Health on the other side of the COVID-19 pandemic

There is no doubt that the COVID-19 pandemic has accelerated the digital transformation of healthcare systems in Australia and throughout the world. In the face of forced lockdowns and social distancing directives, healthcare providers have had to rapidly shift to digitally accessible health care — any fence sitters have been firmly pushed to the digital side.

Before COVID-19 gripped the globe, the landscape of patient care was already changing, with traditional health systems gradually shifting to digital platforms. Online health consultations, electronic records and remote monitoring of post-surgical patients were already becoming more accepted by patients and healthcare providers.

For some time, general practitioners have been the main gateway to health care, but this framework is changing as new access points to health care open up in the digital landscape.

New approaches to healthcare delivery

Greg Horne, Principal Health Analytics Strategist at SAS, explained that we approach health care differently now than in generations past.

“With the rise in outpatient surgical procedures and the recognition that outcomes are improved in the home with monitoring and good physical therapy, the need for long hospital stays and the beds associated with them is disappearing,” he said.

“Another driving force for change in healthcare access is the increased use of diagnostics, testing and screening. These can now be carried out in almost any location and through extended hours to meet patient needs and increase convenience.

“As we move forward with new approaches to care, new needs for infrastructure and service, and the disruption by new players, ‘new doors’ into health care are starting to open and become more prevalent. Analytics can inform locations (both virtual and physical) that are good candidates for care site expansion.”

Where we might go for health care in the future

Pharmacies

With customer convenience at the forefront, many pharmacies are taking on primary interactions with patients. Pharmacies are growing to extend the services they provide to customers, such as vaccination and asthma clinics, and chronic disease monitoring.

Horne explained that this trend is also extending to some supermarket chains, who are employing dieticians to give advice in stores. Retailers such as Walmart are taking this further by providing access to primary care physicians in addition to the eye care and audiology services they have offered for many years. Similarly, many supermarkets in the UK have in-house pharmacies, allowing customers to fill scripts or seek health advice from a pharmacist as part of their grocery shop.

Repurposed shopping centres

As the retail industry continues to transition online, shopping centre infrastructure in certain parts of the world is emptying and becoming vacant. Horne explained that healthcare organisations see this as an opportunity to transform these spaces into care facilities.

“Repurposed healthcare centres are especially useful for diagnostics and imaging, outpatient surgery, primary care and treatment of minor injuries,” Horne said.

“Malls and shopping centres make ideal locations for health care because they’re designed for large crowds and are often in the centre of communities, with transportation infrastructure and ample parking already in place.”

Horne explained that in the Nordic countries, planners are looking to purpose-build health malls in new subdivision areas to promote community mix and movement, and in an effort to prevent health issues associated with social isolation.

“The vision is that these facilities will encourage wellness using AI and analytic technology, coupled with access to primary care and other health services,” he said.

Virtual care

Virtual health has become critical during the extended periods of social isolation as a result of the coronavirus pandemic, allowing patients to consult with their health providers without the need to fill waiting rooms and risk exposure to the virus. Patients and their doctors are becoming more comfortable with virtual face-to-face calls and we have seen a shift from telehealth for remote and rural settings to wider adoption.

As part of the virtual care model, wearable technology will play an increasingly important role, particularly as regulation and payment models catch up with the potential of the technology.

Improved access to health technology will enable patients with mobility challenges to see their physicians more regularly without the challenge of travel, which may mean that people are able to stay in their homes longer, before transitioning to a care facility. Patients with complex conditions can be monitored and cared for in a similar way to that in an aged-care facility.

Contact tracing and protecting health

Contact tracing has entered the digital era and will play an important role in helping communities move out of lockdown. Increased awareness is a valuable tool that enables epidemiologists and healthcare officials to respond faster when instituting containment measures and issuing public alerts to COVID-19 hot spots.

Contact tracing can be enhanced by using data visualisation and analytics to understand:

• missing or unexpected linkages in contact data;
• who should be tested;
• where the virus is spreading; and
• which communities are at greatest risk.
   

People who are unknowingly exposed to an infected individual might carry on with their lives, unaware that they, too, could be infected and further spread the disease. This is precisely where modern technology — such as analytics and machine learning — can play a pivotal role.

Advanced analytics and data visualisation allows public health officials and investigators to quickly identify (with their consent) people who have been exposed to COVID-19 so they can self-isolate, seek treatment if needed and impede the spread of infection. There are four areas where analytics can help.

Contact transaction databases with entity resolution: These databases hold contact tracing data and enable entity resolution that can link multiple records in multiple databases to the same person.

Data management solutions can establish and display linkages between patients, their contacts and the places they might frequent to narrow and focus the efforts of contact tracing resources.

Enriched contact tracing data: Analytics and machine learning give health officials important insights into each patient’s network. Analytics can help determine who might be linked to a patient — such as family, friends and neighbours, but also employer rosters, passenger manifests and school rosters. Machine learning can help automate that effort by building analytical models that reflect real-world data and conditions.

Intelligent alerting: Once the contact tracing team has identified a patient’s links and network, it can begin the task of automatically notifying people in that network via text/SMS messages or emails. Based on the likelihood of close, extended contact, such as a work colleague, they may be notified to get a health assessment.

Public health insights: When assessing a patient’s network, public officials can rely on analytical insights from the data to fill in some of the gaps to answer questions such as: Who should be tested? Who is most likely to spread the virus? How do I find missing or unknown linkages? Which communities are at greatest risk? Is social distancing working?

Advanced analytical modelling tools help health officials and governments answer the critical questions needed to implement smart public health policies. With data visualisation abilities, users can perform deeper investigations of contacts and data to uncover hidden patterns and share them across various health agencies.

Once links have been determined, alerts can be generated. These alerts can convey health risk warnings and can be customised for each recipient, such as directing them to obtain a COVID-19 test at a specific facility or to self-quarantine for a specific number of days. They can be sent via automated channels, such as text/SMS messages and emails.

Image caption: Greg Horne is the SAS Global Principal for Health and is based out of Toronto, Canada. He is considered a thought leader in the future of health care and the introduction of patient-focused technology.