Digital Healthcare Models in a COVID-19 Environment

No doubt that pandemic has created unprecedented disruption. Lots of new technical inclusion being done by institutions, organizations, hospitals,s and other sectors too. The short-term implications of this global challenge are evident everywhere, but the long-term effect is still dubious and still difficult to visualize and creates questions like how it will reshape public health especially in the areas of technology.

Sometimes it takes a crisis to force us to adapt and adopt changes. Like, I have not met any of my colleagues for the past year due to lockdown, but we're all connected than ever. I connect and work with public health professionals from Uttarakhand, Tamilnadu, Mumbai, Delhi, and like we are sitting in one place. 

I found this read really worth.

//www.who.int/china/news/feature-stories/detail/covid-19-and-digital-health-what-can-digital-health-offer-for-covid-19  

Pandemics, which are large disease outbreaks that affect several countries, pose major health, social, and economic risks. A quick-moving pathogen spreading across the globe has the potential to kill tens of millions of people, disrupt economies, and destabilize national security. Climate change, urbanization, and the lack of water and sanitation are all factors that could contribute to fast-spreading, catastrophic outbreaks.

A //www.worldbank.org/en/topic/pandemics severe pandemic can result in millions of deaths, and even the most conservative estimates suggest that pandemics destroy up to 1% of global GDP, which is comparable to other top-priority threats, such as climate change.

COVID-19 not only has rattled the public health strategies, it has left massive disruption in its wake. It called for an advanced healthcare model with strategies to mitigate transmission as well as searching for a cure, rather a traditional face-to-face treatment between the physician and the patient. Various software developers have started to come up different apps that helped in tracking possible carries, tracing outbreaks of infection, helping patients identifying symptoms etc. This advancement in healthcare technologies only proved it efficacy when positive changes were seen.

COVID-19 has provided an opportunity to bring about advancements in the IT industry as everything went online during this time. The authorities responsible for health systems are being driven to develop and come up with new health care strategies in order to mitigate transmission and finding a cure. There is new recognition of just how critical the availability and sharing of comprehensive health data is to addressing major public health challenges. There are tremendous benefits of digital technology like

• Overseas Monitoring of no. of patients.
• Digital health technology can help manage the pandemic by providing an early signal to potential infection. 
• For example, Kinsa Health, a company that uses internet-connected thermometers, has provided smart thermometers to people to record fevers at home.  Users of the smart thermometer can then instantly report their fever and symptoms.

This concludes that “Necessity is the mother of Invention”. For any problem, a solution is always possible in this case being Healthcare technology.

COVID-19 not only disrupted the health care sector but also the global economics and way the services are being given. LMIC's and below countries are the most affected countries in terms of number of COVID-19 cases, diagnosis and management of COVID-19 cases due to shortage of healthcare system and service provider. Teleconsultations and remote consultations & monitoring of patients plays a big role during and even after the COVID-19 in rural and hard to reach areas of LMIC's and below countries. Telemedicine may also includes the combination of real-time image and sound can replace physical presence. Digital health technology also serves as a cost effective method for providing and assessing the health care services in these countries. At present, COVID-19 affected the supply chain of whole world, in my perspective digital health interventions hold a key in providing health care services during and after this pandemic which leads to improved quality of care. Interested individuals may visit the link below:

Opportunities in Telemedicine, Lessons Learned After COVID-19 and the Way Into the Future

KEEPING WHAT WORKS: REMOTE CONSULTATIONS DURING THE COVID-19 PANDEMIC

The COVID 19 pandemic has clearly depicted that there is a need of sustainable digital healthcare model. There are many examples of digital health models such as telehealth and systems for tracking & distribution of COVID vaccine. A large percentages of health visits can be executed successfully through telehealth during COVID 19 pandemic. It is also quite interesting to note that the outpatient care during the pandemic has been disrupted dramatically even though there are well established digital healthcare models. Almost 40% of Americans have put off getting medical care due to COVID-19, and 2.4 million patients in the UK were waiting for cancer screenings, treatment or test. These figures indicates that there is a need of sustainable and enhanced digital healthcare model. This could be possible only when there is a team work between governments, academia, and NGOs.

The COVID-19 pandemic has resulted in massive disruptions within health care, both directly as a result of the infectious disease outbreak, and indirectly because of public health measures to mitigate against transmission. This disruption has caused rapid dynamic fluctuations in demand, capacity, and even contextual aspects of health care. Therefore, the traditional face-to-face patient–physician care model has had to be re-examined in many countries, with digital technology and new models of care being rapidly deployed to meet the various challenges of the pandemic. One of the most demanding area is ophthalmology that have adapted to incorporate digital health solutions such as telehealth, artificial intelligence decision support for triaging and clinical care, and home monitoring. These models can be operationalised for different clinical applications based on the technology, clinical need, demand from patients, and manpower availability, ranging from out-of-hospital models including the hub-and-spoke pre-hospital model, to front-line models such as the inflow funnel model and monitoring models such as the so-called lighthouse model for provider-led monitoring. an interesting read from lancet @

//www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30287-9/fulltext

During the COVID-19 crisis, digital technologies have become a major route for accessing remote care. Therefore, the need to ensure that these tools are safe and effective has never been greater. In the article referred below, they raise five calls to action to ensure the safety, availability, and long-term sustainability of these technologies:

(a) Due diligence: remove harmful health apps from app stores;

(b) data insights: use relevant health data insights from high-quality digital tools to inform the greater response to COVID-19;

(c) freely available resources: make high-quality digital health tools available without charge, where possible, and for as long as possible, especially to those who are most vulnerable;

(d) digital transitioning: transform conventional offline mental health services to make them digitally available; and

(e) population self-management: encourage governments and insurers to work with developers to look at how digital health management could be subsidized or funded.

Read more: //www.ncbi.nlm.nih.gov/pmc/articles/PMC7340162/

This paper, “Digital technologies in the public-health response to COVID-19” reviewed the interconnected digital technologies and approaches used during pandemic. It also talks about legal, ethical and privacy, organizational and workforce barriers. In addition to it, it also highlights the need for data sharing, rigorous evaluation, ethical frameworks   and community participation with strong communication strategies. This systems-level approach is needed for to inform the preparedness for future pandemics.

//www.nature.com/articles/s41591-020-1011-4

Digital tools and advanced technology solutions have been adopted by the healthcare organizations globally in response to COVID-19. The present paper reviews the various digital approaches that were adopted during the earlier stages of pandemic to mitigate the effect of COVID-19 on individuals and health systems. It was reported that proposed digital solutions were for the diagnosis, surveillance and prevention of COVID-19. Numerous articles also suggested the use of artificial intelligence (AI)–powered tools in integration with traditional methods for the diagnosis and screening of COVID-19. It is suggested to monitor the implementation, adoption of best practices and models of care in national health systems.

//www.jmir.org/2020/11/e22280/

This article, 'Applications of digital technology in COVID-19 pandemic planning and response' provides a viewpoint on framework for the application of digital technologies in pandemic management and response, highlighting ways in which successful countries have adopted these technologies for pandemic planning, surveillance, testing, contact tracing, quarantine, and health care. The scale of coordination and data management required for effective implementation of these strategies has—in most successful countries—relied on adopting digital technology and integrating it into policy and health care. 

Read more: //www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30142-4/fulltext

After an extensive lockdown due to the COVID-19 pandemic, the recent reopening of the society called for a digital transformation model of healthcare services which can address major three challenges of 1) reducing face-to-face appointments, 2) minimizing contact among patients, and 3) reorganizing manpower. For this various new models of care have been deployed to ensure continuity of services along with providing adequate safety to the masses.

Out-of-hospital model is one of them which includes sorting conveyor and hub-and-spoke models. The sorting conveyor model facilitates care transitions between primary, secondary, and tertiary care by providing telesupport to patients, which can be leveraged to provide recommendations for self-management or referrals. It optimizes patient flow to minimize unnecessary physical touchpoints. For example, as countries are re-opening, for comprehensive psychological support, at-risk individuals can be directed to AI chatbots that use the “sorting conveyor” operational model. The AI solutions are built with predefined criteria which re-direct individuals requiring more comprehensive psychological support to appropriate services within a stepped-care mental health service. Also, Online Health Communities can enhance public health responses to the pandemic which includes delivery of triage advice which in a way optimizes patient numbers and reduces unnecessary healthcare presence.

Whereas the hub-and-spoke model brings more consistency across operations as it constitutes an organization with authority extending from the hub outward to the spokes which can be a geographically remote setting. This model yields an efficient healthcare network with the most advanced medical technologies and expertise at the main campus (Hub) and with administrators at different satellite facilities who are responsible for implementation in their assigned institutions. This also benefits the financial output by bringing human resources, materials management, marketing, and finance operations to the main campus which further serves the entire system. Also, it is highly scalable with satellites being incorporated as per the requirement of the system.

We are moving into an era of technological advancements and it is the need of the hour that we need to keep ourselves updated with the latest digital interventions; especially when the digital spectrum is taking over every aspect of our lives, including healthcare. Healthcare has always been an important area in human development, and any number of advancements made in this field is never enough. A new health problem always seems to arise along with the growing population and the advancement of time, each time period bringing its novel health challenge- the latest example of which is the COVID 19 pandemic. As health care professionals, it is essential for as to be well equipped with the latest models of health care and to integrate it in our own practices.

The article "Digital Transformation in Healthcare in 2021: 7 Key Trends" by Michael Reddy talks about the various trends seen in the digital platform for the year 2021 and gives a brief outlook on its basis and future predicaments.

//www.digitalauthority.me/resources/state-of-digital-transformation-healthcare/   

Digital health interventions are globally playing a significant role to combat coronavirus disease 2019 (COVID-19), which is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2...

//www.ijph.in/article.asp?issn=0019-557X;year=2020;volume=64;issue=6;spage=117;epage=124;aulast=Sarbadhikari

The Global Health Pandemic Covid -19 has changed the scenario of a normal healthy lifestyle lead by an individual. It has given all of us a major real-time challenge which has changed the perspective of each one, especially in terms of how we make decisions that are essential in maintaining a healthy lifestyle amidst this pandemic. Though there are a lot of awareness programs and in spite of many preventive measures taken by the governments in order to protect people’s health, there is still a lack of knowledge that has to be invoked among people in order to adapt these Covid guidelines into one own lifestyle. As Sudden transition from normal lifestyle to covid lifestyle was a nightmare to all of us. I think something like a digital health intervention is really the “NEED OF THE HOUR” that could help in supporting the decision-making process of an individual.

A Novel Coronavirus (CoV) is a new strain of coronavirus that has not been previously identified in humans. Covid-19 is playing a dual role of both as a BOON and BANE in the current scenario. Surprisingly it has made human life more challenging. The Covid-19 Global Pandemic has vividly changed the normal lifestyle of a common man and has entirely brought a new normal in terms of human’s behavioral aspects.

It’s a bane as it has given a major chunk of its effect on the mental health of an individual which seemed to be more challenging in terms of adapting a couple of things like wearing a mask, maintaining social distancing, and Sanitization being the key as an individual has to adapt to a major change which is related to individual psychological adaption like sanitizing hands prior to any surface contact. Especially Sanitizing the most frequently used surfaces and surroundings which is playing a vital role among all the Covid Precautions by preventing the spread of the infection.

It’s a Boon by creating a new normal, by invoking the need for more advanced technology in terms of health care technology. It has raised the need for the development of much better, effective health care and advancement in the building of a more sophisticated health care technology in terms of “decision making” which would help people in taking the correct decisions for shaping their needs in achieving good health, Which clearly depicts “Health is Wealth”.

Lifestyle is a way in which people lead their Life. More Specifically there should be an app development related to “Digital Lifestyle Intervention”.  The variables of lifestyle that influence health can be categorized in some items:

1.Diet and Body Mass Index (BMI)

2.Exercise

3.Sleep

4.Sexual behavior

5.Substance abuse

6.Medication abuse

7.Application of modern technologies

8.Recreation

9.Study

//www.ncbi.nlm.nih.gov/pmc/articles/PMC4703222/

By involving the community in developing these apps would serve as a great add-on in giving the app which people need. Because “Information is Power” and inculcate the behavior of learning by doing which is a very essential strategy in any Community based activity should be based on the felt needs.

In fact, the approach of Community-engaged research is by involving Community-based participatory research (CBPR), which incorporates community member input at every phase of the research process, ranging from conception to results dissemination.

//www.ncbi.nlm.nih.gov/pmc/articles/PMC6996775/

In this rapidly developing era of technology, there is always an increased interest in lean principles that specify methods for early-stage testing of features related to feasibility including:

• Acceptability and usability
• Demand
• Implementation
• Practicability
• adaptation
• Integration

The Covid has found to show its influence majorly on the mental health of an individual. So that digital Interventions which are more inclined towards changing the psychological perspective of an individual would serve as a better option. This covid situation has clearly depicted the change in the mental health of an individual as a most vital consequence.

//www.sciencedirect.com/science/article/abs/pii/S2215036620303072 .

For Example, the WHO- World Health Organization as a specific platform offers basic psychological support to help better manage the psychosocial difficulties that one might be experiencing during these covid times.

//www.emro.who.int/mhps/index.html