Hospital Management lists the top five terms tweeted on healthcare in Q4 2020, based on data from GlobalData’s Influencer Platform. The top tweeted terms are the trending industry discussions happening on Twitter by key individuals (influencers) as tracked by the platform.

1. Intensive care unit – 2,837 mentions

Efficacy of lower positive end-expiratory pressure (PEEP) strategy in mechanical ventilation in 28 days, effect of functional electrical stimulation-assisted cycle ergometry (FES-cycling) on muscle strength, and long-term health consequences of Covid-19, were popularly discussed in Q4 2020. According to John P Erwin, a general cardiologist at the NorthShore University HealthSystem, among intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) who were expected not to be extubated within 24 hours, a lower PEEP strategy was noninferior to a higher PEEP strategy with regard to the number of ventilator-free days at day 28. The findings supported the use of lower PEEP in patients without ARDS.

The term was also used by Dr Dale Needham, a professor of medicine at the Johns Hopkins University School of Medicine, who retweeted an article on a study evaluating the effect of functional electrical stimulation-assisted cycle ergometry (FES-cycling) on muscle strength, cognitive impairment and related outcomes. The randomised controlled trial with 162 participants was undertaken at four centres and concluded that the addition of FES did not lead to increase in muscle strength during the time of hospital discharge. However, the patients commonly felt the incidence of cognitive impairment post trials, within six months.

Another discussion around the term was discussed by Greg Martin, president of the Society of Critical Care Medicine, a non-profit medical organisation, about a study on the long-term health consequences of Covid-19. The study considered various aspects like cardiovascular, pulmonary, neurologic, and delved into the emotional health aspect to understand whether post-intensive care was necessary for those who required ICU care.

2. Covid-19 – 2,507 mentions

Covid-19 exposure risks more prevalent in families, re-admissions of Covid-19 patients, and the rise in digital health technologies, were popularly discussed during the quarter. According to an article shared by Abraar Khan, a physician and writer, patients at the emergency room claimed that the transmission of the SARS-CoV-2 virus was more prevalent in households and congregate settings such as nursing homes. This was more likely to happen as family members cannot isolate themselves completely, and are more prone to close, high-intensity, and long interactions.

The term also trended with reference to Covid-19 re-admissions, according to an article shared by André Picard, a health columnist at The Globe and Mail. The article highlighted a study which claimed that one in ten patients who were discharged after receiving inpatient care for coronavirus disease earlier in 2020, were readmitted within two months. It was observed that individuals suffering with co-morbidities such as pulmonary disease, diabetes, heart failure, or chronic kidney disease were at increased risk of Covid-related complications and readmission.

On the contrary, patients discharged to home-based or self-care were less likely to be readmitted, but two-thirds of these patients suffered with one or more of these chronic conditions. The US-based study also found that Black and Hispanic patients were less likely than White patients to be readmitted.

Covid-19 also trended in discussions shared by Jane Sarasohn-Kahn, a health economist, on the increasing investments in telehealth and digital health services in 2020. According to Rock Health, a venture fund for digital health, investments in US-based digital health startups rose to approximately $4bn in the third quarter of 2020. A consumer survey also found that the need to stay home motivated most people to use telehealth services, with others claiming that telehealth services enabled quicker diagnosis and treatment from the comfort of their home.

3. Health Insurance – 987 mentions

Tech giants targeting healthcare insurance, the cost of job-based health insurance rising faster than wages, and unsustainable premium costs of health insurance in the US, were popular topics of discussion in Q4. According to an article shared by Lindsay Resnick, a healthcare and insurance expert, tech giants are ramping up investments in digital health initiatives and targeting the healthcare insurance markets. For instance, Apple, Amazon, Google, and Facebook, have all invested heavily in the personal health monitoring devices and virtual care segments. Google’s subsidiary Verily created its own insurance firm to offer tech-driven employer health insurance plans.

The term was also discussed by Bob Herman, a healthcare business reporter, about how employer health coverage costs continued to outpace wages. According to new survey data from the Kaiser Family Foundation, the cost of job-based health insurance averaged more than $21,000 for families and almost $7,500 for individuals in 2020, which is 4% higher than in 2019. This implied that employer healthcare continued eat away at people’s incomes.

Health insurance was also discussed by Rachana Pradhan, a healthcare reporter, who tweeted on how American employers have increased the cost of health insurance provided to their employees. For example, a Kaiser Family Foundation survey found that premiums for job-based family health coverage reached $21,342 in 2020, of which $5,600 was contributed by the employees.

4. Nursing Homes – 929 mentions

Covid-19 outbreaks in nursing homes resulting in deaths of elderly patients, unaccounted employee infections in hospitals, and nursing homes facing penalties for lapses in Covid control and protection, were popularly discussed in Q4. According to an article shared by Annie Sparrow, a critical care paediatrician and global health doctor, a huge proportion of elderly deaths were due to Covid-19 outbreaks in nursing homes. Experts suggest that as vaccines rolled out across Europe, the limited supply should have been prioritised for the elderly aged above 65 years, especially in places of highest risk such as nursing homes.

The term was also retweeted by Dan Diamond, a health policy and politics reporter, on Covid-19 risks to healthcare workers. The article detailed how at least 2,900 health workers succumbed to the disease since its outbreak, and how many of whom belonged to minority communities and had the highest levels of patient contact. While ICU doctors were most well-equipped, paramedics and emergency room staff were most likely to be hospitalised, and nursing home staff died in the US. It was also found that hospitals did not report on staff infections and deaths, while Medicare forced nursing homes to report deaths and infections among the staff employees, the article noted.

Ash Paul, a public healthcare doctor, further shared an article on how US nursing homes were fined for Covid infection control lapses. Meanwhile, industry experts state that penalties can be counterproductive. The article highlighted how the Centres for Medicare and Medicaid Services (CMS) fined 218 nursing homes over $17.6m for violating all infection control protocols. However, industry experts feel that penalties can be counterproductive. For example, excessive fines can cost the nursing homes too much, leading to closure and uprooting patients, staff, and relatives.

5. Digital Health – 658 mentions

Digital health tools to improve healthcare, US tech companies’ increased investments in digital solutions, and now being the opportune time for health plans to invest in direct-to-consumer solutions, were popular topics of discussion in the fourth quarter. According to an article retweeted by Manish Sharma, a chief product officer at Karkinos Healthcare, five trends that could improve healthcare in 2021 include digital tools and services that will enable healthcare professionals to offer consultations, diagnosis, and treatment more quickly and effectively.

The novel coronavirus pandemic has unleashed many MedTech innovations such as virtual care, collaboration, and medical devices to save lives. Apart from the rapid adoption of telemedicine and telehealth services, augmented reality (AR) tools are expected to witness a massive boost in 2021, the article noted.

Digital health was also discussed with reference to 95% of the large US companies covering telehealth, up from 56% in 2016, according to a PWC report shared by Donna Lencki, a digital health, pharma, and healthtech entrepreneur. The report details how business leaders will dictate the usage of virtual care and how it should be integrated into healthcare. Experts believe that digital relationships can help improve the clinician experience, and countless pain points that physicians encounter daily. The report also found that 98% of all the pharmaceutical and life sciences executives believed that digital investment in clinical trials will increase in 2021.

The term also trended with reference to leveraging digital solutions to engage, attract, and retain Medicare Advantage (MA) members in the US, according to an article shared by Dr Greg Weidner, an internal medicine specialist in Charlotte, North Carolina. The Deloitte research suggests that the pandemic accelerated digital delivery, to the extent of care, medicine, and enrolment. The MA plans to leverage digital solutions through various metrics such as member stickiness, cost metrics, and more, as it believes that the rapid adoption of telehealth services will continue to grow in the months ahead.