By Dr. Chris Hobson
The rapid emergence of COVID-19 and its far-reaching effects have been a startling wake-up call for patients and healthcare providers across the globe. Amidst travel bans, political disputes and economic crises, countries are confronted with questions around how to maintain a sustainable healthcare system.
The Angus Reid Institute released a study that shows “five per cent of Canadians are worried that they may face the deadly consequence if they contract COVID-19, while 12 per cent say they fear hospitalization.” Overall, nearly one-in-five feel they are at high risk if infected. The number of Canadians who felt that the country was at serious risk rose from “just 31 per cent in early February to 68 per cent in mid-March.”
These concerns are well founded. It is clear from events that have unfolded in China, Italy, Iran and other countries that health systems need to prepare for a massively increased load – especially on their hospitals. Demand for essential items such as Intensive Care Unit beds, respirators, ventilators and personal protective equipment is expected to greatly exceed supply.
With minimal knowledge on the biology of the disease, interventions need to be agile to meet a rapidly evolving threat. Now is the time for healthcare officials to turn their attention to digital health to support the sustainability of healthcare systems during a pandemic relies on technology.
The ability to screen large volumes of patients is the first major response needed. A self-assessment platform gathers information on each patient, such as their age, chronic conditions and contact with coronavirus. It works to establish a complete picture of an individual’s health, determining those in need of medical attention either immediately, or in the near future.
Using advanced electronic health records, a clinician can then access a combined view of all the traditional clinical data as well as the new data types, perform analytics on that data, and act on those insights. The ability to predict and identify those patients most at risk, limits the strain on the system while ensuring correct patients are treated in the right place, at the right time.
To alleviate pressure within hospitals, it is critical that patients who can safely be managed at home are discharged early. There are several categories of patients where this applies. Most obviously are COVID – 19 patients in recovery and those with other conditions that can be managed at home, such as chronic diseases (COPD and CHF) and patients currently in hospital waiting for alternative levels of care.
For hospitals these are an extra set of tools to manage non-emergent patients in a way that reduces the risk to employees and other patients. Technology has the ability to capture data and help us better understand the disease — as currently there is a real shortage of reliable information.
For successful remote monitoring at home, the technology must offer clear, two-way trigger points. Patients can call for help or transfer to hospital, meanwhile alerts need to be sent to providers when patients deteriorate at home. The data is fed into hospitals, ensuring care can be allocated without overloading individual clinicians or departments.
Progress in remote patient monitoring will see critical data lead to a deeper understanding of the resources available in hospitals. A study in the Lancet identified multi-system organ failure, sepsis and delayed hospital transfers were significant hurdles for healthcare providers in Wuhan, China. In the case of a pandemic such as COVID-19, the death toll increases rapidly when Intensive Care Units are overwhelmed.
One of the greatest challenges in developing technology during a pandemic crisis is the rapid emergence of new requirements, as the disease impacts an increasing number of patients. The technology implemented must be easy to learn, configure and adapt.
What’s more, with a lack of reliable best practices and scientifically validated information on the disease, confident decision-making is difficult.
The COVID-19 pandemic is an opportunity to demonstrate to health care officials and decision-makers that technology can facilitate sustainable healthcare systems. It can support the care of individual patients across the community, while also managing the needs and resources of the wider population. There is plenty more to come from machine learning-based predictive tools as healthcare providers leverage more data and experience from the disease.
Appropriate technology targeted at the key issues health systems face will help drive a multi-pronged strategy. The knowledge and experience Canada already has acquired in digital health, community care and remote patient monitoring can act as a steppingstone through this pandemic. If we seize the moment, there is an opportunity to significantly impact a rapidly evolving crisis.
Dr. Chris Hobson is a former family physician with 16 years of experience and two decades as the chief medical officer at Orion Health, a global provider of health information technology.