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After dealing with the COVID-19 for approximately three months now, one obvious thing is the fact that isolation is the best and only prevention method for it. This forced isolation pushed the trend of technologies a little upward with now everyone interacting with the internet some way or the other. The major part of the population is relying on technological innovations for their daily necessities like groceries, entertainment and most importantly, medication. In the following article, we will be highlighting how telehealth is playing a saviour amid covid-19 epidemic emergency conditions; the benefits people are availing by using it, it’s limitations, areas of telehealth where we need to improve and what its future scope is.

What is telehealth?

As defined by the Health Resource Services Administration, when we use telecommunication technology and digital information to cater to the medical needs of people, it is termed as telehealth. It is popularly deployed in tasks related to distant clinical health activities to extend their aid in remote areas, solve common public medical issues, provide well-being or health-related advisory as well as tips, virtually and also to administer the facilities working for people. Some of the technologies we use in telehealth include store-and-forward imaging, terrestrial and wireless communication, video conferencing and media streaming.

At first, both the terms, telemedicine and telehealth, may sound the same, but that is not the case. Telehealth services include a broad range of remote healthcare services which include clinical as well as non-clinical services, such as delivering medical education, providing proper training and organizing administrative meetings along with clinical facilities. In contrast, medical health strictly refers to clinical facilities.

Role of telehealth during this worldwide pandemic

Telehealth is to contain the spread of COVID-19 in a very efficient way while facilitating people with mostly all primary essential care facilities. Personal Internet of Things (IoT) devices that people can wear will help to diagnose if a person has vital signs of the disease. Artificial Intelligence supported Chatbots can be deployed on various online healthcare platforms where they can deduce initial diagnoses based on symptoms reported by the user.

There are many other examples of tech-health technologies which can benefit the people in amazingly innovative ways. Still, there are also many constraints to this that we can’t ignore. Firstly, there are many countries where medical expenditure is very high, and people need to make sure they have the relevant insurance. Secondly, telehealth demands its users to have a basic level of technical knowledge and exposure so he or she can efficiently operate the facilities offered. The third significant constraint is an internet connection. As all the telehealth facilities are internet-based, it’s mandatory to have a stable internet connection which is unfortunately not the case in many regions of the world.

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How telehealth practices can prove to be a game-changer

As discussed in a journal of Indian Heart Journal, “Digital healthcare: The only solution for better healthcare during COVID-19 pandemic” COVID-19 pandemic has made an enormous impact on healthcare firms worldwide and prompted them to find novel ways to stem the tide. Expectations have turned on the digital health providers community to come up with working solutions to manage the horrible impact of the pandemic. Here are some telehealth practices that can be a game-changer in such crucial times.

1. Tracking highly risky subsets should be our main concern. There are so many solutions telehealth has to offer for this, let’s have a look.

• Digital DHIS2 based solutions will enable us to gather information about the risky people, that is who recently entered the country and have come from high-risk regions and maintain active surveillance on them. With the help and financial aid of the government, innovators are coming up with systems which will record demographics, point of contacts, symptoms of COVID-19, ports of entry and even labs to monitor a patient’s outcomes. After all these screening and surveillance, the relevant data and keys can be passed on to health officials in their area. This way, the process of detection of patients can be accelerated along with active reporting, live surveillance and rapid response in case a patient is found. This will also help produce real-time data of the number of patients increased or decreased, the number of instances healed etc. to keep people in touch with real conditions.
• Creation of dashboards, both national and international by integrating WHO and CDC information and tracking the COVID-19 casualties real-time. These dashboards will contain information about every country and region depicted on maps with the help of charts, making it easier to understand and keep the live track. This will also help engaged communities to capture events ahead of time which is game-changing in situations like this.
• Using drones is an effective way to perform proper surveillance. This will help to ensure if people are following safety guidelines, and if not, they can be guided with loudspeakers attacked in the drones. Defaulters who are not following the instructions deliberately can be easily picked up and reported to the authorities. Drones are also used for providing food, spraying disinfectants in public areas and facilities like streets, buses, trains, stations etc.
• Live Apps for General Public: With the help of Artificial Intelligence and real-time broadcasting techniques authorities can launch an app where people can log in and see live updates. This will include advanced features where people can know if they come across a COVID-19 suspect on the way to their home, or if the route they are taking is safe for them, is the bus they are taking is in a green zone service etc. The Chinese government has already launched such applications where people can log in with their WeChat ids and know if they have been exposed.

2. Creating Efficient Telemedicine facilities for screening people who are COVID-19 positive as well as managing those who are tested negative.

• Virtual Chatbots and Web Bots: This is essential, especially seeing the rate at which COVID-19 is spreading. This will enable HCW’s to offer their services and aid without the risk of getting exposed by paying virtual visits to the patients. Telemedicine communities are training physician to have a quick screening for COVID-19 cases asking questionnaires virtually and needed, to report them to authorities and get them moved to designated areas avoiding clustering and maintaining minimized exposure.

• Virtual Care: To avoid physical visits for follow-ups, virtual care is the best solution. By this, patients will receive their follow up instructions and guidelines by professionals at the ease of their home, without getting professionals exposed. This will also help to divert minor cases off the hospitals eliminating the chances of unnecessary exposures.

• Robotic Telemedicine Carts: Developing robotic carts to serve as assistant to patients who are in isolation hence protecting HCH. One such exemplar of robotic telemedicine carts is Vici, innovated by InTouch Health. These robotic telemedicine carts will be well equipped with cameras, interactive applications, visual screens and necessary medical equipment. Sending them to patients who are self-quarantined or in the areas of quantization like quarantine camps and help centres will help medical staff by assisting patients while limiting the risk of exposure at the same time.

• Tele or electronic intensive care units (e-ICU): This Tele or electronic intensive care units also famous as e-ICU helps HCW’s to monitor more than 150 patients at a time with full isolation. Using these HCW can monitor multiple hospitals and that too, with no exposure and risk. As it’s virtual, it is less tiring and takes less time (everything runs on real-time inputs and provides real-time outputs). In the USA it’s already being adopted by more than three hundred hospitals, in about thirty-four states. These electronic intensive care units or virtual e-ICU’s use two-way cameras, microphones, video monitors and a brilliant alarm system that runs on high-speed optical wires.

• Safe Visiting: with all other concerns, contamination at the time of visits by family members or guardians is a big concern. To eliminate this, we can adopt virtual visiting and interacting solutions for patients and their concerned ones. This may be done using iPads and vICU, thus minimizing the exposure of safe people. If we succeeded in isolating or distancing COVID-19 negative people from COVID-19 positive people, this could result in a rapid flattening of the curve thus saving more people and saving national resources for the ones who are severely affected.

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3. Artificial Intelligence for diagnosis can be used as an effective way to flatten the graph.

1. Backed up by Artificial Intelligence, an innovation of iThermo that reads the temperature of the human body is Developed in Singapore by scientists of Integrated Health Information Systems (IHiS) along with KroniKa which is an AI start-up, eliminates the necessity to take temperature and perform temperature measurements manually. These Artificial Intelligence applications help in distance analysis with proper distance compensation; keeping in mind temperature reduces with increased distance.

2. Quantitative and Diagnostic CT image analysis deploying Artificial Intelligence algorithms for COVID-19 cases. The innovative Artificial Intelligence-based system that evaluates and records the results of chest computed tomography is already launched and used in Shanghai. It measures and evaluates the possibility of infection with high accuracy and precision with the help of omics evaluation and diagnoses of features capture in the image.

3. Using wearable devices to provide COVID-19 focused news and updates while tracking the physiological parameters is another innovation Artificial Intelligence can offer in telehealth. Using wearable devices will allow apps to calculate information like resting heart rate, the temperature of the body in accordance to environment and surroundings and sleep-duration helping in the creation of accurate and precise models of pandemic trends on time. This will help officials and communities analyze the trends better with proper information enabling them to make predictions regarding onset, progression and recovery from the pandemic. This sure is a desirable approach. Those patients who are in self-isolation or self-quarantine, they can use these innovations to monitor and transmit their personalized data for example temperature, heart rate and if needed oxygen saturation to HCW’s abiding any personal visit or contact. A few recently set applications related to this are:

1. SIRI Guidance: this is a recent region-specific Siri update where users can avail the feature of simple voice-prompted guidance regarding symptoms, and in some cases, suitable telehealth app links to provide information related to COVID-19.
2. Apple health check app: This application serves as a portal for screening and information spreading. This was developed in collaboration with Apple, The Centres for Disease Control and Prevention, Foreign Exchange Management Act and the White House Coronavirus Task Force (WHCTF). In this app users can log in by providing relevant personal information, and once entered the portal, they may get directions about what steps to follow by merely answering a few questions regarding exposure and symptoms.

3. Alexa daily checks: The thread named “My day for Seniors” that is on Alexa aims to provide an intense focus on the elderly population, i.e. people above the age of sixty years. These people can be virtually screened for COVID-19 indications by merely engaging with daily questions. If someone is suspected to be a patient of COVID-19, they are shifted to HCW’s 

4. Others: There are many more brands who are providing information and interactive sessions regarding COVID-19 updates and guidelines. Some of these include names like EverlyWell, GetWellNetwork, Phreesia, Orbita, Bright. Md’s and Ro.

What telehealth lacks: 

Telehealth is a tool for managing COVID-19 effectively, and at this hour, this is the best option we can come up with. Besides this, many disconnects must be resolved to gain better and practical results. “The basis for out-of-hospital management is testing. The linchpin of management of a pandemic is widespread testing and conventional telemedicine today may not offer that. Perhaps a ‘crisis-based’ evolution of telemedicine can help find local testing centres and also manage the flow of patients seeking a test.” are words of the president of NostaLab Mr John Nosta. “However, for a smaller subset of higher-risk patients, the clinical course may not be consistent with conventional telemedicine. These patients often present with a more serious condition that results in rapid decompensation and requires hospitalization. The reality might be that for COVID19, telemedicine, as it exists now, needs to be modified to help manage early testing, diagnosis and triage for those who may require in-patient care” he elaborated.

 Telehealth practices and innovation is a very new domain for ordinary people. Youngsters and people affiliated to this field might not face significant difficulties in its adaptation, but for rest, these transitions and adaptations is undoubtedly going to be a tough milestone. With such a speed of progression and lack of time, we severely lack adequate rules that are necessary to govern a proper telehealth system. We need appropriate budgets and bills passed regarding this uprising domain to let people working in this field have free access to the latest inputs that are necessary.