Restrictive regulations and entrenched medical care traditions that once slowed adoption rates of telemedicine and other healthcare technologies are evolving.
“We are in a watershed moment. The technology available in digital health is vast and expanding daily. Because of the constraints of the old analog system, adoption has lagged behind,” says Paula Muto, MD, FACS, founder and CEO of UberDoc, a self-pay healthcare alternative to insurance-based healthcare.
“However, the response to COVID-19 has made us rethink everything from the routine in-person doctor appointment to how to monitor a patient with minimal exposure,” Muto adds.
As incredible amounts of data are generated relative to patients and contagion tracking, seeing the big picture is critical. “It’s important to be able to see the entire scope of the contagion, and the best way is to visualise it, to see it graphically,” says Aivars Apsite, healthcare practice manager at Hewlett Packard Enterprise. “By visualizing it, we can see things that normally get lost in lists of data and aggregated statistics. It’s the proverbial picture worth a thousand words.”
The rise of early-detection systems
One of the technologies to offer early insights on community spread patterns during the COVID-19 pandemic has been smart thermometers. The Internet-connected devices provide real-time temperatures of users and quickly signal rising disease hot spots in the process.
“There continue to be many important lessons learned from the COVID-19 pandemic, the first being the dire need for earlier and better detection systems,” says Rich Bird, healthcare and life sciences strategist at HPE. “There are several smart IoT devices that can help with that, especially whenever there may be testing lags.”
Bird cites consumer wearables, such as Fitbits and smartwatches, as additional examples of potential early-warning systems for disease outbreaks.
“A possible use of community data from wearables could be used to detect community spread and changes in the population,” says Bird. “For example, unusually high heart rates were an early indicator of COVID-19. If public health researchers can see an abnormal rise in heart rates within a given population, they could suspect a disease is present in the area, even if they don’t know which disease or which causative agent, and take precautions to contain it. This could be considered a digital, non-pharmaceutical intervention.”
Consumer wearables can be useful in other ways to detect and track disease progression.
“Tech can be vital in tracking touch and contact points in tracking the origination of a virus, using the technology to track where a patient has been, ascertaining where the person caught it from, and possible people they may have passed it on to,” explains Giuseppe Aragona, MD, general practitioner at Prescription Doctor, a telemedicine provider.
Apsite emphasizes understanding transmission—who contracted and who did not contract the contagion—is equally important. Asymptomatic carriers of the contagion must be tracked. “All of this leads to developing an early understanding of who overcomes the disease or virus and has developed antibodies to it, so we can identify those and hopefully develop an effective vaccine,” he says.
The value of such information in early warnings, and in facilitating a return to some form of lifestyle normalcy, is not lost on consumers. Many are volunteering data right now, or at least not objecting to sharing it. One example of active public participation is the COVID Symptom Tracker. An example of passive data collection made publicly available is Google’s COVID-19 Community Mobility Reports.
“Tracking is difficult, and it gets even harder because we are taught to respect patient privacy,” says Apsite. “Even the HIPAA guidelines say that we must protect patient information, but it is permissible to share protected patient health information to protect the nation’s public health.”
Consumers with wearables can voluntarily make their data available to public health researchers and agencies and thereby collectively build an invisible protective wall, adds Bird. “It would work very similarly to how patients volunteer data from their wearables to clinical researchers for drug and vaccine research,” he says.
Many examples of public participation in suppressing disease outbreak are burgeoning in response to the current pandemic. This goes beyond simply allowing access to medical records or new data from wearables. For example, some people used 3D printers to make everything from respirator parts and masks for medical staff to critical medical devices that can now be used by frontline responders dealing with the active crisis
Changes in prevention and intervention
While early detection within a community is critical, it must be followed by prevention and intervention tactics to stop a disease.
“Wearables are a natural next step to integrate detection capabilities—for example, equipping IoT wearables with temperature sensors would alert wearers as to when they need to self-isolate. They’d also remove the need for medical professionals to endanger themselves with close contact,” says Arslan Usman, a system architect at Pangea Connected, an IoT connectivity provider.
“Data from wearables can be used in the field of big data analytics and combined with artificial intelligence. This will allow us to have better, quicker, and more accurate clinical decisions regarding self-isolation,” Usman adds. “Just like connected cars can help overcome problems like traffic congestion, connected people can help maintain healthcare standards and enhance safety across the board.”
Mobile apps with diagnostic tools for smartphones will also change how patients are diagnosed and treatments delivered. One example is a dermatoscope for smartphones, which acts as a microscope to enable a doctor to virtually evaluate any spots on the skin that concern patients. Another example is smart diabetes monitoring tools connected to mobile apps for tracking patient data and easy sharing of that data with physicians. There are many such apps and more rapidly appearing on the scene.
“Quite naturally, the pandemic is catalyzing the demand for remote mental health tools like apps and chatbots, while text-a-therapist platforms report an influx of users looking for help. Some of those services are going to stick, and after the pandemic is over, healthcare companies will spin off new business units,” says Julia Ryzh, CMO at Just AI, a conversational AI solutions provider.
Remote monitoring, such as remote heart monitoring and several types of ingestibles, are also helpful tools in prevention and intervention.
“Ingestibles, in particular, are going to play a big part in remote diagnostics, as sensor tech advances and decreases in physical size. Attaching sensors to microorganisms within a patient will allow doctors to monitor symptoms with pinpoint accuracy,” Usman says. “And when we have sensors that can report on more than one condition—say, both temperature and pH—doctors could potentially diagnose entire conditions, rather than just detecting symptoms.”
New sensors and form factors, once a novelty, are now being considered much more seriously.
“Wearables are rapidly evolving into much more sophisticated forms, such as clothing. One example is T-shirts produced by AI company Chronolife, which can measure heartbeat with an electrocardiogram, as well as abdominal breathing, thoracic breathing, body temperature, physical activity, and pulmonary independence,” says Ryzh. “With such wearables, patients with a chronic disease that requires constant health monitoring could stay at home with their families instead of in hospitals.”
It’s inevitable that the pandemic and resulting changes in telehealth will change hospital experiences too.
“One non-pharmaceutical IoT development that has come out of the pandemic has been a surge in asset tracking systems for hospitals—both in the small view, such as the need to know where stuff is inside one ER, and in the large view, such as equipment being on loan to other hospitals or other states,” says Adam Dunkels, CEO and co-founder of IoT start-up Thingsquare.
“In general, any non-touch technology has become more interesting, such as touch screen-like interfaces in the air, which looks like magic,” Dunkels adds.
Communication between healthcare practitioners and patients is also going the distance even if the two are mere feet apart or in the same building. For example, by communicating with providers via a screen in the hospital room, patients avoid exposing themselves or their providers to anything contagious. Contactless technologies will likely go far in curbing the spread of hospital-acquired infections too.
“The efficiency of care also brings down the cost. Think of a remote monitor replacing a [24-hour] observation in a hospital. We don’t need an army of people, including administrators, to process that patient’s care,” says Muto. “Price transparency becomes a lot easier when the services are affordable.”
By the time the pandemic is over, the advantages technology brings to healthcare will be obvious to many as nearly all people experience one or more forms firsthand.
“We are experiencing a digital health revolution, and much like the AIDS epidemic introduced patient privacy rules, COVID-19 will usher in a whole new vision of what a hospital needs to be (the place for babies and critical care), what defines good primary care (not sitting in a crowded waiting room), and ultimately, what medicine ought to be (driven by physicians, not politicians or business leaders),” Muto says.
“Digital health reinvents and restores the doctor-patient relationship in the modern world,” she adds. “And it is about time.”