Digital health on the front lines of coronavirus checking, treatment and prevention (updated 2 Mar)

Coronavirus (COVID-19), which originated in Wuhan, China and has spread to at least 40 countries and 80,000 victims, with 2,700 fatalities, has been roiling both financial and healthcare markets. The stock price of payers in the US have been hit hard due to an anticipated uptick in illness, but interestingly, Teladoc has been up quite smartly in the past few days. Teladoc reported that one of eight virtual visits in January was due to flu, which isn’t atypical–but half had not used Teladoc before. Analysts do expect that there’s an opportunity for telehealth and telemedicine providers to attract new users due to what this Editor has dubbed ‘conscious contact’–that if you even feel remotely sick, you’re going to turn to a virtual visit.

COVID-19 is not remotely near a pandemic outside of China. The three hallmarks of a pandemic are cross-seasonal outbreaks (so far only in China), cross-geography (done), and most importantly, attacking the well. The fatalities have been among those with compromised immune systems, not among the young and healthy who do get it. It’s alarming, like SARS, because of the origination in animals, and the ease of person-to-person transmission via travel, as the outbreaks in Iran, South Korea, Italy, and on cruise ships visiting Asia have confirmed. In the US, the CDC is reporting that it is not currently spreading in the community, but is preparing for that scenario including containment, and has been since January.

But beyond the virtual visit, there are other areas where digital health is part of dealing with COVID-19:

  • Preventing the spread to the patient’s family members. Avaya has been working in China since January to provide enterprise customers with home agents to prevent the spread of the virus. For hospitals, they have donated equipment to enable remote consultation services and remote visiting video at the hospitals, including observation of isolation wards. They have provided a case study of their work with the Tongxiang Hospital at the Tongxiang Branch of Zhejiang Province People’s Hospital. (Photo at left courtesy of Avaya.) 
  • Another is remote patient monitoring. Sheba Medical Center in Tel Hashomer, Israel, is using Tyto Care to monitor the 12 Israeli returnees from the Diamond Princess cruise ship, who continue to be in isolation. The patients will perform the tests on themselves, especially respiratory tests. Jerusalem Post 
    • Update 2 Mar: A representative from Sheba, the largest hospital system in the Middle East, was kind enough to contact me with additional information on their RPM program for COVID-19. For patients requiring isolation in that stage of treatment, Sheba has implemented a modular ‘field hospital’ setup, similar to what the Israeli (and US) military use, which can be set up in any open area. This isolation is to protect immunosuppressed patients from disease spread in the main hospitals. Telehealth being used in addition to Tyto are the Vici telemedicine robot and the Datos Health app for home treated patients. This Editor believes that both European and US public health systems are looking at the Sheba and Israeli approach.
  • Robots–actually a telehealth cart–are being tested for patient self-testing, much like Tyto Care’s use at Sheba. Robots could also deliver food (although they could also carry germs) and sweep streets.
  • Other monitoring can be done via symptom checkers (Babylon, K, and others). 98point6 released a coronavirus screening chatbot app as early as January, but what they’ve turned up so far is more cases of the flu. STAT
  • Data analytics can pinpoint outbreaks. The Epic, Athenahealth, and Meditech EHRs have released new guidance, testing orders and screening questions (e.g. around travel and contacts) that will help to identify outbreaks.

Update 28 Feb: This Editor would like to know more about UV disinfection being used versus coronavirus for large spaces such as in hospitals and aircraft. If you have information on technologies such as PurpleSun which have been tested against hospital pathogens also being used against coronavirus, please contact Editor Donna.

Healthcare technologies which weren’t around during the SARS and swine flu epidemics may make a big difference in the spread, treatment and mortality rate of COVID-19. Healthcare Dive, HealthTechMagazine

UPDATE 28 FEB

As a service to our Readers, we are providing the following health service update links:

The UK Department of Health and Social Care and Public Health England has provided the following links to coronavirus guidance (hat tip to DOHSC via LinkedIn):

👩‍⚕️ Health: http://bit.ly/37qkWaV
🚂 Transport: http://bit.ly/2HDOFBW
👩‍🎓 Education: http://bit.ly/38KT41O
👨‍💼 Employers: http://bit.ly/2TfwpUT
🏡 Social care: http://bit.ly/2VhBIG9

US Centers for Disease Control (CDC)

World Health Organization (WHO) main website on coronavirus:https://www.who.int/health-topics/coronavirus

Health Canada’s main page: http://ow.ly/bLtF50yfJb7

Symptom checker K Health gains $48 million Series C (NY/Tel Aviv)

While we’re on the subject of symptom checkers (Babylon Health below), K Health, a competitor in the US HQ’d in NYC, but also based in Tel Aviv, announced today their win of $48 million in a Series C funding round, led by 14W and Mangrove Capital Partners. Lerer Hippeau, Anthem (also a partner), Primary Ventures, and others participated. Their total funding is $97 million since November 2016. The new funding, according to Crunchbase News, will be used to scale the model, expand primary care to mobile devices, and expand to international markets. 

K (as they call themselves) concentrates on three areas. One is an AI-powered symptom checker that uses millions (they state) of anonymized medical records to provide a virtual consult. According to Crunchbase, the medical records came from Israel’s second-largest HMO, Maccabi, over 20 years. The app questions the user based on previous answers. K contrasts it to static protocols, or rules-based symptom checking. The second is to provide a primary care visit via text for $19/visit (or unlimited for $39/year) with free follow-ups over two weeks. The third is mental health, specifically treatment for anxiety and depression, a growing area both online and via mobile. The $29/month fee covers unlimited doctor visits and delivered prescription medication, excepting meds that require blood testing.

The symptom checker is available throughout the US and primary care in 47 states. According to Crunchbase’s interview with CEO Allon Bloch, they recently passed their 3 millionth user and are now available in Spanish. The company has grown in the past year from 80 to 200 people. Originally, the company linked to New York-based providers, but moved away from that to the primary care/text model. Their overall goal is to provide affordable diagnoses that are a lot more accurate than ‘Dr. Google’ and that steer the patient to the right care.

Should Babylon Health be serious about expansion to the US, they will be running up against K Health, as well as competitors such as 98point6. In the hybrid app-and-physical model, there are Carbon Health and One Medical. Also Mobihealthnews