The COVID-19 crisis has highlighted the value that digital health solutions can bring to patients since the start of the pandemic – whether it’s managing patients in their home environments, reducing the burdens and risks associated with traveling to clinics, or streamlining hospital care pathways. As healthcare providers around the world seek to leverage technology to help combat the crisis, the pandemic has propelled digital health onto the global stage. In combination with global trends towards the digitization of medicine, this has resulted in rapid technological adoption and accelerated transformations in digital health.
Digital technology initiatives used in pandemic preparedness and response
Digital health technology can facilitate pandemic strategy and response in ways that are difficult to achieve manually.The control of the COVID-19 pandemic rests, as with the control of outbreaks and pandemics before it, on the detection and containment of infection clusters and the interruption of community transmission to mitigate the impact on human health. Some of these applications for digital technologies in pandemic management and response are discussed below, highlighting ways in which successful countries have adopted and integrated digital technologies for virtual care, pandemic planning, surveillance, testing, contact tracing, quarantine, and quarantine.
- Telemedicine: embracing virtual care
Over the past few months, during the coronavirus pandemic, telemedicine has experienced a huge rise in adoption. It has become the ‘new normal’ way of accessing healthcare, with people locked down at home. Patients can consult doctors regarding their symptoms from the comfort of their homes or be monitored for other ailments. This decreases unnecessary visits to hospitals, allowing doctors to concentrate on urgent cases that require prompt medical attention.
As a matter of fact, since January, Amwell’s use of telemedicine apps in the US has increased by 158%, and appointments through PlushCare have increased by 70%. In comparison, before the pandemic, only 1 in 10 US patients used telemedicine services.
- Planning and tracking
In several countries, Big Data and Artificial Intelligence (AI) have helped facilitate COVID-19 preparedness and human tracking, and thus the spread of infection. To collect real-time data on the location of people, tools such as migration maps using mobile phones, mobile payment applications, and social media-enabled Chinese authorities to track the movement of people who had visited the Wuhan market, the epicenter of the pandemic.
Machine learning models were developed with these data to forecast the regional transmission dynamics of SARS-CoV-2 and to guide border controls and surveillance. Taiwan initiated health checks for airline travellers from Wuhan as soon as China reported the outbreak, integrating data from immigration records with its centralized, real-time national health insurance database.
The need to track COVID-19 has fuelled data dashboard innovation that visually displays the burden of disease. The coronavirus dashboard at Johns Hopkins University (MD, USA) and the HealthMap web-based platform provides up-to-date visuals of COVID-19 cases and deaths around the globe.
- Screening for infection
To screen and guide people to appropriate services, China uses open, web-based, and cloud-based instruments. High-performance infrared thermal cameras set up at Taiwanese airports are used to capture real-time thermal images of people, identifying people with fever easily.
In Singapore, at the entrances of offices, schools, and public transport, individuals have their temperature measured. Thermometer data is tracked and used to classify emerging hot spots and infection clusters where research may be initiated. Iceland has launched systematic monitoring of asymptomatic citizens, unlike most other nations.
Iceland gathers patient-reported symptom data using mobile technology and integrates this data with other databases, such as clinical and genomic sequencing data, to reveal knowledge on the pathology and spread of the virus.This approach has contributed to the knowledge base of asymptomatic COVID-19 prevalence and transmission. To date, Iceland has had the highest testing rate per capita and one of the lowest mortality rates per capita for COVID-19. Germany and South Korea are other countries offering widespread research.
- Smartphone tracking: high tech contact tracing
Digital contact tracing automates tracking on a scale and speed that is not easily replicable without digital resources. It reduces reliance on human recall, particularly in areas with mobile populations that are densely populated. Digital contact tracing apps were developed for use in many countries during the COVID-19 pandemic; these apps rely on techniques and technology not previously tested on this scale and are contentious in terms of privacy. It is important to determine their accuracy and efficacy.
At least 10 countries are using such methods of surveillance. The opt-in app in Singapore uses Bluetooth and wireless signals to trace nearby users. In addition to bank transfers and CCTV video, South Korea’s successful management of the outbreak was in part due to monitoring phone use. A QR-based system was launched by Moscow to monitor the disease. Both Apple and Google, the tech giants, have formed an unlikely alliance to provide contact tracing in their operating systems.
The boundaries between civic responsibility and one’s privacy are blurred by these invasive methods. Fortunately, there are ways to retain privacy while facilitating contact tracing that is in the works.
- Quarantine and Self-isolation
In some nations, the indiscriminate lockdowns for infection prevention have had significant socio-economic repercussions. Quarantine may be enforced with digital technologies for people who have been exposed to or infected with the virus, with less rigorous restrictions placed on other residents.
China’s Quick Response (QR) code system, in which people are supposed to undertake a symptom survey and record their temperature, enables health monitoring and motion control by the authorities. The QR code serves as a certificate of health status and travel pass for COVID-19, with color codes representing low, medium, and high risk; individuals with green codes can travel unrestricted, whereas individuals with red codes are required for 14 days to self-isolate. In Taiwan, via government-issued cell phones monitored by GPS, electronic monitoring of home-quarantined individuals is facilitated.
In Hong Kong, individuals in self-isolation are required to wear a wristband connected to a database through cloud technology that warns authorities if quarantine is violated. Iceland has introduced a mobile phone solution to track people with COVID-19 and ensure that they stay in self-isolation.
- Clinical Management
Rapid diagnosis and risk prediction of COVID-19 can be facilitated by AI. For the identification of COVID-19 pneumonia cases in China, a cloud-based AI-assisted CT service is used. CT images are processed in seconds by this technology, differentiating COVID-19 from other lung diseases and greatly speeding up the diagnostic process. On chest x-rays, COVID-Net, an open-source deep convolutional neural network architecture available to clinicians worldwide, will easily classify COVID-19 cases of other lung diseases.
The probability of developing acute respiratory distress syndrome and critical illness among infected patients can be predicted by machine learning algorithms developed in China. Medical decision-making and resource distribution can be driven by these prediction models, recognizing areas and hospitals in need of critical care services and medical supplies.
- Public communication: informing populations
The successful implementation of pandemic strategies is focused on public education and collaboration, assisted by an adequate communications plan, which requires active involvement by the community to ensure public confidence. With 4.1 billion people accessing the internet and 5.2 billion unique smartphone subscribers, targeted engagement across digital channels can quickly reach billions and promote community mobilization.
A United Nations study found that by early April 2020, 86% of Member States had put COVID-19 data on national websites, and many use text messaging to reach populations who do not have internet access. Chat-bots also provide data to minimize the burden on non-emergency health advisory call centers, and the rapid adoption of remote health service delivery, including telemedicine, especially in primary care, is transforming clinical practice.
One of the characteristic features of countries that have flattened their COVID-19 incidence curves and retained low mortality rates may be the incorporation of digital technology into pandemic policy and response. As a significant tool for sustaining wellbeing and health care delivery around the world, digital health is very likely to be accelerated by Covid-19. With the digital health armamentarium, it is the right time to motivate ourselves better to fight diseases and improve health.