Technology Can Enable COVID-19 Home Medical Care
By Hasith Yaggahavita
The pandemic is causing havoc across global health systems in these challenging times. The world is witnessing extreme strain on hospitals due to the highly contagious COVID-19 spread. The need for isolation, social distancing, lockdowns, scarce resources and limited capacity are significant challenges hospitals face today.
The time has come now more than ever to adopt innovative protocols to respond to this new normal. Possibly thinking along similar lines, General Shavendra Silva recently stated that asymptomatic COVID-19 patients could remain at home, under medical advice. This decision is a significant shift of our government›s protocols on COVID-19 but is not new to the rest of the world. Many other countries, including the US, UK, and Singapore, already allow COVID-19 patients with mild or no symptoms to undergo home care and home quarantine. For example, in Singapore, the Health Ministry determines if a patient could be home quarantined based on the person’s contact history, state of health, and condition of the house.
The role of home care in the pandemic
Although ‘home care’ may be a relatively new term for us during the pandemic, it is commonly practiced worldwide. Most Western countries already use home care to provide for the needs of the elderly population. With the increasing elderly population globally, home medical care has proven cost-effective than residential care. Technology is an integral part of modern home care to monitor patients and manage the treatment process.
With most of the globe in lockdown, I believe that home care and the associated tech industry have much to offer today to reduce the strain on hospitals. Realising this potential, the World Health Organisation also released an essential guide on ‘Home care for patients with suspected or confirmed COVID-19’ some months ago.
Home care is beneficial but not without challenges
Treating noncritical patients at their homes allows the hospital to prioritise resources in supporting critical cases. Fewer patients at hospitals lessen the COVID-19 contacts of health workers, reducing their risk of getting infected. The lower mobility requirements of home care can minimise the social movements of patients on public transport and at public places.
Amid the above positives, there are also significant challenges to overcome before implementing a country-wide home care policy. Patient isolation at homes is more demanding for highly infectious diseases like COVID-19. Isolation is particularly challenging in Sri Lanka, given the size and conditions of homes of lower and mid-income households. Due to this, a patient at home can pose a high risk to other family members. The possibility of sudden emergency requiring trained medical personnel is another risk to address with home care.
How can technologies such as IoT and IoMT help?
Technology can help navigate some of the challenges in using home care effectively to respond to a pandemic. Emerging technologies such as the Internet of Things (IoT) encompass billions of “things” (devices) interconnected via the internet to increase connectivity and data sharing. The Internet of Medical Things (IoMT), an adaptation of the IoT in medical care, refers to a connected infrastructure of medical devices and medical software applications. IoMT is capable of sharing data with medical professionals and performing automated tasks remotely.
An increasing number of connected medical devices join the IoMT family year on year. IoMT has made it possible to introduce sensor-based devices (such as wearables) to real-time monitor patients at home, share data with hospitals, and take actions as required. There are several areas of IoMT that could come in handy to support the home care of COVID-19 patients.
Home diagnostic assessments
The antigen and PCR tests used today require lab involvement that is difficult to scale rapidly in a pandemic situation. In contrast, technology can help build non-intrusive, less expensive means to diagnose COVID-19 patients. For example, there is a space for Artificial Intelligence (AI) and Machine Learning (ML) to utilise smartphone devices to test for COVID-19 infections using the sounds of an individual’s breathing or coughing. Building a Machine Learning expert system well-trained with numerous records may provide this capability to the public through a simple mobile app. With the available technologies today, the success of such research is very much within reach.
Remote patient monitoring
Some hospitals in the west have already monitored, administrated, and managed tens of thousands of COVID-19 patients successfully while at home. Using regular sensor devices and data feeding applications, the hospital could monitor patients remotely and attend to them as required. Inexpensive devices such as thermometers and pulse oximeters can extract essential statistics such as respiratory rate, oxygen saturation, breath-hold duration, and body temperature needed to monitor COVID-19 patients.
An improved and integrated device connected to the internet (IoMT) can simplify and automate this process of monitoring patients at home. Software systems can then assess the condition of thousands of patients simultaneously in real-time, through collected data. Such scale is practically impossible to achieve through manual procedures with no advanced technology. This way, hospitals can deploy their scarce resources to attend to the critical cases when alerted by technology-driven remote patient monitoring systems.
Consultation and treatment management
Apart from automated monitoring, technology can facilitate patients at home to connect with qualified medical professionals virtually when required. Virtual consultation is not new to Sri Lanka. There are a few service providers already operating in this space locally. The Government could partner with some of these providers to implement a solution for asymptomatic patients at home to have access to medical help on demand.
We may further automate the treatment processes through a connected ecosystem of medical experts and pharmacies to deliver medication to patients’ homes. Medical experts can advise nearby pharmacies based on each patient’s treatment needs. Pharmacies can adopt emerging concepts such as ‘unit-dose packaging’ to help patients take the medication without confusion. IoMT machinery for unit-dose packaging can digitally receive a doctor’s prescription and prepare medicine for delivery. For more sophisticated needs, automated and connected ‘pill dispensers’ and ‘video-based medication monitoring mobile apps’ can also be deployed at the patient’s end to increase the isolation level of family members. Such aid is particularly useful for elderly patients being treated at home.
The Government and tech industry should work together
The pandemic opens a new doorway for innovative tech entrepreneurs to solve the problem of providing effective home care. The medical community is open, now more than ever, to try out new technology. I believe private-public partnerships could bring about the most sustainable tech-enabled home care solutions that can last even beyond the pandemic. The government and responsible agencies should swiftly invite the tech community to an inclusive discussion around this topic. As we have already witnessed, the willingness to embrace technology will be the saviour of the world during this time of fear.
(Hasith Yaggahavita is the CTO of 99x, and with over 15 years of experience, has worked as a developer, tech lead, architect, and technology manager around a wide variety of technologies. He is a Certified Scrum Master, Sun Certified Java Programmer, and Microsoft Certified Application Developer. Hasith has been the catalyst for several organisational change processes and is an active member of several industrial and university committees, helping with various industrial initiatives.)