Coronavirus and digital health: a catalyst for change?
With the current global healthcare crisis coronavirus (COVID-19) causing unprecedented demands on our healthcare services and the way in which we carry out our daily lives, there is an opportunity for digital health solutions to support healthcare providers and the way we continue to provide care for patients. Could coronavirus be the catalyst to widespread digital uptake for healthcare?
The current global coronavirus crisis (COVID-19),1 has seen an extraordinary impact on our daily lives; both the way we interact with the outside world and one another.2 The scale and spread of COVID-19 has placed huge demands on the way we approach healthcare. However it also serves as an opportunity to change the way we approach it in the future.2 How is technology leading the way for wholesale changes in the way we treat patients, or the way in which we as patients, approach healthcare, and what impact could this have in the future?
Digital health to the rescue?
In a recent interview with the New York Times, Dr Bruce Aylward, from the World Health Organization (WHO) noted that China’s first step to tackling the outbreak of coronavirus was to move half of all its medical care online.3 How was this achieved? Digital technology. While in 2020, this might seem perfectly reasonable, 15 years ago this simply would not have been possible.4 Surgeries would not have had the means to be online, nor would we have well-established telephone lines for health queries. Put simply, the very fact China was able to move half of its medical care online highlights the sheer importance of our technological advances to date and the power of technology as a tool to tackling this pandemic.
Digital health is not a novel concept. In fact, the recent expansion of these technologies has proven their utility and promised many benefits for patients and the way in which their healthcare is delivered.1 These technology-led solutions include telehealth, big data analytics, artificial intelligence (AI), predictive algorithms, wearable technologies for remote monitoring and electronic health records (EHRs),1 with the ultimate goal of optimizing accessibility, enhancing patient care and streamlining processes.5 While these technologies are becoming slowly more commonplace, previously there has remained some reluctance to adopt these new ways of working. As reported in a recent US survey, telehealth utilization remains low, with reported use at only 9% in 2019.6
The outbreak of COVID-19 has placed demands on healthcare systems that we have not experienced before. There is now a greater need than ever for solutions to optimize patient healthcare globally, and we don’t have the luxury of endless time to debate our options. While COVID-19 is less deadly than initially predicted, it is certainly more contagious;1 making the need for smart healthcare solutions more crucial than ever.
The global spread of coronavirus has forced healthcare services to adapt and evolve their processes rapidly and innovatively.6 The National Health Service (NHS) in the UK for example has developed a means to digitally automate sicknotes for patients, avoiding the need for face-to-face contact with their healthcare provider7 while the US has established drive-through testing for patients with suspected COVID-19.8 Additionally, EMIS Health have announced that they will provide their video consultation platform free for healthcare professionals so that vital patient consultations can be maintained in settings where resources are limited and there is a need for restricted patient contact.7
Big data analytics are also proving critical during this time by allowing disease modelling as a means to guide healthcare policy makers and supplement outbreak response strategies.1 With over 70,000 cases of confirmed COVID-19 in China alone, large datasets like these could prove to be invaluable resources for training AI algorithms to support patient screening and diagnosis.1 Johns Hopkins University is approaching this through its development of an interactive, web-based dashboard to track real-time data and metrics on coronavirus-related deaths and countries across the globe to provide researchers and the public with real-time updates as the pandemic unfolds.9
What’s more, COVID-19 has demanded information sharing on a vast and global level.7 As a novel, previously unseen outbreak, healthcare providers are trying to educate themselves and their colleagues so as to most efficiently tackle the spread of the virus.7 Healthcare providers are being actively encouraged to use technology to share information and analyses related to the virus that may inform its management.7 While big data solutions have previously alluded to enhanced data sharing capabilities, COVID-19 has seemingly placed an important spotlight on the need for knowledge sharing within the healthcare community and may serve to inform the way we share information in the future also.
Most importantly, there is a need for patients to take an active and empowered approach to their own health and well-being during this time. Where social distancing and self-isolation rules have been enforced, patients must seek their own means of monitoring, tracking and reporting their health concerns and needs. Digital health company Babylon aims to support this through their recently launched care assistant tool.10 This tool allows symptom tracking so that patients are able to make decisions around their healthcare needs, monitor any improvement/worsening in their condition and be referred for hospital care should it be required.10 In this instance, Babylon’s tech-focused solution is supporting patient monitoring where resources are limited, and implementation of remote, digitally-led healthcare. The WHO have also responded with the promise of a new open-source app to guide people on COVID-19.11 This app, still under development, aims to provide guidance to patients, share local information relevant to people’s location and offer advice on isolation, symptom tracking and provide details of testing sites if required.11
Individuals with existing health conditions that may make them more at risk to COVID-19, may also be encouraged to be extra vigilant of their own symptoms using remote disease monitoring and tracking, so as to better inform any (virtual) consultations with their doctors. The American Academy of Allergy Asthma and Immunology (AAAAI) has recommended that patients continue their asthma management as normal, while being careful to keep their asthma under control so as to avoid any potential exacerbations, and keeping a record of any symptoms they may develop.12 Digital solutions are able to support these measures; offering a means by which patients can track their medication use, and keep a record of symptoms and potential disease exacerbations.13
Driving rapid digital solutions uptake where they are needed most
Where stringent regulatory policies may have previously slowed, or even prevented the widespread uptake of certain digital solutions, COVID-19 has served to force rapid, widespread global change out of necessity.2 For example, revisions to the US Health Insurance Portability and Accountability Act (HIPAA) have permitted medical providers to utilize existing platforms like Skype, FaceTime and email to communicate with each other and their patients;2 setting a new precedent for rapid augmentation of existing regulation to provide real-time support in a time of public need.
Similarly, the FDA have altered their regulations such that there is no penalty for failing to adhere to risk evaluation mitigation strategy (REMS) requirements for lab testing and imaging studies.14 Moreover, they have relaxed time for adverse event reports during the pandemic. The FDA have also expanded their remote monitoring initiatives by giving manufacturers leeway for remote vital-sign devices with the view to alleviate hospital burden by driving development and implementation of these devices.14
A new template for healthcare
While 9/11 presented challenges related to security and the way we travel and the financial crash reminded us that we are still vulnerable to economic hardships akin to the Great Depression, COVID-19 reminds us that just like the great flu pandemic of 1918, pandemics remain an important health concern to be addressed.1 As we continue to make progress with how technology can help us tackle COVID-19, there is no doubt that we will set a new standard for the way we tackle outbreaks in the future.
Perhaps the adoption of digital health technologies will become more commonplace, not just in times of global crisis. Where healthcare practices may have once been reluctant to adopt telephone or video consultations, perhaps this will become more routine.15 Issues of patient accessibility and ability to travel to medical consultations etc. is not a new problem, nor is it going away. Perhaps widespread digital uptake as forced by these uncertain times may prove to be empowering for healthcare for a long time to come.15 Likewise, is there an opportunity for us to learn how patient care can be truly optimized in the future, even when we are able to interact with one another again. Could coronavirus be the catalyst to widespread digital uptake for healthcare?
- Coronavirus will change the world permanently. Here’s how. 2020. Available at: https://www.politico.com/news/magazine/2020/03/19/coronavirus-effect-economy-life-society-analysis-covid-135579#health. [Accessed March 2020].
- Ting D.S.W, et al. Nature Medicine. 2020. Available at: https://www.nature.com/articles/s41591-020-0824-5.pdf. [Accessed March 2020].
- Postelnicu L. How the world of health and tech is looking at the coronavirus outbreak. 2020. Available at: https://www.mobihealthnews.com/news/europe/how-world-health-and-tech-looking-coronavirus-outbreak. [Accessed March 2020].
- Cellan-Jones R. Coronavirus: what if this had happened in 2005? 2020. Available at: https://www.bbc.co.uk/news/technology-52052502. [Accessed March 2020].
- Gossman W, et al. StatPearls. Digital Health. 2019. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470260/. [Accessed March 2020].
- Umland B, et al. Is coronavirus a tipping point for digital health on demand? 2020. Available at: https://www.brinknews.com/is-coronavirus-a-tipping-point-for-digital-health-on-demand-in-organizations/. [Accessed March 2020].
- Hughes O. Coronavirus news round-up: digital health debrief. 2020. Available at: https://www.digitalhealth.net/2020/03/coronavirus-news-round-up-digital-health-debrief/. [Accessed March 2020].
- Groth L. Drive-through coronavirus testing: how it works, and which states offer it. 2020. Available at: https://www.health.com/condition/infectious-diseases/coronavirus/drive-through-coronavirus-testing. [Accessed March 2020].
- Kent J. Johns Hopkins develops real-time data dashboard to track coronavirus. 2020. Available at: https://healthitanalytics.com/news/johns-hopkins-develops-real-time-data-dashboard-to-track-coronavirus. [Accessed March 2020].
- Med-Tech Innovation News. Digital health company launches COVID-19 care assistant. 2020. Available at: https://www.med-technews.com/news/digital-health-company-launches-covid-19-care-assistant/. [Accessed March 2020].
- Strickland E. An official WHO coronavirus app will be a “waze for COVID-19”. 2020. Available at: https://spectrum.ieee.org/the-human-os/biomedical/devices/who-official-coronavirus-app-waze-covid19. [Accessed March 2020].
- American Academy of Allergy Asthma and Immunology. COVID-19 and asthma: what patients needs to know. 2020. Available at: https://www.aaaai.org/conditions-and-treatments/library/asthma-library/covid-asthma. [Accessed March 2020].
- John’s Hopkins Medicine. Remote monitoring program yields promising results for young people with asthma. 2019. Available at: https://www.hopkinsmedicine.org/news/articles/remote-monitoring-program-yields-promising-results-for-young-asthmatics. [Accessed March 2020].
- Monitoring the impact of COVID-19 on the pharmaceutical market. 2020. Available at: https://www.iqvia.com/library/white-papers/monitoring-the-impact-of-covid-19-on-the-pharmaceutical-market. [Accessed March 2020].
- Downey A. Coronavirus spread has kicked NHS forward in adopting digital solutions. 2020. Available at: https://www.digitalhealth.net/2020/03/coronavirus-spread-has-kicked-nhs-forward-in-adopting-digital-solutions// [Accessed March 2020].
April 2020 RESP-42116