How Tech Has Helped to Combat Coronavirus

““We are stuck with technology when what we really want is just stuff that works.”

— Douglas Adams

ATTEMPTING TO COVER HOW technology can help in the fight against coronavirus is something of a fool’s errand, because it’s such a wide and diverse industry that the number of potential applications is almost infinite.

It’s clear that governments are taking technology seriously as a tool that can help them, too. For example, early on in the outbreak, Dominic Cummings, chief advisor to British Prime Minister Boris Johnson, summoned representatives from 30 technology companies to a meeting with NHS CEO Simon Stevens at Downing Street. The meeting earned the nickname of “the digital Dunkirk”.

Tech companies of all shapes and sizes have already demonstrated a commitment to tackling the coronavirus problem. For example, the Center for Disease Control and Prevention (CDC) is using one of Microsoft’s chatbots to power a COVID-19 assessment bot. Meanwhile, Amazon AWS has used $20 million to create a diagnostic development unit that aims to develop faster and more affordable testing kits. And IBM is providing the White House with supercomputing resources to help their researchers to map and stop the spread of COVID-19.

NHSX, the digital branch of the British NHS, launched an initiative called Techforce 19, which asked “all innovators” to find ways to help the elderly, the vulnerable and those who were self-isolating. As an incentive, they offered developers, programmers and entrepreneurs up to £25,000 (around $31,000) to help them to test their ideas. They also hosted a hackathon called “Hack from Home”.

This is an approach that’s been echoed by other governmental organizations elsewhere in the world. The French Ministry of Armed Forces spent €10 million ($11 million) calling for COVID-19-related projects, while India launched a startup challenge of its own. Even Poland got into the game, arranging an international hackathon that attracted over 1,500 participants.

One interesting approach comes to us via Lantum, a workforce-management platform that was launched to help the NHS to reduce staffing costs. The platform provides access to over 20,000 medical staff and offers up a national snapshot of what’s going on and where capacity is. During the outbreak, it’s refocused itself to better support teleconferencing and to cater to staff shortages during the coronavirus crisis.

Speaking on behalf of Octopus Ventures, early stage investor Zoe Chambers explained, “If you have tech that can be repurposed quite quickly, then it completely makes sense to put your hand up. Say you have an at-home temperature tracking app, initially designed for fertility. It can easily be repurposed for self-isolating people, because the tech is there.”

3D Printers

3D printing is coming of age in the coronavirus era, with the technology being used to create face masks in a time of unprecedented demand. A number of different 3D printing initiatives have been announced, including one from New York’s Budmen, which is printing 1,000 face shields for medical staff each day.

Writing for WUSF Public Media, Daylina Miller covers another example, explaining, “A week ago, out-of-work Walt Disney World seamstress and Orlando resident Cynthia Kirkland turned her 3D printer toward making face shields out of the plastic sheeting commonly seen in overhead projectors in schools, and 3D-printed face bands – all of which are easily cleaned in a bleach bath. It quickly turned into a state-wide and national effort of more than 150 3D printers taking designs, originally created by makers in Sweden, the Czech Republic and elsewhere, and tweaking them.”

One thing to note is that these shields don’t necessarily replace existing gear, but that they can help to make masks last a lot longer. They’re similar in some ways to a welding visor and it currently costs around $20 to make 60 shields, though each shield takes up to two hours to print.

Meanwhile, Kentucky Rural Development State Director in Rural Technology Hilda Legg highlighted the case of Somerset Community College, which also used 3D printing to aid healthcare efforts. Legg explains, “It only took a few hours to go from printing student projects to printing and assembling the first face shield prototypes, and when there was a requested design change, an updated prototype was ready in less than 20 minutes with finished versions coming out within the hour. Now that they have a finalized design, they’re printing and assembling over 100 face shields per hour. Eric, who’s basically living out of his office to continue the process 24/7 with the help of some rotating staff members, said they’ve also shared the specifications with networked additive manufacturers so they could also begin production.”

App-Based Concierges

In the early days of the outbreak, widespread testing wasn’t necessarily available, and so an app-based concierge care company called Forward stepped up to try to ease some of the pressure on the healthcare system. Waiving its usual membership fee, Forward offered up free video consultations with board-certified US doctors for coronavirus-related symptoms.

Writing for Inside Hook, Nadja Sayej explained, “A concierge doctor is a physician who has a direct relationship with their patient by phone, text and in-person appointments. They know and understand your medical history well. They call this privilege ‘primary care’. The cost? An annual fee, often billed as a membership. Most doctors have a small percentage of clients for this service, while carrying on their regular practice.”

Services like the one that Forward offers were vital at a time when demand for testing far exceeded supply. Adrian Aoun, the CEO and founder of the company, explained, “The care team assesses [patients’] risks based on the results of [an] assessment and can quickly triage those who may have the virus. As a supply of tests is still limited in the US, members whose remote assessment indicates [they’re the] the most in need are then scheduled for testing.”

Dr. Sanford Friedman adds, “The role of the concierge physician is immediacy and the main tool of the pandemic is the phone. I have patients calling me up the wazoo with fever. I’ve discouraged people from coming. The phone becomes the critical instrument for dealing with the virus; understanding a patient’s medical history and advising them.”

Big Tech Gets Involved

Another side effect of the COVID-19 pandemic was that major companies all over the world started looking at ways to help out in the fight. General Motors, for example, used its logistics, purchasing and manufacturing expertise to team up with healthtech firm Ventec to make ventilators. Mary Barra, the company’s CEO, explained, “We’re working closely with Ventec to rapidly scale up production of their critically important respiratory products to support our country’s fight against the COVID-19 pandemic. We’ll continue to explore ways to help in this time of crisis.”

Meanwhile, Boise State University, though hardly a tech company, got involved by providing temporary housing for healthcare workers who needed to self-isolate to protect their families. Greg Hahn, vice president of communications at the University, explained, “The university has made it a top priority to be as responsive to the community and the state as possible through all this, so we’re exploring all the ideas that come our way. I believe this need is coming from the healthcare systems and their workers, hoping to do all they can to keep providing needed care but without putting their families in danger.”

Boeing got involved too, 3D printing face shields for healthcare workers which included an adjustable headband and a clear plastic face shield. The company promised to deliver thousands of shields per week via several plants throughout the United States. The company also donated thousands of gloves, goggles, face masks and protective body suits to healthcare efforts, as well as offering up some of their planes to transport medical supplies throughout the States.

Want to learn more?

I talk more about new technologies and their impact on the healthcare industry in my book, The Future of Healthcare: Humans and Machines Partnering for Better Outcomes. Click here to buy yourself a copy.

Dealing with Physician Burnout,

““Burnout is nature’s way of telling you, you’ve been going through the motions your soul has departed; you’re a zombie, a member of the walking dead, a sleepwalker. False optimism is like administrating stimulants to an exhausted nervous system.”

— Sam Keen

WE ALL KNOW that physician burnout is a problem. The real question is how we plan to treat it. The bad news is that there’s no magic bullet, but the good news is that there are four different approaches that we could take. The American Medical Association (AMA) has even spent considerable resources investigating the phenomenon of physician burnout and looking for ways to reduce the challenges that physicians face.

In a study titled Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systemic Review, AMA leaders and IBM staffers collaborated to explain, “Burnout more often stems from organizational or system-level factors, and interventions to prevent burnout may be more effective when they focus on changing the system rather than individual physicians.”

Here are the categories that they identified:

TEAMWORK: The researchers examined 50 different studies and found, “When practices and organizations expanded the duties of medical assistants, professional fulfillment and practice satisfaction improved. Practices with full-time clerical support for physician order entry in primary care also saw a decrease in weekly self-reported burnout. At baseline, 43% of doctors were burned out compared to the four-month follow-up of only 14%.”

TIME: Researchers trialed fourteen different interventions including limited working hours, modified work schedules and promoted time banking. Eight of those studies reported a positive impact.

TRANSITIONS: Eight out of nine studies found that workflow redesigns, targeted quality improvement projects and separating workflows had a substantial impact on physician burnout and job satisfaction.

TECHNOLOGY: Possibly the most interesting thing here is that each of these studies focused on EHRs. Half of the ten studies noted interventions that successfully improved physician burnout and satisfaction.

Physician burnout is such a hot topic at the moment that it seems as though everyone has an opinion. One that stood out in particular was a Q&A between HealthTech Magazine’s Andrew Steger and Esteban Rubens of NetApp, who made the case for AI’s potential to combat the burnout that’s sweeping the nation’s doctors.

Rubens says that administrative tasks such as data entry aren’t what physicians signed up to do. He explains, “We have some anecdotal evidence of people leaving the profession because they don’t want to have to deal with repetitive tasks and data entry. And then there’s this phenomenon of concierge doctors. The doctors take payment from the patients directly, and they don’t really have to deal with any of the software that’s required for providers who work in a standard organization.”

Human “Check Engine” Lights

This is a concept that I’ve been advocating for a while now, and I’m glad to see that it’s finally gaining traction. The idea is that we should have “check engine” lights for human beings like we have on the dashboards of our cars. Now, University of Alberta computing scientist Pierre Boulanger is working on making it a reality.

Writing about Boulanger’s work for Folio.ca, Bren Wittmeier explained, “He’s developed two products that could help take patients down the road. One is MEDBike, a biking system that remotely monitors blood pressure, oxygen levels and heart activity in recovering cardiac patients. The other is MEDRoad, a cloud-based tele-monitoring system that allows patient health to be observed without the need to go to a hospital or clinic.”

These are important steps towards a future in which we routinely use continuous monitoring to keep patients in the best health possible. MEDBike is interesting too because it taps into virtual reality and the developers have even created a version for children in which they can chase animals or race through wormholes. Wittmeier says, “He envisions the technology being used in nursing homes, where vital signs telemonitored by cloud analytics could make sure the exercise is done safely. In remote communities, the bike could be used to conduct stress tests.”

It’s also worth noting that these new devices aren’t cost-prohibitively expensive. The prototype MEDBike cost over $4,000 per unit, but the team has made a cheaper system for $1,500 and a simpler, budget model for $400. And while the human check engine light is a little further away, it’s good to know that Boulanger is still working on the project, including by carrying out pilot testing and software certification.

As for Boulanger, he concludes, “A cardiologist told me if we could detect cardiac conditions before someone has a heart attack, the money saved by the healthcare system could be enormous. The idea is to explode healthcare into the virtual world, improving outcomes and quality of life.”

And on the subject of the MEDBike, he adds, “I always say that the gamer of the future will have a six-pack.”

The Role of Employers

How much of a role do employers have when it comes to the health of their employees? And arguably even more importantly, are there some things that should be off limits to them?

They’re tough questions which we’ll have to address as a society, but they were brought to mind for me when I saw the news that U-Haul International will be rejecting job applicants in 21 different states if they’re regular users of nicotine, their reasoning being that they want to maintain a healthy working environment. We should note here that this policy didn’t apply to current staff members who were regular nicotine users.

Writing about the new policy, Valerie Bolden-Barrett explains, “Job seekers in affected states will see U-Haul’s nicotine-free policy in statements on application forms and will undergo questions about nicotine use. In states where it’s legal, applicants will also be subjected to nicotine screening.”

Of course, arguments could be made that this is discriminatory to nicotine users, but then you can also argue that other employees have a right to work in a nicotine-free environment, especially when we consider the negative effects of second-hand smoke.

Jessica Lopez, U-Haul’s Chief of Staff, says, “We’re deeply invested in the well-being of our team members. Nicotine products are addictive and pose a variety of serious health risks. This policy is a responsible step in fostering a culture of wellness at U-Haul, with the goal of helping our team members on their health journey.”

We should also note that U-Haul isn’t the only organization to be adopting a tobacco-free policy. The city of Dayton, Ohio also announced that it would become tobacco-free, showing that governmental institutions can also be instrumental in setting precedents.

Want to learn more?

I talk more about new technologies and their impact on the healthcare industry in my book, The Future of Healthcare: Humans and Machines Partnering for Better Outcomes. Click here to buy yourself a copy.

Reframing the Conversation on Drug Pricing and Healthcare Consolidation

““If every drug in the world were abolished, a physician would still be a useful member of society.”

— Sir William Withey Gull

WE ALL KNOW that drug pricing is starting to get out of hand. In the United Kingdom, Public Health England (PHE) has reported that up to a fifth of antibiotic prescriptions are unnecessary because many illnesses get better on their own. They believe that more patients should be told to go home and rest instead of being given antibiotics, and the BBC reports that “overusing the drugs is making infections harder to treat by creating drug-resistant superbugs.” If we continue at the current trajectory, by 2050, drug-resistant infections around the world are expected to kill more people than currently die from cancer.

This ties into a firmly held belief of mine, a belief which is shared by the authors of an article for the New England Journal of Medicine about how we can reframe the conversation on drug pricing. They cite the “tsunami” of healthcare costs that are caused by Alzheimer’s disease, a figure which is set to increase from $259 billion in 2017 to $1 trillion by 2050.

“Our society can’t afford for current trends to continue,” they explain. “There is only one solution, and it isn’t building more efficient hospitals, healthcare delivery systems and nursing homes. It is discovering new drugs that arrest, delay, prevent or cure the disease.”

They’re right, in a way, but there isn’t just one solution. New drugs may well help of course, but that doesn’t mean they’re the be-all-and-end-all. Preventative medicine encompasses so much more than just drugs, including lifestyle factors and other contributing factors that right now, we might not even be aware of. This is where artificial intelligence can shine, identifying commonalities between Alzheimer’s patients that we’ve never noticed before and giving us a better chance to head it off at the pass.

When it comes to drug development, the authors say, “So far, these attempts have largely failed. More than 400 clinical trials of more than 200 agents yielded only one approved drug for Alzheimer’s disease in the period 2002 – 2012. The failure rate at the clinical trial stage has been a staggering 99%, and that doesn’t include agents that didn’t make it out of the lab. Abandoning the search is not an option unless the patients who suffer from this dreaded disease are also abandoned. Each failure advances our knowledge and increases our chances for eventual success. But it will be a costly search. In general, the average cost to develop a drug tops $2.5 billion, according to a Tufts University study published last year.”

This is where the fun begins. At $2.5 billion for just one breakthrough in one disease, you can imagine how expensive it becomes when we look at healthcare as a whole. As explained in the NEJM, “For companies to justify risking billions on finding a breakthrough drug, they need to be able to anticipate a corresponding return on their investment. But at the same time, the patients who can benefit from a drug need to have access to it without facing bankruptcy, and health insurers need to feel confident that they will reap a return on their investment.”

There’s no simple answer to this dilemma, although the authors of the article have some interesting suggestions that I won’t go into here – because you should follow the source link if you want to find out more.

Consolidation

Consolidation is the process of big companies buying up smaller companies and absorbing them to form a composite whole. A great example of this is the $77 billion merger of CVS and Aetna. CVS is the biggest pharmacy chain in the US by both number of locations and prescription revenue, while Aetna is the nation’s third-largest insurance company. Meanwhile, CVS partners Epic are the largest electronic health record vendor.

The interesting thing about this is that the huge size of each of the three companies and the fact that they’re all aligned together means that we could be about to see a new era of interoperability, at least amongst the key players. CVS Health CEO Larry Merlo said, “The traditional healthcare system lacks the key elements of convenience and coordination that help to engage consumers in their health. That’s what the combination of CVS Health and Aetna will deliver.”

Carolyn Y. Johnson discussed the deal in an article for The Washington Post back when it was just a rumor. She said, “A successful deal could push millions of Aetna’s members towards CVS’s retail pharmacies, walk-in MinuteClinics and home services for infusion drugs at a time when retail pharmacy companies are facing stiff competition. It would also give Aetna the ability to move deeper into the lives of the 44.7 million people it serves and manage their healthcare more efficiently. For example, the insurer might be able to create better coordination of care using insights from CVS’s retail clinics and pharmacies.”

Want to learn more?

I talk more about new technologies and their impact on the healthcare industry in my book, The Future of Healthcare: Humans and Machines Partnering for Better Outcomes. Click here to buy yourself a copy.