Health

Which covid-19 digital health workarounds should translate into permanent service provision?

July 19, 2021

Global

Which covid-19 digital health workarounds should translate into permanent service provision?

July 19, 2021

Global
Marcela Casaca V. da Cunha

Analyst

Marcela is an Analyst in the Health Policy and Clinical Evidence team. Her areas of expertise are public health, policy monitoring and evaluation (M&E), and socioeconomic development in low- and middle-income countries. Marcela has been working on several projects in the Health Policy team, such as the Vaccine Initiative, policies for pandemics response, and indexes development.

Covid-19 has accelerated the implementation of digital technologies across healthcare systems. Here we look at a few recently completed EIU projects that focus on how digital technologies have been used to mitigate the challenges created by the pandemic but also have great potential to address current and future healthcare challenges.

Digital health uses information and communication technologies to support and promote health.   These technologies offer the promise of reducing inefficiencies and costs in healthcare management, making processes more efficient and maximising the usage of resources. In the coming years, we expect to see a paradigm shift where digital and virtual care will be core to health facilities instead of supplementary technology. The necessity of using digital technology to deliver care during covid-19 has paved the way to the incorporation of digital solutions in the long-term.

A case study produced by the EIU for Siemens Healthineers on scaling up and sustaining the digital transformation of US hospitals brought about by COVID-19 describes how covid-19 has created the imperative and circumstances for various pilot schemes and the expansion of digital technologies.1

US hospitals experienced many digital transformations in order to manage the pandemic. Social distancing requirements motivated hospitals to deliver virtual care, especially for chronic disease treatments, for instance. Specialists and chief information officers (CIO) we spoke to feel that this will lead to permanent shifts in the care model towards virtual consultations where patients can experience a more convenient and faster service. 

Digital solutions also enabled new models of collaboration across and within institutions, as part of better integrated health care systems. New models of data-sharing partnerships were fundamental to facilitate this collaborative working.

Increasing technology to reduce infection risk: a case study for Siemens Healthineers of how covid-19 has increased the roll-out of virtual hospital wards rounds.2

The advantages of virtual hospital rounds during covid-19 include preserving personal protective equipment (PPE) supplies and reducing staff exposure to covid-19. It also enables staff from outside the institution to provide support remotely and the same infrastructure can allow families to maintain contact with inpatients from distance.  

The efficient and long-term adoption of virtual hospital rounds could help healthcare systems to provide care across greater distances using a broader range of specialists. Future opportunities include larger medical centres providing expertise at the community level remotely and new partnerships to share expertise across hospitals facilities.

The exploratory use of Artificial Intelligence (AI) tools for covid-19 diagnostics may generate benefits for the future development of tools for other conditions, another EIU case study for Siemens Healthineers highlights.3

AI promises to improve healthcare in unprecedented ways with different applications across healthcare management. The implementation of new and disruptive procedures in healthcare takes time especially when we do not have a full understanding of the benefits they can offer. The exceptional situation of the pandemic created an opportunity for large-scale experimentation. 

In the case study, we highlight studies of covid-19 diagnosis using algorithms in imaging tests. Although these are still early stage research, we can learn a lot from this research about how to train AI to distinguish between different lung pathologies. There are still many gaps in our knowledge about AI tools, so every experience contributes to the development of the field, says Dr Ranschaert, a radiologist and AI project leader at Elisabeth-Twee Steden Ziekenhuis. 

Digital technologies offer great promise for the management of chronic diseases and the EIU’s Digital Diabetes Index, sponsored by MedTech Europe, found that in Europe there was a good foundation of health IT infrastructure, but access to newer diabetes technologies was inconsistent.4

People with diabetes experienced a contradiction between covid-related advice that labelled them as “clinically vulnerable” individuals who should avoid unnecessary contact, and having to physically access services to manage their condition. For example in many countries people with diabetes had to physically fill their prescriptions for insulin and medications because this could not be done electronically. We saw in some countries that the long-awaited adoption of such systems as eprescriptions was possible when the pandemic made it a necessity, the question for many is whether these will persist beyond the current emergency. In countries where diabetes monitoring systems were already adopted, healthcare professionals were able to monitor people’s condition online with real-time and flash glucose monitoring. 

The EIU’s Digital Diabetes Index showed broad engagement with the fundamental digital health policies necessary to support digital diabetes care in 10 European countries. The index includes the presence of underlying eGovernment and eHealth plans, the utilisation of electronic health records, and the presence of national diabetes policy. However, to enable digital diabetes care at scale, there is a need in many countries for national diabetes plans that address digital technologies, assessment and evaluation processes that recognise the value of digital technologies, appropriate reimbursement pathways, guidelines to inform clinical practice and training in digital tools at all stages of initial and on-going medical training.

A case study produced by the EIU for Siemens Healthineers – Outside the hospital: cancer monitoring with apps – shows how monitoring with apps could improve cancer care.5

Smartphone apps can enable people with cancer to share updates about their condition remotely. Similar to diabetes monitoring, they can share real-time data and communicate with their healthcare team from home, enabling faster feedback and more personalised care. 

Although reimbursement for mobile health tools has been a barrier to implementation, the pandemic has accelerated their adoption into clinical pathways. The next phase of implementation is deciding how to translate data from these apps into valuable and actionable insights for clinicians and make their usage widely available.

The usage of digital health to accommodate social distancing requirements and assist healthcare centres to deal with the pandemic has shown us how such technology can be incorporated into the delivery of healthcare services. It is unclear, however, how much of this change will translate into permanent changes to service provision and when these will be widely available and not restricted to certain populations. The long-term outcomes of many of these digital technologies are currently unknown, necessitating robust research and evaluation to truly understand whether, how, when and why these technologies work. Taking digital health expansion from a temporary to a permanent solution requires evidence-based policies and robust investment in on-going research.

The question remains: how can we translate short-term policies to a permanent change in service delivery aiming at a more cost-effective, accessible and personalised healthcare system.

 

[1] EIU. Scaling up and sustaining the digital transformation of US hospitals brought about by covid-19. Erlangen: Siemens Healthineers, 2020 Available from: https://cdn0.scrvt.com/39b415fb07de4d9656c7b516d8e2d907/c928facd630f8ada/4467079b7c51/siemens_healthineers_eiu_digitalizing_healthcare_case_study_us_hospital_transformation.pdf.

[2] EIU. Virtual hospital ward rounds involve wider number of clinical experts and families. Erlangen: Siemens Healthineers, 2020. Available from: https://cdn0.scrvt.com/39b415fb07de4d9656c7b516d8e2d907/bcc96e6f9eee4919/fbe0bd4f4f35/siemens_healthineers_eiu_digitalizing_healthcare_case_study_virtual_rounds.pdf.

[3] EIU. Using medical imaging and AI to help diagnose and manage COVID-19 patients. Erlangen: Siemens Healthineers, 2020. Available from: https://cdn0.scrvt.com/39b415fb07de4d9656c7b516d8e2d907/c4a0c10965d7b37b/8d79e9f8b314/siemens_healthineers_eiu_digitalizing_healthcare_case_study_covid_ai.pdf.

[4] EIU. Digital diabetes index: comparing European digital diabetes readiness [Internet]. London: The Economist Intelligence Unit. Available from: https://digitaldiabetesindex.eiu.com/.

[5] EIU. Outside the hospital: remote cancer monitoring with apps. Erlangen: Siemens Healthineers. Available from: https://cdn0.scrvt.com/39b415fb07de4d9656c7b516d8e2d907/0198a76c86d68573/9d1d7de8d0ef/siemens_healthineers_eiu_digitalizing_healthcare_case_study_cancer_apps.pdf.

 

 

 

 

Enjoy in-depth insights and expert analysis - subscribe to our Perspectives newsletter, delivered every week