By Katherine H. Capps, Co-Founder and Executive Director, GTMRx Institute
April 7, 2020
Surveillance and tracking? Point-of-care diagnostics? Remote medicine? Thinking about the “new normal”
Just what is this “new normal” everyone is talking about? Is it something temporary that will gradually disappear once we subdue COVID-19? Or is it something more lasting—a true new normal, not a temporary normal?
The answer is yes—to both questions. Yes, it’s temporary. Eventually, we will be back in our offices and gyms and houses of worship. Stores will be well-stocked with toilet paper, and we won’t be wearing masks.
But that’s just part of it. I believe that, for better or worse (mostly better!), we have indeed entered a permanent new normal, especially when it comes to the use of technology. From remote clinical trials to telemedicine visits to AI triage, we’re seeing technology’s use expand more quickly than we might have expected. Let’s start with remote visits.
Care and research from a distance
During a pandemic, the more you can do from afar, the better. Here’s a look at two examples of technology supporting social distancing.
This one’s probably no surprise. We’ve been watching telehealth gain ground over the last few years. Now, because of the necessity of social distancing—and a loosening of regulations—telemedicine is becoming the default method of contact for non-urgent encounters. Patients can visit physicians without coming near another person or entering a facility. This prevents the spread of COVID-19 and obviates the need for providers to use personal protective equipment.
What will the pathway back to traditional face-to-face visits look like? Will we find new ways to expand telemedicine, bringing care teams together with the patient virtually? If payors begin to reimburse appropriately for remote encounters, it could transform team-based care delivery for team members not traditionally found under one roof, controlling costs, improving access and alleviating stress for patients and providers.
Clinical trials going remote?
Researchers and pharmaceutical companies are having to decide whether and how to continue clinical trials. Think about it: Patients participating in a trial may have to visit a clinic or hospital several times. But that’s not practical today. So now, these trials are making modifications that include remote monitoring, data gathering, etc.
Will we see a hybrid form blending virtual and face to face brought to clinical trials? It would reduce the burden on patients and perhaps put such trials within the reach of a more diverse population.
Surveillance and tracking
We all understand public health surveillance, and we all know that phones can be used to track us. COVID-19 is driving efforts to do both.
I came across several examples in a Forbes article earlier this month. Here are two that jumped out at me.
- A group of European researchers announced plans to release contact-tracing technology for smartphones. It keeps a record of when a smartphone gets close to other smart phones. If the owner of one test positive for COVID-19, the others he or she came in contact with can be quickly identified and alerted. I admit, I find this Big Brother-ish. While I see the value, I’m not sure how I feel about this as part of the permanent new normal.
- Meanwhile, the Feds are in talks with tech companies such as Facebook and Google about tracking whether users are social distancing. This approach, which uses anonymous, aggregated location data, isn’t likely to identify specific people—it’s likely to be more useful in anticipating outbreaks rather than pinpointing individuals who have been exposed to the virus. Suddenly we see Facebook and Google in a different light. But does our country have an appetite for this type of surveillance?
Whatever the new normal becomes, it will most certainly include an even greater focus on balancing the protection of personal privacy with public health information needs.
The new normal: AI and HIT transforming the point of care
Perhaps the most promising potential new normal is point-of-care diagnostics and risk stratification.
As I’m writing this, most point-of-care COVID-19 testing isn’t delivering the rapid results health care professionals want—and the tests still haven’t been distributed as widely as they need to be.
But artificial intelligence (AI) has become one of the first lines of defense. Hospitals are using it to help screen and triage patients and to identify those most likely to develop severe symptoms.
STAT, with help from the Commonwealth Fund, has developed a guide to how various clinics and hospitals are using AI during this crisis. There are many exciting examples, including a hospital in Israel that has deployed an AI tool designed to predict which COVID-19 patients will likely experience complications such as sepsis in the next six to eight hours.
How could that sort of risk stratification be used in the future?
To provide a useful, actionable and effective medication plan, we need tools like that—tools that equip the team with clinical information at the point of care in order to optimize medication use. We need algorithms that will improve identification and risk stratification of patients who would benefit most from an integrated comprehensive medication management strategy.
See you on the other side
Just as new advances in technology emerge from the horror of war, they will emerge from the horror of this pandemic. When we emerge from the other side, we will leave some of this new normal behind. But we must call on the government, payors and our own organizations to make sure we don’t lose the advances in health IT and AI. This pandemic has precious few silver linings. Let’s hold on to this one.