The concept of telemedicine, which is the practice of doctors delivering care and consultation to patients remotely, is well-established. However, the adoption of telemedicine has been slow, mostly because technology adoption in the healthcare sector tends to trail other industries.
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has changed the dynamic of technology adoption in healthcare. The virus-causing COVID-19 has the unfortunate combination of being more transmissible than SARS or Ebola and deadlier than the flu. As a result, patients who visit hospitals or clinics have a much higher probability of getting the virus from other patients.
Therefore, it is preferable that patients and doctors practice social distancing, especially in clinical settings. As a result, the adoption of telemedicine has spiked recently. Now, some healthcare systems are conducting more than half of their primary care visits via telehealth.
In addition to replacing routine, primary consultations, telemedicine also has significant potential in addressing other needs that have arisen during the COVID-19 pandemic. For example, it can help healthcare workers and ordinary citizens identify COVID-19 cases and prevent the spread. Also, telemedicine can help healthcare staff monitor potential COVID-19 cases that are in quarantine. In addition, telemedicine takes a page out of the Amazon playbook and uses drones to deliver essential medical supplies without endangering the medical staff.
Using Phone Apps to Trace COVID-19 Cases
Contact tracing is a public health intervention tool that is used every day to monitor and prevent the spread of transmissible diseases, such as tuberculosis, syphilis, HIV, Ebola and COVID-19. Through numerous and painstaking phone calls with patients with the identified condition, the medical staff tries to track down everyone who may also be in jeopardy of developing the disease (contacts).
Asian countries gravitate toward using big government databases. Centralized databases of phone numbers and time-specific locations are already in use in China and South Korea. Data analytics can link positive test results of a patient to their most recent contacts and GPS locations. The algorithm then sends text messages to people who have been in contact with a confirmed case. However, Western countries have much more concerns for data privacy, as most people will not agree to have their movements tracked so extensively by the government. Also, GPS location is not always accurate. Being in the same place does not indicate if the person-to-person interaction was close or long enough to transmit.
Alternatively, phone-to-phone notification apps are being developed for smartphones. Such apps use Bluetooth technology to track the contacts a person has had and if the connections have been close and long enough—within 6 feet for 15 or more minutes—to be potentially dangerous exposure to infection. Some manufacturers have already implemented these solutions.
These apps help patients become more aware and proactive of potential exposure so that they do not have to wait for guidance from public health officials. While such apps preserve patient privacy to a higher degree, they are only useful if a large number of people use the app—10 to 20 percent at minimum, depending on population density—and take the conclusion from the analytics seriously. However, the debate between privacy and public health will be an ongoing hot topic.
Remote Patient Monitoring
After medical staff have located people who have been exposed to the virus, the potential cases need to be persuaded to quarantine themselves so that they do not expose more people to the disease. The staff must check on the potential cases to make sure they are adhering to the quarantine. Also, the medical team needs to continuously monitor the patients, such as taking body temperature and checking for the presence or disappearance of symptoms.
Daily calls to cases and contacts are time-consuming for everyone. Apps can be developed to enable quarantined people to enter their symptoms into a database and alert the staff of unusual scenarios or quickly worsened symptoms. The apps do not replace the role of human interaction and direct phone calls but automate the routine cases so that they can process more cases.
During the quarantine, people may need help getting food, medicine or social support. They will be more likely to adhere to quarantine guidelines if they receive frequent reminders and adequate support. Telemedical apps can send text messages to the quarantined people to remind them to stay isolated and ensure they have the support or resources they need. Lastly, telemedicine can keep a quarantined person’s support network updated so that it can step in to help.
Robot Delivery of Medical Care
While telemedical software can reduce the non-essential face-to-face interaction between healthcare providers and patients, there are still times when physical objects, such as medication or medical devices, need to be delivered to the patient to implement care or collect data.
Drones have been used during the pandemic in China to check the temperature of residents who live in high-rise buildings. A drone carrying an infrared thermometer was flown up to whichever floor the residents lived in, and the residents would stand on their balconies to have their temperatures taken.
Drone delivery of goods has made significant progress by companies, such as Amazon, and many drone enthusiasts. Therefore, telemedicine and drone delivery can potentially be combined in a way that they can deliver medicine or other essentials to the patient without jeopardizing the healthcare staff.
Robots can make a significant contribution to minimizing infections in the hospital. Robots that perform cleaning tasks can be used to clean and sanitize areas in a hospital that have a high count of virus particles. This way, the human cleaning crew can reduce their exposure. Lastly, chatbots, or robots that can interact with patients and fill out questionnaires, will help reduce the workload of nurses in the hospital.
Remote Patient Management Technologies
One silver lining of COVID-19 is the acceleration of telemedicine technology development. With the pandemic, many are willing to adopt the use of telemedicine. Here is an example of what is to come. TytoCare offers a home kit with an app allowing healthcare professionals to remotely diagnose and treat many common conditions including ear infections, fever, eye irritation, sore throat, allergies and more.
How does it work?
The TytoHome kit is a handheld device that, with the help of the patients, enables a healthcare professional to perform guided physical examinations of the ears, lungs, heart, throat, skin and abdomen, and measure heart rate and body temperature. It comes with a camera, thermometer and attachable adaptors. Additionally, an otoscope adapter can be attached to the device for the examination of the ears, a stethoscope for the heart and lungs, and a tongue depressor for the throat.
The FDA has recently cleared other medical devices, including remote noise-cancellation stethoscopes. Additionally, Eko Enterprise offers digital stethoscopes with EKG capabilities. Most of these home devices would cost around $300. This is only the beginning. We can expect more telemedicine innovations to come.
Future Trends
In the past, telemedicine gained wider adoption among specific segments of the patient population, such as Type 1 diabetes patients, who need intense, around-the-clock monitoring. COVID-19 will push the adoption of telemedicine to a much broader segment of the general population.Here are some of the promising trends.
1. Patients using telemedicine technology to see their doctors will increase
Patients with underlying conditions, who usually go to clinics for an in-person checkup, are more vulnerable due to their compromised immune system. Telemedicine will reduce their chance of infection.
2. Real-time location system use will increase
The real-time location system used in telemedicine will be useful in identifying infected persons and equipment within a hospital so that these people do not go on to spread the infection.
3. More DNA sequencing
Next-generation sequencing, which has massive DNA and RNA sequencing prowess, has been and will continue to be used to analyze the virus that causes COVID-19 during vaccine development and epidemiological studies.
4. Telemedicine technology innovation will continue to accelerate
Today, using telemedicine, many common medical conditions can be treated over the Internet. They include ear infections, cold and flu, fever, headaches, eye irritation, congestion, sinus pain, allergies, constipation and stomach aches, bug bites and rashes, coughs and upper respiratory issues, sore throat, and even minor heart conditions. Future innovation is expected to add new capabilities. Success belongs to those who can deliver easy-to-use yet accurate solutions. After all, COVID-19 may have revolutionized the telemedicine industry.