Will telehealth be fundamental to smart cities?

Think about how urban transportation strategy would change if citizens could travel by laptop or mobile device to a doctor visit.

Research firm Markets and Markets reports that the telehealth market is expected to reach  $9.35 billion by 2021, from $2.78 billion in 2016, growing at a CAGR of 27.5%. This parallels the growth in the population health technology segment, which will rise from $21 billion in 2016 to near $90 billion in 2025, according to Grand View Research.

As our mobile phones become medical devices, what opportunities and challenges will smart city leaders need to consider?

In recent years, tremendous scrutiny has been given to the challenge of treating veterans, given the shortage of resources in Veterans Administration hospitals and related organizations, many of which are located in cities. Reports of six-month wait times have not been unusual for medical evaluations, coupled with long, on-site waits for appointments.

While conducting appointments via laptop or mobile device would not solve the veteran backlog, it could improve the “customer” experience, especially for veterans who must now travel long distances to receive care. But challenges include getting patients to feel comfortable with online clinical care, and then finding medical professionals who feel comfortable conducting “visits” in a virtual setting.

As the size of the digitally proficient patient population grows — and as physicians grow in their comfort level for televisits — it’s possible to apply this approach more frequently in veterans’ care. (And it’s something the VA is pursuing; you can read about some of its telehealth programs here.)

Add to this population the number of urban elderly who have a limited ability to leave home or take public transportation to healthcare facilities, and you have a prime client base for telemedicine.

In my earlier smart cities work, I saw that one of the major goals for urban transportation leaders was to synchronize public transportation stops and schedules with heat maps noting the location of large populations of elderly citizens.

While telemedicine could be very beneficial to this group, there are challenges to getting the elderly to engage with technology. Truth be told there is a huge technology gap between high engagement millennials and the skeptical baby boomers, who ironically will be one of the main targets for these clinical telemedicine platforms.

Another obvious city silo that could ride the wave of telehealth is the Department of Public Health. Many of the programs handled by this division relate to wellness strategies, including nutrition, exercise, family services and mental health.

As wearable devices, IoT and population health strategies converge, public health departments can provide services and counseling to a much broader swathe of the urban population (and to city employees) based on 24/7 data exhaust.

One of the more rapidly growing applications of telemedicine to public health is in diabetes treatment. Since, in many cases, office visits are not needed to monitor and adjust blood sugar levels, patients can use telemedicine at reduced cost and increased quality of life.

And since most healthcare providers are now able to get reimbursed by insurance companies for some telemedicine applications, these connected technologies are beginning to scale.

Perhaps the most obvious use case for smart cities is in the application of telemedicine for public safety and emergency services.

In Kentucky, for instance, the USDA approved two grants worth $720,000 to establish telemedicine networks that will provide treatment for medical conditions, including mental health and drug addiction treatment. Telemedicine also serves to bridge gaps in emergency management on a global, regional and local scale, making the highest level of expertise and care available in the most remote settings.

And to take this idea one step further, consider the benefits on medical education. Every telemedicine engagement also becomes a learning experience for medical students and professors since the classroom is no longer limited by physical borders.


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