an extensive value chain. There are the repeat consultations, the medications, the food and lifestyle website, the coaching and even enrolling customers on clinical trials.” The most valuable part of all is prescriptions. In the US, for example, spending on prescription drugs accounts for approximately 18% of total healthcare expenditure. And chronic diseases, overall, eat up 90% of the country’s $4.1 trillion annual healthcare budget according to the Centers for Disease Control and Prevention (CDC). Citi calculates that admin accounts for about one quarter. “The system’s hugely inefficient,” Spielman states. “But it’s starting to change. We predict that AI could eliminate up to one-third of admin spend.” A greater efficiency drive is prompting hospital groups to move toward blended online and offline models. As Gupta explains: “In the digital world, you can see a specialist within minutes and pay online. In the physical world, you might spend a couple of hours traveling to and from hospital, before waiting in line to pay for treatment at a hospital counter. Then there’s all the admin around invoicing and billings reconciliation in the back office.” Polling at Citi’s 2023 China Healthcare Forummade clear the desire for change: nearly two-thirds of participants’ customers are reportedly actively looking for healthcare solutions that save time. This has big implications for treasury operations too. Batch processing is out: real-time treasury is in. “Traditional medical practices have specialists on their monthly payroll,” Gupta says. “But digital platforms don’t. They’re paying specialists the moment that consultations are over, so liquidity needs to move quickly and efficiently.” Physical medical practices also tend to store data on EHRs (electronic health records) that only they can access. Digital platforms are accelerating a shift towards greater data operability across the entire system. This also paves the way for more integrated care. “Patients with chronic conditions will no longer waste as much time and their health trying to navigate around siloed specialists,” says Sigal Atzmon, founder of UK- headquartered medtech company Medix Global, which offers chronic care as part of its international medical management services. “Better co-ordination is facilitating a holistic approach and a much greater focus on prevention.” So, for healthcare, the digital continuum is enabling far greater personalization across prevention, treatment and patient delivery mechanisms. This should help to significantly reduce the burden that chronic diseases place on national healthcare budgets at a time of ageing populations across advanced economies. “People who have a better understanding of their health will be less likely to develop a chronic disease in the first place,” Gupta concludes. “And when they do interact with healthcare systems, the experience should be more seamless and collaborative too.” Digital healthcare is transitioning from routine consultations to the prevention and management of chronic conditions — to the benefit of providers and patients alike. The Covid-19 pandemic normalized our use of telemedicine and in its aftermath, the industry has not only grown but also shifted emphasis. Telehealth is no longer simply about booking a one-off doctor’s consultation. It is increasingly about signing up to a longer- term partnership focused on the prevention and management of chronic diseases. This is shaping up to be a win-win situation. Business models focused on specialisms should be more profitable because repeat consultations and prescriptions create recurrent revenue streams. Engaging customers through broad ecosystems also generates greater value add. And customers benefit too. Ongoing and personalized care provides the end recipient with far greater agency over their health. One such growth area lies in the treatment of type 2 diabetes. This is partly because case numbers are exploding, especially across Asia. As people get richer, their eating, working and fitness habits typically get poorer. The result: people living in advanced economies are far less likely to die from a communicable disease than a chronic one caused by systemic inflammation. Left unchecked, inflammation triggers lifestyle diseases such as diabetes and autoimmune conditions like rheumatoid arthritis. Digital platforms manage these conditions by providing the same treatment of symptoms as family doctors. But they also aim to do more to help their customers understand the root cause of problems and make positive changes. Wearables are one key digital tool in taking a whole-body approach. Continuous monitoring enables more nuanced judgements about the impact of medications and lifestyle changes. As Adam Spielman, Head of Health & Consumer, for Citi Global Insights says, “We’re moving towards a world of smart analysis — taking data about our food habits, exercise and sleep, then overlaying it with our genome data and, in the not-too-distant future, from our medical records too.” One Indian company using digital therapeutics to treat chronic diseases is Fitterfly. Co-founder Dr Arbinder Singal is a pediatric urologist who cured his own prediabetes by creating a data model to pinpoint why his blood sugars were fluctuating so much. He used that knowledge as the basis for a start-up serving a country with the second highest number of type 2 diabetes sufferers worldwide. Fitterfly allies personalized data with coaching across high- and low-touch programs. The company has recently introduced AI and automation across workflows, in addition to partnering with insurers to improve access. “Nearly half the Indian population have a smartphone and can afford $50 to $100 for the service,” Singal says. “There’s also more willingness to pay for it.” He adds that the company’s low-cost SaaS (software as a service) integrations are also changing the way that people use Treatment of chronic diseases involves an extensive value chain” 90% spend on chronic diseases US annual healthcare budget “Digital healthcare has big implications for treasury operations - batch processing is out: real-time treasury is in. Unlike traditional medical practices, digital platforms do not have specialists on monthly payroll. They pay them the moment that consultations are over so in the new digital world, liquidity needs to move quickly and efficiently.” Telehealth dialsup specialisms