Digital Healthcare Models in a COVID-19 Environment

The COVID 19 pandemic represented an unparalleled challenge for health care frameworks globally. Health care has been responding to the COVID 19 pandemic through the quick adoption of computerized health care solutions and advanced, cutting edge automation tools.

Most countries that have flattened their COVID-19 incidence curves and maintained low mortality rates have incorporated digital technology into government-facilitated containment and mitigation processes - including

• Surveillance for suspected patient tracking -using population informatics, drones- for surveillance and also for spraying disinfectants,
• Screening- using Artificial intelligence; digital thermometers; mobile phone applications; thermal cameras; web-based toolkits
• Testing,
• Digital contact tracing - using global positioning systems; mobile phone applications; real-time monitoring of mobile devices; wearable technology and strict quarantine
• Clinical management- using Artificial intelligence for diagnostics; machine learning; virtual care or telemedicine platforms
• Quarantine- by electronic monitoring of home- quarantined individuals using AI-powered surveillance cameras, drone-borne cameras, portable digital recorders etc.

//www.sciencedirect.com/science/article/pii/S2589750020301424

COVID -19 crisis favored the execution of digital solutions rapidly with an unprecedented impact and has has drastically changed numerous aspects of human life and worldwide society both now and for a long time to come. We are essentially at the apex of new developments in the digital space and it is worth exploiting the push given by the pandemic we are experiencing today. It is important to mandatorily keep track of the ideas and solutions proposed today to implement tomorrow's best practices and models of care, and to develop exemplars that can help guide the future direction of digital global society for everyone's merit.

//www.medrxiv.org/content/medrxiv/early/2020/05/01/2020.04.26.20080341.full.pdf

A good read on change of International Business models during COVID-19 and Digital health models during and Post COVID-19

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//www.the-digital-insurer.com/wp-content/uploads/2020/06/1658-McKinsey-Telehealth-A-quarter-trilliondollar-post-COVID-19-reality.pdf

Digitization has played a significant role in healthcare during this time of pandemic as it has extensively affected the healthcare at multiple levels. Digital tools have been adopted to find different healthcare related issues by the healthcare organizations globally. Various digital solutions like Arogya setu which is a software application that helped to connect essential health services with the people of India with the combined fight against COVID-19. Various websites, dashboards and tools like Ministry of Health and Family Welfare and Smaart Rapid Tracker to acquire latest updates and insights to track and address the current situation of COVID-19 across different states of India (mohfw) and other countries (Smaart Rapid Tracker).

Apart from surveillance, various digital solutions have adopted and still need to imply for diagnosis and prevention of COVID-19 and other diseases. 

Models like tele health, stream fishing, pyramid model should consider and assimilate into clinical practice. By equipping them with the foundation of necessary technology skills, it makes it easy for clinicians to adopt these technologies and interact with patients. In the long run, they will be familiarized with the digital tools that will complement clinician workflows and enhance the productivity of healthcare professionals.

-No doubt that pandemic has created unmatched disturbance. Many new technical inclusion being done by institutions, organizations, hospitals etc;. This disturbance has caused rapid lively shift in demand, capacity, and even contextual aspects of health care. Various software developers have started to come up with different apps that helped in tracking possible carries, tracing outbreaks of infection, helping patients identifying symptoms etc. Digital health technology also serves as a cost effective method for providing and assessing the health care services. 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.. It is suggested to monitor the implementation, adoption of best practices and models of care in national health systems.

Leveraging the existing experience and robust enterprise-grade technologies can have a substantive impact on the immediate and distal consequences of COVID-19 as well as other future health care needs. The paper presents several cases to illustrate possible digital applications useful during the COVID-19. 

1. Stronger Infection Control through Remote Monitoring and Training

• Tele-consultations With Early Stage or Mild COVID-19:The use of teleconsultations is being widely recommended in most high-income contexts to protect health facilities from being overwhelmed by cases with mild to moderate illness that can be managed at home, as well as they might be in a health care facility environment. 
• Remote Monitoring of Infection Prevention and Control (IPC): Digital tools can play a crucial role in IPC by facilitating the monitoring and quality control of IPC practices. Highly trained infection control observers monitor IPC procedures, ensure adequate IPC supplies, and provide real-time aid by radio when needed.
• Centralized Training and Capacity Building, Delivered Digital: Centralizing training through the internet or mobile phones will make it easier to train staff in rural and remote areas where provider and training capacity is often variable.

2. Centralized Helplines for COVID-19 Information: It is likely more efficient to train call center–based doctors on the management of suspected cases than to conduct mass communication campaigns necessary to ensure the general population has sufficient knowledge to protect themselves and their communities.
3. Psychological Intervention for the Quarantined: We can use digital communication (telepsychiatry) to deliver mental health support, provide counseling, and link individuals through online social networks. This also protects counselors and psychologists who will be able to provide support without exposing themselves to the pathogen. 
4. Public Health Surveillance and Epidemiology: Contact Tracing: Example: A centralized EMR system, accessible through a web interface or smartphone app, can facilitate the tracking of COVID-19 cases during this public health emergency.

Source: Mahmood S, Hasan K, Colder Carras M, Labrique A Global Preparedness Against COVID-19: We Must Leverage the Power of Digital Health
JMIR Public Health Surveill 2020;6(2):e18980 DOI: 10.2196/18980

The Covid-19 pandemic has resulted in massive disruption in health care. The traditional face to face interaction in health care during the pandemic has reduced due to certain norms. This can be replaced with digital health care models and technology. Digital health care models include electronic health, mobile health. Their role became more prominent during the pandemic times.                                                                                                                                                                                                                                                                                                         

The Covid-19 pandemic shows that digital health is a demand of the future and many countries have moved towards digital healthcare systems. There are so many services we are already using even before COVID-19. We can use digital health in different forms such as telemedicine, telehealth services and also using a digital platform to change behavior modification of individuals. Currently, Artificial intelligence, blockchain technology and so many other digital applications play an important role in addressing the new healthcare challenges at the time of the COVID-19 pandemic. The digital technology during the pandemic has been fast-tracked, has shown great results and helped the healthcare workers carry out their work more efficiently.
Digital health interventions are playing a significant role to combat life-threatening diseases globally. In India, the government has launched National Digital Health Mission. This policy could be a game-changer, if everybody will maintain the equity, privacy of every individual and hopefully India turn into the most accessible and affordable health care system country globally.

Read This: //indianexpress.com/article/opinion/columns/ndhm-health-id-covid-19-india-6574094/

The COVID-19 pandemic has created an unprecedented disruption to global economies and health care,with extensive lockdowns and travel bans to flatten the curve. 

Health-care systems also had to address the surge in patients at a high risk of COVID-19, including patients with respiratory diseases, while minimising their contact with other patients requiring continued care for non-COVID-19 illnesses. These changes required the reconfiguring of workflows and physical infrastructure to reduce the risk of health-care-associated transmission. In addition, health-care organisations had to reorganise manpower to meet large and sudden fluctuations in clinical need at different geographical regions and settings (front-line and community-based settings) in response to local outbreaks.Public health policy responses, such as the quarantine of those returning from travel, or alternate week split-team measures to physically separate health-care workers.

Digital health solutions are playing a key role during the COVID-19 outbreak . The health and social distancing measures imposed by the pandemic made  to think of health care delivery solutions to ensure continuity of services . it should be strategic and sustained process , not just a response to public health emergencies .

Recent times have seen a surge in advancement in digital industry, especially in digital healthcare. dissemination of health care services have improved a lot, and we can witness this improvement through all the personalised and value-added services provided to the consumers.

Emerging healthcare delivery models like Social healthcare networks, On demand health care in form of quick booking of appointments, receiving digital medical reports, settling medical fees online, scheduling doctor visits, E-pharmacies have proved very helpful.

Also COVID-19 pandemic has increased the use of tele health and virtual consultation to curb the spread and deliver health remotely. keeping in mind the current situation voice assistants with all essential build and constructions, can be good support tools in healthcare considering their increasing use and popularity.

The article Readiness for voice assistants to support healthcare delivery during a health crisis and pandemic highlights how Voice assistance can be of extreme support with proper partnership between healthcare experts, technology developers, regulators, and legislators.

 The covid 19 pandemic has lead the entire world to switch to digital technology  education, work and daily life. Technology represented by video based communication platforms brings alot of change.There are many guidelines related to healthcare activities that have been given through technology during the covid 19 pandemic which lead to better patient outcomes,reduction of spread of virus by following the precautionary measures.The integration of digital technology into pandemic policy could be one of features in flattening the covid 19 incidence curves and lower mortality rates.

As an initiative under the NCD Partnership (PARTners in Ncds Engage foR building Strategies to improve Healthy ageing In Patients) model of Upjohn, a web-based advisory board of patient and caregiver advocates was held on July 28, 2020, to bring together key stakeholders from public and private sectors.

This article ( //www.ncbi.nlm.nih.gov/pmc/articles/PMC7850778/ ) presents views of an advisory board of patient and caregiver association members on the role of digital health tools in managing patients with NCDs (non-communicable diseases) during and after the COVID-19 pandemic, and to identify future directions based on patients’ perspectives.

They put forth following key themes for optimization of digital tools:

 (1) technology developers should understand that the goals of patients may differ from those of health care professionals and other stakeholders

 (2) patients, health care professionals, caregivers, and other end users need to be involved in the development of digital health tools at the earliest phase possible, to guarantee usability, efficacy, and adoption

(3) digital health tools must be better tailored to people with complex conditions, such as multimorbidity, older age, and cognitive or sensory impairment

 (4) some patients do not want or are unable to use digital health care tools, so adequate alternatives should always be available.

Monaco A, Palmer K, Holm Ravn Faber N, et al. Digital Health Tools for Managing Noncommunicable Diseases During and After the COVID-19 Pandemic: Perspectives of Patients and Caregivers. J Med Internet Res. 2021;23(1):e25652. Published 2021 Jan 29. doi:10.2196/25652

As the pandemic shut all the doors, it indeed opened the window of exploring digital solutions for every problem".
Digital Healthcare have been a savior in this era and will continue to equip the society with delivery of much needed quality care transcending the barrier of time and distance.
A gap may arise with advancement of digital healthcare and its effective utilization with the lack of public awareness .The advertisement of such helpful and efficient tools must be initiated by the government to spread awareness and motivate public to use these resourceful health interventions to manage, track and improve their health.

"A ship in the harbor is safe, but that is not what ships are built for", in other words relating to the topic, technology of high potential is of great value but when not exploited it is next to nothing. As the pandemic has taken over our lives, digitalization is like a ship loaded with technology that has huge capacity to transform the mankind's against infectious diseases when put into right use. but i feel that it is still moored in harbor due to various direct or indirect reasons. 

I believe that digitalized environments in such critical conditions are always on the positive end. 

Undoubtedly the covid19 pandemic has created a huge effect on mankind all over the world, but thankfully due to the new advancements in technology and gradual development of new innovative healthcare models in healthcare systems we are being able to cope with the situation and  brought down the cases of covid-19 considerably.  Digital Health care has brought some sort of relief to all healthcare sector workers who were burdened by the overwhelming covid19 cases, for example doctors, they were able to treat and communicate with the patients while not having a person to person contact physically which is  much needed in such situation, with the cooperation of the government and private sector in funding for research and development (R&D) in order to create new innovative technologies has thrown limelight on how important there is a need of funding to constantly develop newer and impactful digital healthcare models to be able to control the situation when such a pandemic occurs. Further, based on the experience , there will definitely be a rise and improvement in digital healthcare technologies in coming days. This pandemic situation has been a learning lesson for all of us and taught  how the world needs to be prepared to tackle such pandemic situations in the future.

Digital technologies are being harnessed to support the public-health response to COVID-19 worldwide, including population surveillance, case identification, contact tracing and evaluation of interventions on the basis of mobility data and communication with the public.

Digital epidemiological surveillance: A range of digital data sources are being used to enhance and interpret key epidemiological data gathered by public-health authorities for COVID-19.

Online data sources for early disease detection: Syndromic surveillance networks are based on reports of clinical symptoms, such as ‘influenza-like illness’, rather than a laboratory diagnosis, from hospital and selected sentinel primary and secondary healthcare facilities, which agree to provide regular surveillance data of all cases.

Data-visualization tools for decision support: Data dashboards are being used extensively in the pandemic, collating real-time public-health data, including confirmed cases, deaths and testing figures, to keep the public informed and support policymakers in refining interventions.

Rapid case identification: Digital technologies can supplement clinical and laboratory notification, through the use of symptom-based case identification and widespread access to community testing and self testing, and with automation and acceleration of reporting to public-health databases.

Digital contact tracing: In the COVID-19 pandemic, digital contact-tracing apps have been developed for use in several countries; these apps rely on approaches and technologies not previously tried on this scale and are controversial in terms of privacy. Evaluating their accuracy and effectiveness is essential.

Public health has been slower to take up digital innovations than have other sectors, with the first WHO guidelines on digital health interventions for health-system strengthening published in 2019. The unprecedented humanitarian and economic needs presented by COVID-19 are driving the development and adoption of new digital technologies at scale and speed.

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