Getting ready for the next pandemic
I’ve seen a lot of pundits over the last year and a half refer to the COVID-19 pandemic as a “once in a lifetime” event, but I don’t think that’s accurate. Certainly, the effects of the virus will be felt for generations, but it would be naïve for us to think that the crisis has passed just because vaccination rates are going up.
Even though there are victories we should all celebrate – including the development and deployment of no fewer than five vaccines in less than a year – now is not the time to collectively let our guard down. Local health departments must now shift their focus from containing the outbreak to remaining vigilant against whatever comes next.
That includes continuing to monitor new developments with the current pandemic. All you need to do is look at the tragedies happening in South Asia right now to see that there are many countries around the world that still do not have the virus under control. Even here in North America, vaccination rates are uneven at best. Canada is months behind the United States when it comes to inoculations, and there are many regions in the US where vaccination rates are low due to scepticism about their safety and efficacy. In many cases, these trends are closely and unfortunately tied to prevailing political allegiances.
It is against this backdrop that thousands of city and county health departments find themselves trying to fight a global pandemic on a local level. Their work is nothing short of heroic, with teams of medical professionals working around the clock to provide vaccines while simultaneously caring for people who are already ill. And it’s not just front-line workers who have the responsibility to keep their communities safe: IT teams also have a critical role to play.
It’s no secret that health department technology teams have spent years being forced to do more with less. Because of budget cuts at the state and federal level, resources have been harder to come by. But, thanks to the pandemic, 2021 may actually be a year when budgets increase. The federal government recently announced a $24 billion initiative to help the US improve its healthcare infrastructure, which gives city and county health departments an opportunity to make the structural changes they need to improve outcomes.
One of the biggest imperatives faced by public health organizations throughout the country is the need to finally embrace a fully digital strategy. It is amazing to think that in 2021 there are many healthcare protocols (including tracking vaccinations) that are managed manually; in today’s fully wired world, that should absolutely not be the case. Health departments need to make technology a key part of their strategies and develop best practices that allow them to automate as much as possible. This will cut down on inefficiencies while providing for better recordkeeping, better data, and better health outcomes.
This is easier said than done, of course. Not only are new technologies costly to buy, but they can take a long time to implement… and there’s still no guarantee that users will embrace them. We’ve all heard stories of expensive technology systems going to waste because no one actually uses them. That simply cannot be an option moving forward. Public health departments need to select tools that not only look good on paper, but can actually make their work more efficient and effective. That is only possible if CIOs have a seat at the table.
Digital transformation is long overdue in the public health sector, as the strains of the past year have clearly shown. But COVID-19 has been good at forcing changes that have been a long time coming, like the remote-work economy and mail-in voting. Hopefully it helps bring about change in the public health sector as well, because successfully navigating the next global health crisis might just depend on it.
The next generation of wearable technology
Wearable technology for healthcare has evolved significantly since Fitbits started becoming household items. The combined possibilities of tracking data, constantly advancing technology , and a pandemic that forced most of the world to receive healthcare at home for more than a year, has led to huge innovations in wearable devices that do everything from reduce hospital stays to monitor the menstrual cycle.
A complicated operation like an organ transplant typically requires a lengthy stay in hospital and significant post-op care. Two major reasons for this are to prevent wounds from becoming infected, and regaining mobility. But what if there was a device patients could easily wear that helped both these areas so they could return home sooner?
geko™ is the name of a wearable created by British company Sky Medical Technology, specifically for patients who have had a kidney transplant. This small muscle pump activator is worn round the leg, transmitting painless electrical pulses to stimulate blood flow.
This prevents oedema, a common symptom of kidney disease caused by swelling due to a build-up of fluids, typically in the legs and ankles.
In a randomised controlled clinical trial at Canada's Lawson Health Research Institute, 221 transplant patients were either given a conventional compression stocking or the geko™ device for six days after their operation.
Researchers found that the patients wearing geko™ had less fluid retention as they were able to urinate more frequently. They experienced 31 per cent less swelling, and were able to return home several days earlier than patients wearing the compression stocking.
Perhaps the most remarkable outcome was the reduction in surgical site infections by nearly 60 per cent. Infections acquired in hospitals remain a huge problem worldwide, and transplant patients are at a particularly higher risk because of the immunosuppressant medication they need after an operation.
Dr. Alp Sener, who led the trial, said: "The study results have been both surprising and exciting. Not only have we cut down wound infection rates, but we have also seen a considerable improvement in the new organ's function following transplantation. Patients reported feeling more satisfied with the transplant process and are more mobile."
Sener is the Chair and Chief of Urology at Western University in Ontario. He added: "Reducing infection means a much better outcome for the patient and considering that recent data shows wound infections can cost the health care system thousands of dollars per person, it's a win-win situation."
Monitoring menstrual cycles
British medical device company Fertility Focus launched OvuFirst this year, a wearable sensor that helps women monitor their menstrual cycles. Worn on the arm or wrist overnight, it is alleged to be over 90% accurate at predicting ovulation, even for women with irregular cycles.
It works by measuring temperature multiple times through the night. A woman's body temperature tends to dip slightly just before the ovary releases an egg; 24 hours later it rises and remains at the same level for several days.
By downloading data from the OvuFirst sensor to a synchronised app each morning, it can track the ovulation period within an eight day window.
The sensor works in a similar way to the company's existing product OvuSense, which is inserted like a tampon. While OvuSense is aimed at women who have been trying to conceive for a while, the wearable version is for women who are in the first months of trying to conceive, designed to be as non-invasive and simple to use as possible.
“We took our revolutionary OvuSense patented technology proven in over 190,000 cycles of use, and used it to develop and test the most accurate skin-worn fertility monitoring sensor available on the market,” CEO Robert Milnes explained when the product launched.
“We are proud to offer a convenient and easy-to-use solution to assist and support women during the early stages of their fertility journey, whether that is trying to start a family, or simply learning more about their bodies and cycles.”
Advanced blood pressure monitoring
Perhaps the most common application of wearable technology is for measuring blood pressure. The prevalence of hypertension and its associated risks (it's frequently labelled "the silent killer") makes frequent blood pressure checks vital.
Traditionally blood pressure monitors that work remotely have been uncomfortable, noisy and disruptive, until smartwatches were enabled to do this, leading to a wide variety of cuffless devices.
The technology within these devices is evolving too. Pulse Transit Time (PTT) is the most common type of cuffless blood pressure monitors, the Apple Watch being one example.
However PTT monitors use two sensors and need frequent calibration. PPG blood pressure monitors (or photoplethysmography to give their full name) only have one sensor and don't need to be calibrated.
Valencell is a US-based biometric company that develops PPG sensors, and Dr. Steven LeBoeuf, President and Co-Founder, believes that PPG monitors are more accurate. "The advent of modern machine learning tools has helped earn PPG a solid edge in terms of accuracy, generality, and convenience" he says. "This is because the complexity of the PPG waveform and the richness of its features provide more information for machine learning approaches to “connect the dots” between PPG and blood pressure. "
Calibration-free, PPG monitoring is ideal for small wearable devices, and the remote blood pressure market is growing steadily each year - by 2025 it is projected to be worth almost $3 billion.
"By enabling accurate, cuffless, calibration-free blood pressure monitoring within familiar wearable form-factors, PPG-based monitoring solves this final technical challenge" LeBoeuf says. "Ultimately, the marketplace will see finger clips, rings, smartwatches, headphones, hearing aids, chest patches, and more incorporating PPG-BP technology. This will enable seamless monitoring throughout one’s daily activities, providing the feedback needed to target user-specific therapies, managing hypertension, improving public health, and reducing medical costs."
- This article appears in the August issue of Healthcare