Observations from the ongoing coronavirus (COVID-19) disease outbreak
19 March 2020
The COVID-19 pandemic is showing people how useful digital health can be in public health emergencies.
Future investments need to take use cases associated with communicable diseases into consideration
Health systems and public health authorities are facing a new pandemic that is affecting individual and societies. It is not the first time that a respiratory disease outbreak caused by a coronavirus is affecting global health. At least two similar situations have been seen over the past two decades. Severe acute respiratory syndrome (SARS) in 2002 and Middle East respiratory syndrome (MERS) in 2012 mobilised the entire public health community to prevent and contain the reach of those diseases. Coronavirus disease 2019 (COVID-19) shares many epidemiological and clinical aspects with these previous episodes.
This time is different, at least from an informational perspective. In 2020, many people are used to have real-time information at their fingertips, and data is flowing faster and more in-depth than ever before so as to inform every single decision people make. However, inaccurate or fake information also spreads quickly through social media and distorts public perception, generating an infodemic that public health authorities need to manage as well.
On the professional front, epidemiological surveillance is benefiting from advanced integrated health information systems that enable public health authorities to deploy data-driven mitigation strategies. Epidemiologists and researchers at public health centres for disease control are running multiple forecasting and simulations of infectious disease models: they use these to predict the spread and burden of the disease and inform governments about appropriate measures to adopt.
Use of digital technologies
Against this wider public health backdrop, the COVID-19 crisis is providing several examples of the use of digital technologies for health protection.
First, telework and alternatives to face-to-face meetings like video conferencing are now being widely considered as a public health measure to be used at the outbreak peak and, at the same time, as a contribution to the green agenda against climate change. Telemedicine, the healthcare version of telework, is now being used in more and more countries as an appropriate means to deliver care in the middle of the coronavirus outbreak.
Second, mobile health is finding new uses of digital technologies to cope with COVID-19 testing and treatment. In Japan, the Japanese Ministry of Health, Labour and Welfare provided 2,000 mobile phones to the passengers and crew who were in isolation on the Diamond Princess cruise ship, to enable them to undertake teleconsultations with a medical doctor. In South Korea, the government strategy to control disease spread is supported by a mobile application that guides people to drive-through testing centres and monitors the movement of those people who are tested positive. Many more examples are following this route across the globe.
These two examples illustrate how the three priorities of the European Commission Digital Transformation of Health and Care are being applied in the context of a public health emergency:
- encouraging citizens to access health portals to find accurate health information;
- finding new applications for the secondary use of health data to prevent diseases;
- empowering patients and health care providers through the use of virtual care.
Public health and digital health
From a digital health perspective, in recent years public health has to some extent been neglected as a field for priority action. In high and upper-middle income countries, the digital transformation of health and care has focused more on chronic conditions affecting people than on infectious diseases. One can seek explanations for this that relate to: the economic burden caused by chronic diseases; and communicable diseases were mainly seen as a major issue only in low- and middle-income countries.
There has, nevertheless, been a need in recent years for information continuity and coordination between health providers and patients. Hence, electronic health records, health information exchange systems, personal health mobile apps, and telehealth tools have been in focus, so as to equip health systems, providers and patients with digital innovations that are improving health and care across the globe. Some of these long-term ICT investments are now revealed as being relevant whenever there is a pressing need to face public health emergencies.
However, new investments are also needed to ensure that communicable diseases are really viewed as a priority.
In the digital age, modern public health systems are exposed to the digital transformation of their operations. According to the European Centre for Disease Control (ECDC), public health training, emergency preparedness and response support, and surveillance are all key public health functions. The WHO Regional Office for Europe has also defined ten Essential Public Health Operations (EPHOs). All ECDC key public health functions and EPHOs can be made more effective by digital enablers. (In March 2020, European Health Telematics Association (EHTEL) was invited to participate in a consultation meeting on this very topic.
EHTEL and its interest in public health
Since its foundation in 1999, EHTEL has brought together corporate, institutional, and individual actors, including public health authorities, dedicated to the improvement of healthcare delivery through digital health. EHTEL has led, and participated in, several eHealth projects and taskforces where health promotion and disease prevention were central topics.
The goal has been to advance the exchange of health information between health institutions within and across borders, deploy and scale-up telemedicine services, and innovate health service delivery for proactive and preventive care.
All this 20-year accumulation of experience is now available to provide reflections and solutions to a recurrent public health challenge – infectious diseases – that has re-emerged in a digital age. Among the threats and challenges are indeed the resilience of Europe’s health and care systems.
It is for this reason that EHTEL especially notes the launch by the European Commission of the recent call to encourage the involvement of Europe’s small- and medium-sized enterprises in helping to resolve challenges like COVID-19.