In the outbreak of the novel coronavirus, the disease now known as COVID-19, there’s a clear and present danger for community transmission. Cases of COVID-19 in the United States are, for now, still imported from travelers from Wuhan. And while the “virus is NOT currently spreading in the community in the United States,” we are not immune from the possibility.
With almost 76,769 confirmed cases around the world and over 2,239 deaths in China where the novel coronavirus began, patients tested in United States (as of February 24, 2020) are now at 426, of which 14 are confirmed: 2 are person-to-person spread, and 12 are travel-related infection. According to the Centers for Disease Control and Prevention (CDC), the potential public health threat posed by COVID-19 is high, both globally and to the United States.
The CDC expects that “...more cases are likely to be identified in the coming days, including more cases in the United States. It’s also likely that person-to-person spread will continue to occur, including in the United States.”
The first confirmed case of infection in the U.S., reported on January 20, gave U.S. public health authorities a better understanding of identification, diagnosis, clinical course, and management of the case. More importantly, it highlighted the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection, according to The New England Journal of Medicine.
Therefore, the keywords in clinical management, care, monitoring, and response to COVID-19 patients are:
This is where telehealth can play an integral role.
Telehealth and COVID-19
According to the World Health Organization, telehealth enables remote communication and treatment of patients with the use of telecommunications and virtual technology to deliver health care outside of traditional healthcare facilities. It also reduces the number of visits for health services, which puts telehealth on the front line to contain and prevent the spread of the virus.
As noted by the Center for Global Development, technological innovations hold the potential to support the response to COVID-19 and future major pandemics. One of its Expert Recommendations for US and Global Preparedness for COVID-19 is to support research and innovative technologies like digital health platforms, rapid point-of-care diagnostics, and population-level data tools that could prove important to the response, mitigate the outbreak, and accelerate bringing solutions into timely use.
The CDC believes that at this time some people will have an increased risk of infection, for example, healthcare workers caring for COVID-19 patients and other close contacts of COVID-19 patients. Prompt detection and effective triage are essential to prevent unnecessary exposures among patients, healthcare personnel, and visitors at the facility.
Telehealth’s support for patient engagement through monitoring, communication, and outreach enables early detection and effective triage. This enables healthcare providers to risk-stratify patients before or immediately upon arrival to the healthcare facility, then initiate isolation of potentially infectious patients.
“Ensure that patients with symptoms of suspected COVID-19 or other respiratory infection (for example, fever, cough) are not allowed to wait among other patients seeking care,” according to CDC’s Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings.
Not all patients under investigation for COVID-19 require hospitalization, not even those showing symptoms and mild clinical presentation. Determining where to manage the care of the patient is a crucial first step. More specifically, the CDC points out that the decision to monitor a patient in the inpatient or outpatient setting “...will depend not only on the clinical presentation, but also on the patient’s ability to engage in monitoring, home isolation, and the risk of transmission in the patient’s home environment.” This is according to the CDC's Interim Clinical Guidance for Management of Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) Infection.
Telehealth, through patient engagement platforms, champions remote population and patient monitoring. This platform approach to telehealth can be readily deployed to engage the patient remotely and to provide access to personalized care anytime, anywhere.
Using Technology as a Countermeasure
A patient engagement platform such as provided by LifeWIRE Corp has the versatility to engage the patient anytime, anywhere, and on any device, to check in with the whole healthcare team in one loop of communication, both collaborating and coordinating care. Population monitoring is made easy on any media chosen by the patient, whether text, voice, email, app, wearables, and more, anytime and anywhere. There is no barrier to communication and personalized care.
Where care management, monitoring, and tracking are crucial in COVID-19 for outpatients as much as inpatients, LifeWIRE automates routine protocols, follow-up, feedback, and outreach. Patient engagement transcends beyond patient participation to patient activation for better health outcomes.
While medical countermeasures for COVID-19 are yet to be developed and while treatment protocols, for now, are for acute respiratory infections, it is still important to personalize care. Patient engagement platforms such as LifeWIRE allow an immediate response to patient needs like assessment, call-to-action, information, weblinks, video, or warm hand-off to care managers.
In any outbreak, frontline health workers are always at risk and need all the support they can get to safely manage a surge in cases. This outbreak, and future threats of other pandemics, have the potential to overwhelm normal health systems.
Treatment and care on a mass scale will require efficiency in staffing, if not more healthcare workers. Telehealth can increase efficiency through population management. Through its Administration Platform, LifeWIRE makes it as easy to manage 500,000 patients as 1 patient. By using this platform, and the ability to access it via its API, a provider can upload patients automatically, with onboarding initiated using rule sets and interactions created by the provider.
Experts from the Center for Global Development, the Georgetown Center for Global Health Science and Security, the Nuclear Threat Initiative|Bio, the University of Nebraska Medical Center’s College of Public Health, and In-Q-Tel/B.Next have come up with recommendations for action as the U.S. updates its national pandemic planning.
Experts recommend that the U.S. government should develop clear mechanisms for distributed care, including home diagnosis and isolation for mitigating the mass-scale domestic transmission of the virus and for providing mass-scale isolation and treatment.
Community transmission of COVID-19 is imminent, and it will take a community to effectively deal with it—by monitoring and engaging patients, and by collaborating and coordinating care to contain any health threat. This is where technology stands ready to take control.