NearForm's privacy-first contact tracing app has high uptake
Software firm NearForm have built a contact tracing app that's having a high rate of uptake in the countries it's been launched. In fact, they believe it's more successful than any other exposure notification system.
It's currently in use in several US states, Ireland, Northern Ireland, Scotland and Gibraltar, where it's among the most successful exposure notification apps worldwide in terms of citizen participation.
Colm Harte, NearForm's Technical Director, says this is because they took a privacy first approach when building the app, using open source, peer-reviewed technology to ensure people’s privacy and data was protected.
The app is also fully customisable, so it can be altered to meet the specific needs of different countries and states. "This allows for custom screens and text, national and regional statistics, symptom checking and recommendations if someone is not feeling well, in addition to any other state-specific requirements and integrations" Colm explains.
Ireland’s app has a symptom checker and statistics on the virus and its spread, allowing it to serve as an information centre. Scotland and Northern Ireland have opted for a more streamlined approach, focusing on the exposure notification service it provides.
One of the first countries to launch a contact tracing app was Singapore in March, using Bluetooth technology. Iceland launched a GPS-based app in April, which 38% of the population had downloaded by May.
By July around 50 different countries were either developing or had already rolled out their own contact tracing app, using various types of connectivity and with different functions.
"Some countries have opted for a centralised model" Colm says. "NearForm's approach means we follow the decentralised model, where all the information remains on the phone and the phones do the work."
The app works via bluetooth, which means that phones in close contact exchange anonymous keys. If someone tests positive, they are given a random six-digit code by the public health authority to upload, and this anonymously notifies those apps they have exchanged keys with. This is all done without identifying the user as no personal information is provided.
"The whole process is completely voluntary" Colm explains, "and if they so choose, no personal information is provided. The only personal information that could be provided is a phone number, and again this is not mandatory and completely voluntary, and will only be used to contact someone if they are a close contact with a positive case. Users can add a phone number and remove it again if they want to."
For a contact tracing app to work effectively there must be a high level of uptake, and one of the biggest setbacks for this is people's fear of data monitoring. "When Ireland’s app launched on July 7th, over 25% of the population downloaded it in just 36 hours. It is now at 40%" Colm says.
Additionally as part of its launch in Ireland, the Irish public health authority donated NearForm's code to the Linux Foundation Public Health project under the name COVID Green, to make it possible for others to use and build upon it.
"Since then we have worked with Northern Ireland, who had over 300,000 people download the app within the first month, and the interoperability with the app in the Republic of Ireland allowed for an all-island approach."
Elsewhere, downloads of the Scottish app have exceeded 22% of the population, and in the US, the state of Pennsylvania saw 50,000 downloads within 24 hours of its launch. These figures are encouraging, as a recent study by the University of Oxford found that a 15% uptake of tracing apps could reduce infections by 15% and deaths by 11% .
Colm says the main challenges to adoption are establishing trust and communicating with people. "This is why we use open source technology. When it came to launching the app in Ireland we allowed for everything to be peer-reviewed, and for privacy and security experts to essentially look under the hood and see what was going on. When it came to the app being launched they had no concerns.
"It’s important that the general public know how the app and the underlying technology works."
Zoom enters the healthcare market - a timeline
Since the pandemic began Zoom has become an integral part of daily life for people working from home, as well as a vital tool for families and friends to communicate. However it's also been eyeing up the healthcare space since 2017, and following the boom in telehealth the company has been rolling out additional services. Here we chart Zoom's move into healthcare.
2011 - 2013
Zoom is founded in San Jose, California, by Eric Yuan, formerly of Cisco. He got the idea to create a video calling platform from his visits to his girlfriend while he was a student, which would take 10 hours by train.
A beta version is released in 2012, which can host up to 15 participants. In 2013 this rises to 25. By mid-2013, Zoom has 1 million users.
2014 - 2017
Zoom attracts investors, including Sequoia Capital, Emergence and Horizon Ventures. By January 2017, Zoom has a series D funding worth $100 million.
2017 - 2019
Zoom for Telehealth launches, including an integration with EHR system Epic. It has cloud-based video, audio, and content sharing features, a "waiting room" for patients, and can easily be integrated into healthcare provider's workflows.
In 2019 Zoom goes public, with its IPO rising 72% in one day.
As a result of the pandemic, Zoom gains 2.2 million new users, more than in the whole of 2019. On the 23rd of March alone - the day the UK lockdown was announced - the platform was downloaded 2.13 million times around the world.
Share prices rise to around $150, and founder and chief executive Eric Yuan becomes one of the world's richest people, with an estimated net worth of $7.9 billion.
Early security issues are addressed by encrypting data with the Advanced Encryption Standard (AES). By now the the platform allows 99 people to be on a call simultaneously
New features launch, including Zoom Home and Zoom for Chats. Throughout the year the platform is used to replace most kinds of real life events: work meetings, online classrooms, church services and social events.
Renamed Zoom for Healthcare, users can share secured video, audio, and content through desktops, mobile phones, and conference devices. As well as Epic, it can be integrated with Strmr, IntakeQ, and Practice Better.
It can also be used with diagnostic cameras and other point-of-care devices, including digital stethoscopes.
In an interview with Korea Biomedical Review, Zoom Global Healthcare Lead Ron Emerson said: "Our service is not simply a virtual care and telemedicine platform but a multi-purpose platform that can satisfy the needs of healthcare institutions."
"It can be used for administrative tasks, including telemedicine, medical team meetings, recruitment, medical education, employee training, and disease prevention. Analysing electronic records managed by Zoom could provide meaningful insights into patient care."
Phoenix Children's Hospital, Belfast's Hospital Services Limited, Butler Health Services and the global Project ECHO are among Zoom for Healthcare's current customers.