COVID-19 Impact on Medical Second Opinion in Healthcare Industry

New coronavirus disease outbreak (COVID-19) in 2019 caused by extreme acute respiratory coronavirus-2 syndrome (SARS-CoV-2) has posed a significant threat to the population and has a huge effect on the economy, GDP and industry worldwide. The World Health Organization (WHO) has announced that the pandemic of COVID-19 has a high transmission rate that threatens many lives. The association of the Spike-S protein in SARS-CoV-2 with the Ace-2 receptor found in the human lungs is the primary cause for the high transmutability. This is the primary reason or the largest obstacle in the health care sector and perhaps the biggest challenge for healthcare providers in 2020. In December 2019, Chinese health authorities told World Health Organization (WHO) of a mid-serious situation when a group of 40 patients with pneumonia had symptoms, most of them related to the Huanan Sea Food market. Looking at the current situation, China is not suffering from any industry worldwide deficit as the number of graph cases in China is stabilizing. The countries namely the U.S., India, Brazil, Russia and many others around the world are experiencing business decline and a decrease in GDP. Since the declaration of the pandemic, several nations including China, India, the U.S., Russia, Germany and others have entered the full lockdown state in order to minimize the spread of COVID-19 in several countries such as China, New Zealand and South Korea which have succeeded due to their tight laws and increased monitoring and the Chinese company Baidus has begun heat mapping which has made testing simpler.

The second medical opinion is the type of service or supplemental consultation that the patient gets following their primary diagnosis. After that, the patient may get a second medical opinion if the patient is displeased with the diagnosis or if more information is required in the case of any critical surgical procedures. There has been a recent rise in medical second opinion providers largely due to clinical, financial and legal risks associated in care. As we say “Second Opinions: Two Heads are better than one”. Because of the contagion nature of COVID-19 and the rising number of pandemic events and various new diseases, a second opinion is very common and encouraged by doctors. So, the demand for second opinion market has increased though the growth is anticipated to be increased at a higher pace then it is now but due to pandemic and lockdown globally, the growth was subdued. It has also been forecasted by research analysts that after pandemic, this growth will further increase due to COVID-19, people are now more conscious about their health, further more increasing prevalence of peripheral vascular disorders and growing importance on superior treatment outcomes, rising inclination for healthcare cost optimization and increasing prevalence of diseases due to change in lifestyle, growing number of hospitals all over the world are also expected to fuel medical second opinion market. Due to COVID-19, on the basis of disorders, cancer and especially (lung cancer) patients have been at the front position of using the technology (tele-medicine) to manage their diagnosis for years, also with growing concern of people cardiac disorders, diseases related to respiratory system and surgical interventions are going to get huge revenue in future. Apart from that, organ transplant opinion by primary doctor make patient concerned and in-turn patient will look for medical second opinion and increases the revenue.

According to the weekly epidemiology report of 9th February 2021 by World Health Organization (WHO) stated 3.1 million cases of coronavirus has been reported globally in past week, this brings to over 105.4 million reported cases and over 2.3 million patients are dead due to the coronavirus globally. The outbreak of COVID-19 is having a huge impact on the healthcare industry which also means need for medical second opinion because of the growing concern of patients.

IMPACT ON DEMAND
The global market for medical second opinion market is mainly related to the high prevalence of the cardiovascular disease, high rate of obesity, major surgical advices, lungs & respiratory tract disorders and the growing need for minimally invasive procedures. Additionally, factors such as increased number of tough healthcare decisions, expensive tests are right or not and risky surgery and finally unsure about the diagnosis, government initiatives and support, increased demand for advanced treatments, research and increased clinical trials for new diseases and increasing players that are offering newer solutions will probably stimulate the market. Tele-medicine and online second opinion become lucrative to increase the demand during the COVID-19 pandemic and will remain be a boon technology in future. This technology has by this time already demonstrated there efficacy, accuracy and refinement of results, that’s why researchers, physicians and pathologists know the value of the technology and hence, they are looking to hasten their productivity and potentially improve their accuracy in diagnosis of clinical abnormalities and problems related with patients.

Furthermore, accruing proof suggests that a sub-group of patients with severe COVID-19 acute respiratory distress syndrome (ARDS) with hypoxemia might have cytokine storm syndrome. Certainly, 25–31% of COVID-19 patients displayed irregular blood clotting. Blood clots can break apart and lodge in the pulmonary organs as lungs, causing in pulmonary embolism, while clots from arteries can lodge in the brain, triggering stroke. While the lungs are “ground zero”, clots can form in organ systems from the brain to blood vessels. This is a major reason for the increasing concern in patients to look for secondary option to treat the disorder or preventive measures against the virus.

Additionally, it has been found in the study of direct SARS-CoV-2 infection of endothelial cells and diffuse endothelial inflammation. Subsequently, SARS-CoV-2 targets blood vessels, patients with pre-existing damage to those vessels such as from diabetes and high blood pressure, face a higher risk of serious disease as hematological blood disorders, this is another main dynamic factor powering the market growth presently by multiple biotechnological and pharmaceutical companies globally to accelerate drug or vaccine development processes for the COVID-19.

Global medical second opinion market is expected to gain market growth and not just because of COVID-19, although the impact of COVID-19 has increased the growth of the market but the demand for medical second opinion was also higher in the period of 2015-2020 due to increasing number of geriatric, diabetic and cardiovascular diseases, although it is not as high as it is now. Because of the COVID-19, a new respiratory disorder with lots of mystery, it is clear that after COVID-19 pandemic will get over, it will further boost the global medical second opinion market because of the awareness in people about diseases and the increasing concern for physical care. In the pulmonology sector and cardiac sector especially, the demand will be higher. The participation of various start-ups that make some apps and smart tracking devices as fit-bands are also tracking the SpO2 levels which will help in the expansion of blood flow measurement market and become the key factors backing to the growth of the market. The U.S., China and the U.K. are developing as popular hubs for healthcare innovations. Japan and South-Korea also holds the scope for the development of medical second opinion market in healthcare with skilled workers and technologies they possess. Growth in Asia-Pacific is expected to be fast owing to the demand of advanced technologies and increasing cases of cancer, lung cancer, cardiovascular diseases and diabetes. North America rules the medical second opinion market due to highly aware people, innovative healthcare infrastructure, favorable government initiatives and rising prevalence of diseases due to change in lifestyle in the region.

On the other hand, growing healthcare expenditure and amount of hospitals will further boost various opportunities that will lead to the growth of the medical second opinion market. Some companies are launching new products to increase their revenue by meeting the emergent need.

Globally the surge in the demand of medical second opinion market in diagnostics market is going to be observed due to the infectious nature of COVID-19 which could be spread via touch, mucous droplets, use of clothes among others and due to lockdown, the advancement and the pace for development which was expected is likely reduced, but in coming few years, the growth is going to be much higher with increasing awareness of health in people and more accurate results from A.I. and new product launches and smartwatches.

Some of the applications which can increase the demand for medical second opinion are:

Increasing investments in telemedicine technologies
Rising modernization
Technological advancement in the healthcare sector
Rising R&D activities
Assessment of auto-regulation capability

IMPACT ON SUPPLY
The bulk of the consumer supply has been affected due to COVID-19. The lockdown imposed by many countries is the key reason why imports and exports for many markets have been slowing down. The medical second opinion market is extremely fragmented and the key players have used different tactics such as expansions, creative solutions, joint ventures, alliances, collaborations, acquisitions and others to expand their presence in the market.

Although, the ease of use, relatively low cost of doctor's telephone consultations and the ubiquity of smartphones make this an attractive option for monitoring patients and identifying problems at an early stage, there are important considerations with these devices that patients and providers may not be aware of the potential to have an impact on the successful implementation of such a monitoring programme.

These technologies as tele-medicine and online prescription are not halted during the pandemic and serve as a boon technology for human beings based on software’s and A.I., so the technology relies on the vast supply of medical case data to train the machine model, for that, machine learning and deep learning is utilized, this is done to train it’s algorithms and to find the patterns in the images and identify specific anatomical markers. Also to keep the vast amount of data stored, big data is needed. Medical reports and data can be transferred in the form of pdf, images and others. So accessibility for medical records were easy, only thing that was halted is to perform diagnosis tests as they were carried out in hospitals and reaching to hospitals during the pandemic time was not so safe.

For instance,

To keep the track of patient SpO2 measurement, we need to first train the model by using training data of a fit individual collected from various databases, hospitals data, surveillance and others. After that we can provide the tested data to machine which then provide us accurate results.
Via a detailed study of trends in a given digital image, imaging algorithms may produce metrics and outputs that fit radiologist analyses which can be useful for rapid diagnosis.

Supply of the data is somewhat complicated by COVID-19 owing to a worldwide lockout, quick access to hospital data is not necessary to train the machine learning algorithm and without that artificial intelligence cannot be applied. Supply chain for data is broken but this is not entirely so because much of the patient data is stored on cloud servers or databases, one may still approach officials and purchases the data, many websites such as Kaggle and github are instances that store data and are easily available to everyone. Also tele-medicine and online consultations helps a lot and their supply chain of data in the form of images or pdf was not hampered.

Better and increasing numbers of diagnostic procedures carried out is expected to drive the medical second opinion market growth and supply for new solutions

The capacity and performance of customized care, better treatments and treatment of patients is also expected to fuel development in the demand for portable physical exercise products such as SpO2 and bpm fit-bands and smartwatches, although measurement also improves the supply of second opinion medical devices. On the other hand, some restraints are:

Rising lack of awareness
Reluctance toward opting for medical second opinion in emerging nations
Frequent changes in the economic status of developing countries
Also, providing tele-medicine facilities in the under-developed nations can be challenging
High cost and reluctance of adoption of these systems
Due to COVID-19, easy accessibility of data from hospitals to train machine learning model is not possible

KEY INITIATIVES BY MARKET PLAYERS DURING COVID-19
Major competitors currently present in the market are Medisense Healthcare Solutions Pvt. Ltd., Second Opinion International, Cigna, EMS | Elite Medical Services, WorldCare, Medix Staffing Solutions Inc., 2nd.MD, AXA, Medo Asia Sdn Bhd., Medisense, London Pain Clinic, Mondial Assistance, GrandOpinion, Penn Medicine, The Johns Hopkins University, Keio University, Toranomon Hospital and Cleveland Clinic among other domestic and global players.

For instance,

Medisense Healthcare Solutions Pvt. Ltd. as well as all the competitors is now focusing on corona consultation specifically and in turnhelp boosting the revenue for global medical second opinion market.

Another recent study by Medisense Healthcare solution: “Here's How Night Time Artificial Lights Exposure May Elevate Thyroid Cancer Risk!!”, it states people living in regions with high levels of outdoor artificial light at night may face a higher risk of developing thyroid cancer, suggested the findings of a novel study. These finding comes from a study published early online in 'CANCER', a peer-reviewed journal of the American Cancer Society.

“During plasma exchange, the plasma of COVID-19 patients is replaced with donated plasma,” explains Maier. “This reduces the viscosity by normalizing the fibrinogen and other factors contributing to the stickiness and potentially may reduce clotting. Still, correlation does not mean causality and we need to study this in large trials to understand whether viscosity is simply a marker of disease or actually contributing to clotting.

CONCLUSION
The COVID-19 virus is expected to have a long-lasting effect on each business field. The pandemic of COVID-19 forced people to deal with the confusion and regulation of the virus. The virus poses a risk not only to human health but has also created economic hardship and extreme mental pressure, people are losing their jobs and every industry has suffered, causing chaos in everyone's minds. It is now fashioned to wear masks and gloves since COVID-19 has established a modern hygiene method around the world. Although, it cannot be assumed that a second medical opinion is not needed sooner. However, considering the extremely infectious nature of the virus and the ease with which it spreads through droplets or even fomites to some degree, the demand from the medical second opinion and the healthcare sector continues to grow not only for diagnosis but also for R&D to produce a drug or vaccine for the virus. With a spike in the number of cases, countries can also adopt these instruments to track SpO2 amount such as those of South Korea and China in order to keep the number of cases in check. It can be used in diagnostics to provide precise, consistent and accurate results since it is based on a huge and previous amount of data. Patients mostly have their health insurance which is covering for their treatment having a second opinion helps lot in the situation. "Looking to the future, there is clear potential for the medical second opinion consolations & solutions to become mainstream tools in the treatment of COVID-19 patients."