Telemedicine can be more than just video calls to the doctor

BarcelonaAt the recent Health Revolution Congress in Barcelona, ​​several companies with a local presence showcased solutions for remote patient monitoring: Lifevit offers connected medical devices for tracking vital signs; ClaraCare offers home hospitalization by integrating health devices and personalized reports; Garmin Health offers healthcare app creators a telemedicine platform based on its watches, which are not just for athletes; Sense4Care has created a wearable device, similar to cardiology Holter recorders, but in this case to detect movement patterns, with Parkinson's patients in mind. All of them boast pilot tests with this or that Catalan hospital, but they all share a common sense of frustration over the difficulty of deploying their technologies across the broader healthcare system.

It's a message we've been hearing for over 10 years. Technology has always been an ally in healthcare, but the digital revolution of recent years has brought advances beyond healthcare centers, directly into the lives of citizens. In this new digital health landscape – which goes far beyond simple video consultations – portable consumer devices (wearables) may be the key to moving toward a more preventative and personalized model of medicine, as opposed to traditional reactive medicine.

Some of these devices—a global market that will exceed €150 billion by 2030—are incorporated into the body in the form of watches, rings, bracelets, or clothing, and can measure heart rate, blood oxygen content, and daily steps. Connected blood pressure monitors, scales, and glucometers must also be added. The capacity for continuous and remote monitoring transforms healthcare, alerting before a pathology manifests and facilitating early diagnosis in chronic diseases such as hypertension or diabetes.

Device manufacturers make their move

In Europe, the French company Withings is a pioneer in specialized telemedicine with its remote cardiology service. For €9.95 per month, the Withings+ service offers up to four annual check-ups by certified cardiologists who analyze electrocardiogram data from its watches and blood pressure monitors—which include a stethoscope—in less than four hours. The service, available in France, Germany, and the US, integrates the brand's devices with artificial intelligence (AI) clinically validated by recognized hospitals and human medical supervision, and allows for the detection of atrial fibrillation and other arrhythmias before they cause serious events.

In the US, Apple's ResearchKit software linked to iPhones and Apple Watches has facilitated numerous clinical trials, some with more than one million participants. The Stanford Apple Heart Study, with 419,297 participants, achieved 84% accuracy in detecting atrial fibrillation, while the University of Rochester's WATCH-PD study has transformed Parkinson's research through continuous movement monitoring.

The role of health insurance

The Apple Watch often appears in health insurance companies' push for consumer devices as a prevention tool. UnitedHealthcare, with 50 million customers, offers a free Apple Watch to policyholders who meet six months of physical activity goals. They achieved a 45% participation rate, much higher than the typical 5% rate for corporate wellness programs. Participants average 11,000 steps per day, almost double the national average.

John Hancock Vitality, with more than 10 million policyholders, allows users to purchase the Apple Watch for just $25 if they meet monthly exercise goals. A RAND Europe study with 400,000 participants shows that Apple Watch users with incentives maintain 34% more physical activity, equivalent to 4.8 extra days of monthly exercise and up to two additional years of life expectancy.

In Spain, the most digitally active mutual insurance company is Sanitas, a subsidiary of the British group BUPA. They say that one in five consultations is conducted online, and this week they opened what they consider the first fully digital hospital in Spain in Valdebebas (Madrid). The company claims that its Blua digital health platform serves more than 25,000 patients in active monitoring programs using connected devices and AI for data analysis. Services include AI-based preventive check-ups; monitoring of physical activity, sleep quality, and heart rate using devices such as smart scales, pulse oximeters, and blood pressure monitors that transmit automatically; and the "digital physiotherapist," which monitors rehabilitation exercises in real time, a feature that Huawei also demonstrated at the last MWC.

Pharmaceutical companies as digital intermediaries

Pharmaceutical laboratories have taken an active role in this digitalization, to the point that some of the aforementioned companies recognize that they are the only viable channel for accessing the public healthcare system.

In some countries, pharmaceutical companies have massively adopted Apple technology: Johnson & Johnson leads the Heartline cardiology study with 180,000 participants; Biogen participates in the Intuition brain health study; and Novartis develops multiple sclerosis programs with the ResearchKit platform. Novartis itself, like Bristol-Myers Squibb, Otsuka, Pfizer, and Sanofi, has clinical trial consortia with Alphabet, Google's parent company, either with its healthcare subsidiary Verily or with Fitbit. In Spain, Pfizer has support apps for patients with cancer and hemophilia, which sync with devices.

Catalonia: innovation without deployment

Paradoxically, Catalonia hosts one of the most powerful healthcare innovation ecosystems in Europe. With 386 digital health companies with a turnover of €633 million, Barcelona is the fifth European city in terms of healthcare funding. start-ups Digital health.

The TICSalut Foundation has been managing healthcare technology innovation since 2006, and 94% of healthcare centers are connected to the shared system. However, the Catalan public healthcare system shows notable reluctance to the widespread adoption of digital innovation. Recall the (unjustified) political mistrust regarding the lack of privacy in the transfer of aggregated citizen health data to pharmaceutical companies for research (during the time of Minister Boi Ruiz), which halted the initiative in its tracks. Another problem is the lack of a budget allocated to hospitals to purchase innovation, which forces them to establish collaborations based on clinical validations that drag on for years, without the results being generalized. Another Catalan company explains to ARA that in Catalonia they wanted to charge them for testing their diabetic patient management system, while in Mexico they were paid to host the trial. Naturally, they went there to do it.

In general, the fragmentation and lack of agility of the European public system, which some entrepreneurs call "killing"start-ups", contrast with the agility of the American model. Catalan startups propose various measures: centralizing access to the system, standardizing clinical evaluation, adjusting salaries, establishing specific and flexible regulations, allocating a budget for innovative public procurement, and improving the training of healthcare professionals.

The digital future and the cost of inaction

While other countries are moving toward preventative medicine based on continuous data, Catalonia maintains a costly and less effective reactive approach. American insurance companies are already demonstrating premium reductions of up to 25% for active users of medically approved consumer devices, while European services like Withings+ are already clinically validating the early detection of cardiac pathologies.

The Catalan public system's reluctance to adopt these technologies squanders the local innovation ecosystem. Catalan companies develop solutions that are applied abroad, while Catalan citizens depend on a 20th-century healthcare model in the digital age. Telemedicine based on properly approved consumer devices would facilitate the leap from reactive to preventative medicine. The tools are there, but political will and investment are needed.